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Reports


Inspection carried out on 25th June 2019

During a routine inspection

We rated Providence Project 6 as good because:

The building was clean, well equipped, well-furnished and fit for purpose.

The service had enough staff and had plans in place to adjust staffing levels when client numbers increased. Staff assessed and managed risks well. They achieved the right balance between maintaining safety and providing the least restrictive environment possible in order to facilitate client recovery.

Staff assessed the physical and mental health of all clients on admission. They developed care plans which staff reviewed regularly and updated as needed. Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided.

Staff provided a range of treatment and care for clients based on national guidance and best practice for substance misuse services from the National Institute for Health and Care Excellence (NICE).

The service treated incidents, concerns and complaints seriously. They investigated them, learned lessons from the results, and shared these with the whole team and wider service to improve practice.

Systems and processes around prescribing, administering, recording and storage of medicines were robust. The service had an agreement with the local GP practise for a responsible clinician to prescribe all medicines, including detoxification medication.

Staff training compliance levels was 100% for mandatory training such as safeguarding, first aid and medicine management as well as some substance misuse specialist training courses. Staff were confident with their safeguarding responsibilities and made referrals to the local authority as appropriate to ensure that people were safe from abuse.

Staff treated clients with compassion, kindness and respected their privacy and dignity. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity. Clients we spoke with spoke highly of the staff and the standard of care they delivered.

Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of substance misuse and the service they managed. Leaders were visible in the service and approachable for clients and staff. Staff felt respected, supported and valued, and morale was good. Staff received regular internal and external supervision, and all staff had been appraised.

Inspection carried out on 06 September to 07 September 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

  • The provider had a formal agreement with a local doctor and GP surgery to provide prescriptions for opiate detoxification and medical treatment for clients. The practitioner regularly prescribed medication for opiate detoxification that guidance states is not a first line treatment and should not be used routinely. The service did not use formal rating scales to measure client’s withdrawals in line with best practice during opiate detoxification. This meant staff were unable to accurately and impartially assess the efficacy of the treatment given.

  • The service placed clients at potential risk of harm. It did not provide safe supervision overnight for clients in the early stages of alcohol detoxification to ensure their safety.

  • The service used structured formulaic care plans that did not capture client’s views although clients did tell us they had discussed them during one to ones with their counsellors. Staff did not provide clients with nutritional advice and support even though clients’ care plans specified this as a need.

  • Governance structures were not robust and had not identified and managed areas of concern raised during the inspection. The management team was not aware of the potential risks posed to clients by the service’s practices, or that the service did not adhere to best practice guidelines. There was no formal structure for managers to provide one to one supervision of staff or for staff to feedback on the service to help it develop.

However, we also found the following areas of good practice:

  • The service completed a thorough admission process including a risk assessment prior to prescribing treatment.

  • There was good communication between the provider and services that referred clients to them. Referrers we spoke to were positive about the care given.

  • Clients felt supported and cared for by staff. They stated that the programme provided by the service kept them safe and supported their recovery. The service actively engaged with families, providing support and information to enable them to support their relative who was in recovery.