We rated Somewhere House as good because:

• The service provided a positive therapeutic community setting for clients who required support following detoxification from substance misuse addictions. Staff has the skills and experience to meet the needs of clients in this setting. All staff (with the exception of two) were qualified counsellors and came from a wide range of therapeutic specialities which allowed them to provide clients with therapies that were in line with national guidance (Drug Misuse and Dependence: UK Guidance on Clinical Management). They received regular clinical supervision and specialist training to help improve the quality of care they provided. They worked well as a team to ensure that they shared information with each other in a frequent and structured way.

• Clients were put at the centre of care. They were included in all aspects of their care to ensure their needs were holistically assessed and met. Clients acted as buddies to each other which helped them settle into the service and aid their recovery. Clients had regular one to one sessions with staff alongside a range of group work.

• Staff ensured that clients were safe by assessing and managing risks posed by the environment and regularly assessing client’s individual risks. Clients were offered testing for blood borne viruses on admission and were encouraged to live healthier lives; including eating a balanced diet and stopping smoking. Clients were registered with a local GP surgery where their physical health and medication needs were met. There were processes for staff to follow in emergencies to keep clients safe from harm, and they made plans with clients on what to do should the client exit treatment early.
• Staff treated clients with compassion and kindness, respected their privacy and dignity and understood the individual needs of clients, including those with protected characteristics (for example, age, disability, gender, religion etc.)
• Somewhere House benefited from a strong and experienced management team that provided positive leadership and who were appropriately involved in the day to day running of the service. Staff said their leaders were supportive and that they all worked well as a team. Staff felt valued and included in service development and felt they had opportunities to develop their careers through additional training and qualifications.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Somewhere House provided a safe and supportive environment for clients undergoing treatment for substance misuse and addiction. Clients were empowered to develop as individuals and to build important life skills. Staff helped to arrange funding extensions for clients when they needed a longer stay.
• Clients remained actively involved with the service following the completion of their treatment and supported others. Both current and former clients were overwhelmingly positive about their experience at the service.
• The provider managed risk by building good relationships with clients, gaining a comprehensive understanding of their needs and ensuring good lines of communication. Conflict was managed well.
• Staff were committed and sought to involve clients in their recovery at every opportunity. We found positive leadership at the service. The provider made good use of information technology such as tablet computers to aid the efficient delivery of the service and the involvement of clients in their care.
• Staff were trained in the Mental Capacity Act and demonstrated knowledge and awareness of how to use this in practice.

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

• It was noted that some internal fire doors on the ground floor in communal areas such as the entrance to the kitchen and office were wedged open. This practice presented some increase in the risk of fire spreading and the provider did not have appropriate fire door release mechanisms in place.

We spoke with thirteen people using the service in a group setting. They told us that they signed their therapeutic agreements and this explained very well what the treatment at Somewhere House involved. They told us that the treatment was directed towards them as individuals and that they had been able to give their full consent to the care, treatment and support that was on offer at Somewhere House. This meant that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We saw four case files which showed us that the assessments completed had been comprehensive and the care plans were relevant to the needs of the people using the service. We saw that the care plans had been signed by the people using the service and written in a way that was person centred.

We spoke with thirteen people who used the service in a groups setting. They told us that “we write the care plans ourselves, it helps us learn so much about ourselves while we are here”. They told us that “we review our care plans every two weeks on our one to one sessions and with the group because this holds us to account”. This meant that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that there was a safe system in place for the recruitment of staff.

We saw that there was a complaints procedure available to people using the service.

During this inspection we joined people in their daily house meeting and spoke with everybody who lived at the home. We also spoke with one person who had completed their programme at Somewhere House. They lived in one of the move on houses also run by the organisation. People told us they were very well supported by the staff team. They praised the support they received to attain their goals. One person told us, “They have turned my life around, we have to work hard but they are there to direct and support us”. Another person told us, “I can honestly say they are brilliant, they put in the support to help you repair family relationships and deal with your emotions”.

We observed a very professional but supportive rapport between staff and people who used the service. People could talk with staff at anytime.

We found people who lived in the home were involved in the day to day running of the home. They decided at house meetings on menus, shopping and activities.

We saw care plans were written by people who lived in the home. They discussed their identified needs, their goals and agreed how to achieve those goals.

We found the receipt, storage and administration of medication was managed safely.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the manager.

The provider had a quality assurance system in place that ensured people were safe and changes could be made to improve the service provided.