We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The building was safely maintained. Health and safety of clients and staff was managed. All necessary health and safety checks had been completed and were in date. Equipment was maintained and subject to regular checks.

• Staff were supported to deliver care. Staff had completed a programme of mandatory training and received regular supervision and annual appraisals. Appropriate policies and procedures were in place to provide guidance.

• The service was recovery focused. The treatment programme was delivered in line with the 12-step programme. Clients were engaged with the local recovery community and were encouraged to develop recovery capital. Peer mentors visited the service and supported clients.

• Client risk and need were assessed on admission. Clients were involved in developing their recovery plans and identifying goals and objectives. Progress was reviewed regularly.

• Clients were positive about the service and the treatment they received. They gave positive feedback on staff and considered them caring and helpful.

• Staff morale was positive and there was good team working. Managers were considered supportive. There was an open and honest culture. Staff knew how to raise concerns.

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

• The service did not have a Mental Capacity Act policy in place.

• The décor in the building was tired and in need of refreshing. A programme of redecoration had begun.

We visited THOMAS on 12 November 2013 and it was full, with seven people currently residing there and undertaking the first stage recovery programme. There were ten people residing in the second stage houses, accessing group sessions and continuing support.

Consent was obtained where required and signed consent forms and agreements were held within service user files.

We looked at support plans for three people; these contained relevant health and personal information and were reviewed and updated on a regular basis.

We spoke with three people who used the service. One person told us, “I feel really positive about my recovery. Things have changed dramatically. Staff have been there”. Another person commented, “Staff are all supportive and easy to talk to”.

There were appropriate records concerning the maintenance of the building. Fire safety equipment was in evidence and fire exits were unobstructed. Signs were in evidence throughout the building outlining evacuation procedures, fire safety instructions and health and safety information.

Staff were appropriately qualified for their employment and the service had robust recruitment procedures in place. Thorough inductions were given to new staff and training and development was on-going.

Regular audits were carried out and feedback from people who used the service was sought in a number of ways. This feedback was used to inform continual improvement to the service.

During our inspection we spoke with four people accessing support, all were positive about the support they had received. They told us: “The main thing here is that the people truly understand addiction, and they genuinely care about you. It's every member of staff, and that's very important, they understand the support people need to change.” “You get challenged here, but you get a lot of love which is what most addicts need, its been like a family, they treat everyone the same.”

We looked at four support plans during our inspection, centred around a twelve-step rehabilitation programme, which was a set of guiding principles outlining a course of action for recovery from addiction.

The records included a comprehensive assessment, including people’s physical health, mental health, social wellbeing, employment and education needs.

During our inspection we saw the safeguarding vulnerable adults and policy and child protection policy, both of which had been updated in January 2013.

The manager told us about the procedures in place to monitor the quality of care that people receive; these included a monthly audit of support plans and medication administration records. They told us: “I look at support plans to check that people's needs are being met, ensure that records are up to date and include appropriate records. I follow this by speaking with the clients.”