Archived: U Turn Recovery Project

We do not currently rate independent standalone substance misuse services.

This was an unannounced focussed inspection. We undertook this inspection to check the progress the provider had made in addressing the breaches of regulations identified at the previous inspection in September 2016.

At this inspection we found the following improvements:

• At the September 2016 inspection, clients’ risk assessments did not include potential risks. Clients did not have risk management plans. At the July 2017 inspection, potential client risks were assessed and risk management plans were in place.

• At the September 2016 inspection, we found the management of medicines was unsafe. There was an increased risk of medicines errors. The service did not have a controlled drugs register. At the July 2017 inspection, medicines management had improved. Staff had been trained to dispense medicines, a controlled drugs register was in place, and medicines audits were undertaken.

• At the September 2016 inspection, the system for safeguarding adults and children was not effective. Staff did not know how to make a safeguarding adults referral. At the July 2017 inspection, all staff were aware of when and how to make a safeguarding adults referral. Staff in the service no longer supervised clients’ visits with children.

• During the September 2016 inspection, we found there was no central incident reporting system. The learning from incidents was not recorded. At the July 2017 inspection, there was a system for the reporting and investigation of incidents. The system also supported learning from incidents.

• During the September 2016 inspection, we found client assessments were not always comprehensive. Care plans did not describe plans of care. At the September 2017 inspection, clients’ care plans were detailed, reflected clients’ views and preferences and identified clients’ needs.

• At the September 2016 inspection, infection control procedures were not effective. The service was not clean and other infection control risks were increased, including the potential for food poisoning. At the July 2017 inspection, the service had been partially renovated and redecorated. The service was clean and clear infection control procedures were in place.

• At the September 2016 inspection, we found the service did not have the full range of policies to ensure a safe and high quality service. Policies in the service had not been reviewed since 2012. At the July 2017 inspection, all of the service policies had been reviewed, and some additional policies had been introduced.

• At the September 2016 inspection, there was a lack of effective systems to underpin safe, high quality care. At the July 2017 inspection, there was a system of standards, procedures and audits, which ensured that the quality and safety of the service was monitored.

• At the July 2017 inspection, the notice board at the entrance to the service displayed the weekly staff rota for the following week. If clients wanted to speak with a particular member of staff they would be aware when the staff member was next at work.

• At the July 2017 inspection, we found the service had funded a client to attend English writing courses. The service had also arranged regular internet video calls for the client to speak with their family who lived abroad.

• The service had included a ‘chat’ function on its website. Members of the public, or referrers, could seek advice via the ‘chat’ function at any time. When the ‘chat’ function was activated, all staff members mobile phones would connect to the ‘chat’. The most appropriate member of staff could then discuss any queries.

• The manager had involved all staff in all of the changes to the service. The manager had systematically worked through improvements required with staff. This led to changes being quickly embedded into practice. The manager had demonstrated exceptional leadership during a period of significant service change.

We also found the following areas for improvement:

• At the September 2016 inspection, we found that almost all of the staff and volunteers did not have the required criminal records checks and other pre-employment checks. At the July 2017 inspection, although all staff and volunteers had criminal records checks, all staff did not have required references, and one staff member did not have any employment history recorded.

• Clients’ care records did not include a daily entry documenting the client’s activities or the support they received.

• Staff had supervision every two months with the manager. The contents of supervision meetings were not formally documented.

• At the July 2017 inspection, there had been no registered manager in day to day control of the service for more than 18 months. The providers’ Care Quality Commission registration requires a registered manager to be in post at the service. The current manager started their application to become the registered manager immediately after the inspection.