During our inspection, we met five of the six people using the service. One person said, “I am encouraged by both the staff and my peers. Since I have been here, my yearning for a drink has decreased.” Another person said, “When I first arrived at the service, I dreamt about drinking but now the dream has stopped. I feel I am getting better. Now I don’t feel I need to drink anymore.”

Another person told us, “Staff are helpful. If I have any concerns or problems, the staff are there for me.”

Some people expressed concern about the difficulty of communicating with two members of staff. They felt that the staff had sometimes not been listening to them. However, people felt that they got on well with their key workers. One person said, “If I feel bad, I can speak to (key worker). If I am happy I can laugh with (key worker), who is now more like a friend than a key worker. Staff help us to keep to the treatment programme.”

The service worked closely with local authorities and other healthcare providers. This meant that people had received co-ordinated care, treatment and support. A visiting professional said, “We have placed people with this service before. We are pleased with the care and treatment provided.”

Concerns relating to safe medicines management were identified during our inspection. We also identified concerns with record keeping. We found that confidential records had not been kept securely.

Herbert Street had seven residents at the time of our inspection. People told us that ‘The staff are very good’ and that the place is ‘Cool’ and ‘You get a lot of freedom’. A person who started the programme recently said that ‘I settled in quite well, staff and the others are friendly and my room is nice’. We spoke to a person who was about to complete the programme and was moving on to the next stage of the recovery. He said ‘I’m very comfortable at here and I will actually miss the place’.

People went through a structured recovery programme and also had free time to socialise, attend college courses or to be involved in different activities in the community.

Staff told us that they enjoyed working at Herbert Street and liked the ‘ethos’ of the service.

We found that people’s needs were assessed, and that their care plans were available and were reviewed on a regular basis. People’s progress was continuously monitored and they were involved in the development of the programme and the service.

People told us that the service supported their recovery from alcohol dependence. They said that they had full information before they came to the service; that their needs had been fully assessed and that they were fully engaged in setting goals and making decisions about their treatment. People felt safe, comfortable and supported by staff, who listened to them and treated them with respect and kindness.

We do not currently rate independent standalone substance misuse services.

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

• Staff received induction training when they started at the service. However, there were gaps in specialist training around mental health, substance misuse and eating disorders. While some of this training was planned to take place in the future, there were people who used the service who had complex needs. The training provided did not support staff to work with people with complex needs.
• There had been a high turnover rate of staff, particularly at night. This meant that there had been a strong reliance on agency and bank staff so there had not been consistent staffing. This had improved with the recruitment of new staff to cover the service since January 2016.
• Some risk assessments were comprehensive. However, some did not include clear crisis management and relapse prevention plans. The provider has told us that since the inspection, the service has introduced separate relapse prevention planning and separate crisis planning documents that will be utilised with people who used the service.
• Staff were not clear about their responsibilities relating to the Mental Capacity Act. This was reflected by the policy which did not reflect the use of the Mental Capacity Act in a rehabilitation setting.

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

• The service had governance systems in place to ensure that information was fed up and across the organisation as a whole. Staff were positive about local leadership and management.
• The service had been newly refurbished. There were available sitting rooms and areas for therapy groups as well as an outdoor garden area which people could access. The service had a main house and a bungalow. The bungalow was used for people who were further on the road towards recovery.
• The service had implemented a buddying system which assisted people who arrived at the service to receive informal support from other people who were further along the recovery programme. This peer support was helpful to people who came to the service