A drug and alcohol detoxification and rehabilitation service in Towcester, has been rated inadequate by the Care Quality Commission (CQC) following an unannounced inspection in February.
Asana Lodge provides residential drug and alcohol detoxification and rehabilitation services for up to 22 people. It was providing care for 20 people at the time of the inspection.
The service was rated inadequate overall following this inspection, it has also been rated inadequate for being safe and well-led. Effective and caring, was rated as requires improvement and the rating for responsive was good. This is the first time the service has been rated.
Craig Howarth, CQC deputy director of operations in the midlands, said:
“During our inspection of Asana Lodge, we had serious concerns about the safety and quality of care people were receiving while undergoing detoxification treatment. Leaders didn’t always have the skills, knowledge and experience to provide a safe and effective service for people.
“We found staff didn’t always know about safety risks and weren’t prepared to prevent or reduce them to keep people safe. Although there were care and risk management plans in place, they weren’t accurate as initial medical assessments hadn’t identified risks appropriately. For example, we found allergies hadn’t been recorded and medications that could cause people harm had still been given to them.
“Additionally, inspectors found staff didn’t always review each person’s medicines or provide relevant advice to people and carers about why they should take them. For example, people undergoing an alcohol detox regime were prescribed and administered medicine to help them sleep. However, there was no evidence any discussions had taken place explaining why it was prescribed or potential side effects. The provider must address this as a priority to support people and ensure they are involved in decisions about their own care.
“We’ve reported our findings to the provider, who have informed us that they have started to address some of the issues. We will return to inspect the service and if sufficient progress has not been made, we will not hesitate to take further action to ensure people’s safety and wellbeing.”
Inspectors found:
- Staff did not make a comprehensive assessment of people’s physical and mental healthcare needs before treatment started. The prescriber did not conduct a face-to-face assessment of people using the service before issuing the first prescription and before making any changes to prescriptions
- The admissions assessment and process was not thorough and did not take into account people’s medical history, medical conditions and prescribed medications. This led to inappropriate admissions and allergies not being recorded. The service did not have people’s full medical history before starting treatment
- Not all medicines were prescribed with a clear prescribing rationale or a clear discussion with people around possible side effects
- Staff did not complete appropriate protocols for peoples prescribed ‘as required’ medicines
- Staff did not always complete post incident checks. Injuries sustained after an incident were not always recorded clearly and staff did not always complete and record thorough checks after an incident
- Staff had not fully completed risk assessments and risk management plans or updated them to reflect changing risks
- Managers at the service did not have the knowledge and skills to be able to identify for themselves that the service was not keeping people safe in terms of assessing and prescribing
- Governance processes in place did not identify areas where compliance with the requirements of the regulations was not being met. Auditing systems did not identify where staff were not following medication management and administration within best practice. Auditing systems did not identify gaps in post incident checks and logs
However:
- The service offered a range of therapies including yoga, walks, sound therapy and regular one-to-one sessions, with something available seven days a week
- Staff treated people with compassion and kindness. Staff understood the individual needs of the people using the service and supported them to understand and manage their treatment and condition.