18 September 2019
During an inspection looking at part of the service
This was a focused inspection to follow up enforcement action. The rating for the service has not been updated as we only looked at very specific issues. The purpose of the inspection was to see if the provider had made significant improvements to the service following the issue of a section 29 warning notice in June 2019. We also followed up on whistle-blowing information we received about the service.
- The provider had improved the process for obtaining clients’ mental and physical health history prior to accepting clients for treatment.
- The provider had improved processes to ensure, where there were concerns about a client’s cognition, that an assessment was carried out prior to alcohol detoxification treatment commencing.
- The provider had improved their assessment and management of patient risk. At our previous inspection we found that clients’ risk assessments did not clearly describe how staff were to manage clients’ withdrawal symptoms safely during detoxification. At this inspection we found risk assessments now detailed how staff were to manage clients’ withdrawal symptoms.
- The provider had made improvements to medical and nursing assessments. At our previous inspection we found that nursing and medical assessments for clients receiving detoxification contained only limited information and the rationale for the chosen treatment/s was missing. This was no longer the case.
- The provider had made improvements to the use of monitoring tools to assess clients’ withdrawal symptoms during alcohol detoxification treatment. Staff now used the appropriate tool every four to six hours to better monitor withdrawal symptoms.
However:
- At our previous inspection we found that that there was no clear system to ensure that blood tests and electrocardiograms (ECG) were undertaken promptly. At this inspection we found that there were still some shortfalls in this area. The manager reported they were working on arrangements with a local private clinic so that any investigatory procedures were carried out quickly. The shortfalls meant there was an on-going breach of Regulation 12.