We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The service received a requirement notice under regulation 18 Staffing at the last inspection in relation to mandatory training. On this inspection, the service had implemented a mandatory training schedule for all staff. Current compliance rates were 100% and medicines awareness training was included within this schedule.

• The service received a requirement notice under regulation 12 Safe care and treatment at the last inspection in relation to risk assessments for clients. On this inspection, the service undertook risk assessments for all clients and risk was discussed daily by staff. The service had clear exclusion criteria and signposting procedures to ensure that clients did not carry greater risk than it could safely manage. Additionally, the service implemented a thorough safeguarding adults policy and all staff were trained in safeguarding of adults at risk.

• The service received a requirement notice under regulation 19 Fit and proper persons employed at the last inspection in relation to disclosure and barring service checks. On this inspection, the service ensured all staff were disclosure and barring service checked with an appropriate policy in place for the employment of ex-offenders.

• The service received a requirement notice under regulation 9 Person centred care at the last inspection in relation to care plans. On this inspection, the service had implemented appropriate recovery plans for all clients to discuss with staff and agree goals and actions to aim for throughout their treatment

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

• The service did not include a safeguarding procedure for use if a risk to a child was identified. This meant that staff did not have a clear procedure to follow if they identified a safeguarding issue with a child at risk.

• The service did not record expiry dates of medicines or routes of administration for medicines on client medicine administration records. This meant that staff could not immediately identify on the medicine administration records if the dispensed medicine was in date and taken by the route with which it was prescribed.

We do not currently rate independent standalone substance misuse services.

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

• The service did not undertake client risk assessments or formulate appropriate risk management plans for identified risks.

• The service did not appropriately check all staff backgrounds using the Disclosure and Barring Service before allowing contact with clients.

• Staff at the service had not received medicine administration training even though they administered medicine to clients prescribed by their personal GPs.

• Staff were not trained in safeguarding and there was no safeguarding policy in place.

• The service did not use a holistic recovery plan that was developed and agreed with clients.

• There was no mandatory training schedule in place for staff to complete.

• There was no management system to monitor the regularity or quality of supervision for staff members.

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

• The environment was well maintained and offered an array of suitable rooms for client use. Health and safety and fire safety provisions for the buildings were well met and monitored regularly.

• The service undertook a thorough pre-admission assessment of clients to ensure suitability for the service. The service temporarily registered clients with a local GP to monitor their physical health needs throughout their treatment.

• The service was proactive in their discharge planning and offered appropriate aftercare to all clients leaving the service.

• We saw interactions between staff and clients that were kind, dignified and fostered mutual respect. The service received positive feedback from all clients.

We spoke with the four people on the recovery treatment programme. They all confirmed they had agreed to comply with the rules of the programme, and had reviewed and signed written contracts. People were highly complementary about the programme, saying, for example: “They knew more about me than I did; they really understand and get what’s going on”, “All the activities play a part in achieving our goals” and “It’s been fantastic”. We saw that people were assessed before being admitted onto the programme and their progress was monitored. The course included guidance on how to continue with recovery after leaving the residential programme.

Staff were selected for their specific skills and appropriate recruitment checks were undertaken before they started work. Comments about the staff included: “All the staff are very experienced” and “The staff are fantastic and help break down barriers”. We saw that the provider monitored people’s views to monitor the quality of the service.

We found that medicine management was insufficiently robust and we judged that the provider was not compliant with this standard. Although people using the service were satisfied with the procedures, the provider had not ensured that people’s medicines were stored and administered safely.

During our visit we spoke with the registered manager, the nominated individual and four people using the service. People using the service said they had an understanding of what to expect before they attended the service for care and treatment.

They were positive about the quality of their treatment programme which they said reflected their needs. People told us that they found the programme an “Unbelievable experience.” They described it as “Inspiring and uplifting” and said the structure of daily programme was very important and helpful.

People were very complimentary about the skills of the people providing support, saying, for example, “They seem handpicked” and “They are very good at their jobs and have experience and understanding.” Another said; “They are the best.” People completed feedback forms before leaving the programme. We read comments such as; “It was excellent,” “Very good and helpful” and “great experience and I have learned a lot.”