We rated New Writtle Street as requires improvement because:

• The provider was unable to demonstrate they had considered the risks posed by mixed sex accommodation. Female clients were situated in bedrooms next to male clients. Bedrooms did not have ensuite bathrooms, which meant that women would have to walk past men’s bedrooms to get to the bathroom. The provider had not fitted locks on the bedroom doors which posed a risk others could go into the rooms. This posed a risk to clients’ safety, privacy, and dignity. The provider had not completed a risk assessment of mixed sex accommodation, so were unaware of potential risks, or how these should be managed. The service was not accessible for people with disabilities. The service did not use key performance indicators and there were no auditing processes in place to monitor staff compliance.
• The door to the bedrooms did not have a lock. The provider did not have governance systems in place to monitor mandatory training, supervision, and appraisals for staff. The provider could not provide information on compliance rates.

However:

• Staff completed risk assessments of clients. If staff considered clients a risk of self-harm or suicide, staff would increase observation levels to reduce any risk identified. The provider covered shifts with sufficient staff of the right grades and experience. There was adequate medical cover for the service. A doctor was available on call should the staff require medical advice. If there was a medical emergency staff called the emergency services. Staff received safeguarding training and knew how to raise safeguarding alerts. Staff knew how to report incidents and what to report. Staff knew how to use the provider’s whistleblowing processes. Staff received feedback from the investigation of incidents during team meetings. Staff were open and transparent and explained to clients when things went wrong.
• Staff had good staff morale throughout the service. Staff told us they felt happy in their role and that senior colleagues supported them.
• All areas of the service were clean and tidy. The provider recently redecorated the service and installed new furniture. The service employed a cleaner who attended once a week. The service adhered to infection control principles. There were hand-washing facilities and disinfectant gel was located throughout the service. The service had policies and procedures in place for the use of observations and searching clients. The service had beds available when clients needed them.

• The service did not admit clients who were detained under the Mental Health Act. Clients were aware of the right to leave at any time. Clients received a comprehensive assessment following admission which covered substance misuse history as well as all other needs. Clients received a physical examination upon admission. Clients told us staff were very kind and caring and treated them with dignity and respect. Clients told us that staff were very responsive to their needs and very supportive. Staff showed clients around the service on arrival and provided a welcome pack containing information about the service. Clients gave feedback on the service they received. Clients attended community meetings in which they could give their input. Clients made private phone calls in bedrooms, and had access to outside space. Clients could personalise their rooms, and each room had a small safe and a lockable drawer to keep valuables secure.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The service was clean and safe. Environmental risk assessments were completed and actioned and equipment was checked regularly.

• Staffing levels were sufficient for the service.

• The service had access to resuscitation equipment and emergency medication.

• Staff were compliant with mandatory training and received training relevant to substance misuse.

• Clients took part in community meetings and service user groups held at the PCP Chelmsford treatment centre and gave feedback on any issues relating to the service.

• Clients had access to facilities, could personalise their bedrooms, could store away possessions and could access food and drink 24 hours a day at New Writtle Street.

• The service had an on-call doctor available and telephone support with the registered manager, a nurse and the director 24 hours a day.

• Staff received regular supervisions and annual appraisals.

We saw that each person received an assessment of their care and treatment needs, including any risks associated with their care provision. In all the cases we looked at, we found that the care provided matched with the care required and this was what people had agreed to. We saw that their care was provided by a sufficient number of suitably qualified and trained staff.

We found the premises were in a good state of repair and some measures were in place to ensure it was adequately maintained. However, some additional measures to minimise the risk of harm from fire were lacking.

We saw there was an effective complaints system available. Comments and complaints people made were responded to appropriately.

During our visit to New Writtle Street we spoke with two of the four people who were staying at this accommodation while they received treatment for substance misuse from the PCP Luton treatment centre. People we spoke with said they were happy living at New Writtle Street.

Staff showed an understanding of people’s needs and preferences and we saw that staff were polite when speaking with people. We also noted that people living in the home appeared comfortable with staff and we saw good-humoured conversations.

People were satisfied with their treatment, and complimented the staff who supported them. One said. “The counsellors are very good; they are fully equipped to understand what I’m going through. I ‘m very happy with the programme”. They said they were always treated with respect by the staff.