We rated Abbeycare Newmarket as good because:

• The service employed sufficient staff to administer and oversee detoxification safely, including two staff overnight.
• The service had good medicines management procedures including safe storage and handling of medications.
• Staff completed thorough risk assessment prior to and on admission, and these were reviewed and updated weekly.
• Staff completed a thorough medical and psychosocial assessment on admission to the service. This included blood and liver function tests.
• Staff completed personalised and holistic care plans with clients and updated these weekly at one to one sessions.
• The service offered a range of therapies that included cognitive behavioural therapy groups, one to one therapy and complementary therapies.
• The service provided access to four mutual aid support groups per week.
• The consultant held a weekly clinic to monitor and review any physical health problems.
• Clients spoke highly of staff and their knowledge, skills and compassion.
• Care plans were personalised, recovery focussed and clients were involved in setting goals Staff supported clients to maintain relationships and to build recovery focussed support systems by attending mutual aid support groups.
• Staff morale was good and staff told us that they worked well as a team and supported each other.
• Staff took part in weekly medication audits and regular care records audits and the outcomes were discussed at clinical governance meetings.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The service employed enough staff to provide safe care and treatment, including staff staying overnight.

• Staff completed thorough risk assessments of each client and updated these throughout their stay at the service.

• The service had good medicines management procedures including safe storage and handling of medications, and weekly medication audits.

• Staff completed hourly observation checks on clients commencing detoxification to ensure there were no negative physical health effects.

• The service completed comprehensive assessments of all clients prior to and after admission. A consultant and recovery worker completed joint medical and psychosocial assessments after admission and this included a urine drug screen and breathalyser test.

• The consultants held a weekly clinic to monitor the physical health of clients and we saw examples where clients had ongoing blood pressure and liver function tests throughout their stay.

• The service offered a wide range of activities including mindfulness, 12 step groups, complementary therapies and access to mutual aid support groups. Staff encouraged clients to attend physical activity sessions including gym and swimming sessions.

• The service offered weekly aftercare groups for up to two years after completion of treatment.

• Client feedback was positive and clients told us that staff were caring, approachable and supportive.

• The service provided a welcome book in each bedroom that contained information about the service, treatments and how to complain. Clients we spoke with knew how to make a complaint.

• Clients completed a feedback questionnaire when they left the service. All questions scored over 80% satisfaction from 181 responses.

• Staff morale and job satisfaction was good. Staff told us that they worked well together and felt supported by their colleagues and managers.

However, we also found the following issues that the service provider needs to improve:

• Staff had not all completed all mandatory training sessions and eight training sessions had less than 75% completion rates.

• The service had not completed a risk assessment of ligature risk points (something that people might tie something to in order to harm themselves).

• Clients did not feel fully involved in writing their care plan goals.
• Governance systems for monitoring mandatory training and supervision had not identified where there was low compliance.

We do not currently rate independent substance misuse services.

We found the following areas of good practice:

• The service environment was safe and clean. Staff were aware of lone working policies and carried personal safety alarms.
• The service employed sufficient numbers of suitably qualified and trained staff to deliver care to clients. Staff provided adequate time for clients to receive therapy and support. The service had access to a doctor when needed, and employed a variety of therapists on a sessional basis.
• Staff completed risk assessments on admission and updated these as required. Staff were aware of required actions if a client left treatment early.
• There had been no serious incidents reported in the last 12 months, but staff were aware of how and what to report when things did go wrong.
• Patients received a holistic assessment within 48 hours of entering the service for treatment. This included seeing a doctor and staff at the location. If staff identified the client had a physical health care need they could not meet, they referred the patient for specialist care. If it required a specialist to become involved in the patient's care, they were able to facilitate this.
• The service used recognised treatment methods, including therapy based on cognitive behavioural therapy and alcoholics anonymous. Staff received regular supervision and appraisals and all staff received an induction. Staff felt confident in assessing a client’s ability to consent in line with the Mental Capacity Act and had received training on this.
• Patients reported feeling safe and supported when accessing the service for treatment. Staff treated clients with kindness, dignity and respect. Patients knew how to complain, and felt their loved ones were involved in their treatment where appropriate.
• The location had a variety of rooms used for treatment, and had clear policies in place around visiting, admission and discharge from the service to protect the clients.
• Daily handover meetings provided an opportunity to discuss compliments, complaints and lessons learnt.
• The team worked well together, staff were aware of senior staff and reported they often worked alongside them. Morale was high, and there were no reported incidents of bullying or harassment.
• The service engaged in national research programmes, the national drug treatment monitoring system.

We spoke with four staff on duty, a therapist and looked the records for two people who used the service. We spoke with five people about the care and support programme they received. We observed medication being administered and looked at records required for the safe recruitment and selection of staff and management of the service. We found gaps in record keeping. This meant we could not be assured that there was a robust staff selection and recruitment procedure or that staff were adequately trained and supported. Effective systems were not in place to identify where the service was doing well and where improvements were required.

We spoke with two people. One person said, “The staff are friendly and polite. The staff are available to help when you need to speak to someone and goals to achieve were clearly worked out with me and written down.” Another person said on admission their family had stayed with them while the Doctor and care staff explained to them the admission procedure.

found that people’s care and welfare was met and people benefited from a structured treatment programme with their prior agreement and consent. We found that people were well supported but at times staffing levels fell below agreed levels the service had set which meant we could not ensure care was always delivered safely and effectively.