We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Staff considered client safety throughout their stay at the service and completed a comprehensive risk assessment of each client before they moved in. The risk assessment included physical health, mental health, as well as current and historic substance use. Staff reviewed risk assessments frequently and discussed this at each staff handover.

• The service had a comprehensive safeguarding policy for adults and children with reference to the safeguarding principles in the Care Act 2014. Staff completed safeguarding awareness training and knew the process for making a safeguarding alert. The service employed a social worker who provided the link with the local safeguarding authority.

• Staff completed a thorough two stage assessment for each client, including a homeless outcome star. Clients were involved in producing and reviewing their own support plan and they all had a copy of their own plan.

• Staff gave clients choices regarding treatment for their substance misuse issues. The service used an alcohol managed withdrawal programme to support those clients who wanted to reduce their alcohol use without stopping completely. Staff promoted clients’ independence by encouraging them to engage with addiction services in the community, such as Alcoholics Anonymous, rather than run groups within the service.

• Staff received appropriate training, including core training in motivational interviewing, brief solution focused therapy and relapse prevention. The service supported staff to attend additional training, for example, managing overdose risk, emergency overdose first aid, mental health awareness and working effectively to reduce risk of suicide.

• Staff demonstrated a non-judgemental attitude towards their clients and showed respect for them at all times. Clients reported feeling safe in the service and said that staff were kind and encouraging towards them.

• The manager had a robust system in place for ensuring all staff supervisions, appraisals and mandatory training was up to date. Staff had regular monthly supervision with the service manager and staff appraisals were booked for the forthcoming year.

• The service was recovery focused and planned for clients’ move on when they arrived at the service. Clients were encouraged to think of the service as their home and were able to personalise their rooms. The service had good links with housing associations and the local council to support clients to register on housing lists and bid for properties when suitable.

• Staff demonstrated the service values of hope and recovery. The staff reported high levels of job satisfaction and peer support. The manager consulted with staff regarding service development.

Delaney House provides a support for people who are homeless and have substance misuse problems.

We considered all the evidence we had gathered under the outcomes we inspected. During our inspection. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found –

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe. People were positive about the support they received and the attitude of staff. They all told us that staff treated them with respect, were available at all times and provided excellent support. One person stated, “I feel safe here. There is a freedom to the place. You’re treated like an adult, which is what I need.”

Each person had a support plan which had, in most cases, been completed by the individual. This identified desired long-term and short-term goals within a holistic framework. This meant that the significant areas of each person’s current and future situation had been considered and aims for recovery set.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

The service was effective. People received support in line with their support plan. Relapse prevention plans were in place for people. Weekly keyworker meetings ensured that goals were regularly negotiated and updated to ensure they were meeting people’s current needs.

Staff received regular training and support.

Is the service caring?

The service was caring. People were supported through a difficult time in their life in a caring way. Everyone praised the care and support they received. One person told us “The staff are brilliant. There is always someone to talk to night or day. They do an amazing job.” Another person said, “This place has saved my life.” “This has been an excellent experience; everyone is brilliant.” Another person said, “The staff are superb, I can’t fault them. They are there to listen and help and guide. I consider them caring friends.”

Is the service responsive?

The service received weekly feedback from everyone using the service to ensure they tailored the service to meet the needs of the individual. Feedback from the keyworker sessions was positive. The service also ensure that any perceived risk was addressed.

Is the service well led?

The service was well led. Staff told us they felt supported by management and would be able to go to management with any concerns and feel listened and responded to.

During our visit at Delaney House we spoke with the manager, members of staff and six of the people living there. We found that the atmosphere was relaxed and people were getting on with their daily routine without hindrance. People we spoke with told us; “I am very happy here”, “I made a lot of progress”, “everyone is supportive”, “I have to get up by 9.00 and do my daily chores as agreed I am happy with that”, “staff are friendly”, “this has been a safe haven for me and I am so lucky to be here”.

We found a comprehensive assessment procedure in place that proved people willingness in consenting to treatment and care offered by the service. People said that they had chosen to use the service and abide to the agreements that they had signed for. They were aware of the consequences that could bring their contract to an end prematurely.

Staff we spoke with were knowledgeable about people’s needs, behaviours and showed empathy. We found the recruitment process was thorough and involved people using the service. The manager said that the selection process for staff recruitment was to reflect the special needs of the people as well as having staff from diverse backgrounds.

Each person was responsible for collecting their prescribed medication and we found the storage and management of medicines to be safe. People’s records were stored in the organisation secured web based client database that conformed to data protection and only accessible to designated members of staff.

People told us they were happy with the quality of service and support they received. They told us they were being treated with dignity and respect, and supported by staff who promoted their privacy and independence. We found good quality information to advise prospective service users, their families and/or representatives about the type of service provided. There were systems of assessment and risk assessment, leading to a pro-active approach toward managing risks with people using the service, and great care was taken at the point of accessing the service that people were committed to becoming and remaining substance free.

People had personalised plans of care, support and treatment. We saw records that showed plans were followed on a daily basis, and that interventions were informed by up to date guidance and best practice. There was clear guidance to support staff dealing with emergency situations.

People told us they felt safe at the home. Staff had been trained in safeguarding and had a good understanding of adult protection issues related to the needs of service users.

Good relations were observed between staff and residents. Staff said they felt well supported and valued by the organisation running the service.

There were arrangements in place to monitor and assess the quality and safety of the service. There were a range of methods to engage service users, families and other stakeholders in the running of the service, and a clear complaint procedure.