Archived: Hope House

Updated 17 March 2017

Hope House provides both a residential rehabilitation service for women who require treatment for substance misuse and an aftercare programme for those no longer requiring the residential service. The provider is Action on Addiction which is a national charity. They support women to recover from drug and alcohol dependency and also receive additional support for other compulsive disorders. The service provides treatment to women aged 18 years and over, who have undergone detoxification from drink and/or drugs, and have been free from mood- altering substances for at least two weeks. The service has 23 beds, at the time of inspection there were nine women receiving treatment. Individual funding is provided through different funding streams: privately funded , a bursary from the charity or through health or social care. There can also be a combination of these funding sources.

The service is registered to provide accommodation for persons who require treatment for substance misuse.

At the time of our inspection a registered manager had been in post since the previous month and had just received their registration from CQC

The service was registered in October 2010. We previously inspected this service in July 2013; at the time of this inspection, the service was meeting the essential standards, now known as fundamental standards. This most recent inspection was undertaken using CQC’s new methodology and was an announced, comprehensive inspection.

Updated 17 March 2017

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• Medicines were not appropriately managed. In the two months prior to the inspection there had been 19 occasions where the actual medicines available did not correspond with the medicines tally recorded by staff. The provider had identified medicines administration and management as an area for improvement prior to this inspection and was reviewing its policy and procedures in this area at the time of our visit.

• Whilst overall the care and treatment provided to clients was safe, a range of records relating to the safe care and treatment of clients were not appropriately maintained. Potential risks for individual clients were not readily identified in client records and there was no plan in client care and treatment records to show how potential risks were managed or mitigated. Unexpected exit or discharge plans did not highlight to clients the increased risk of overdose associated with drug or alcohol misuse after a period of abstinence. Not all care plans were reviewed and updated in accordance with the provider’s policy and procedure. Some care plans were not holistic. A record of daily contacts by staff with clients was not maintained. Individual or group supervision sessions where decisions regarding client care and treatment could be made were not recorded. Employment records for staff did not include a record of staff previous employment records including an explanation of any gaps in employment history.

• The provider had not carried out some of their planned fire alarm checks. Whilst the provider had a lone working policy and procedure in place, staff did not take personal alarms with them when meeting with clients in interview rooms and it was unclear who would respond to the lone night relief workers alarm if activated.

• Not all staff had received training in areas such as mental health and eating disorders which could impact upon their ability to meet the needs of some clients.

  However, we also found the following areas of good practice:

• There were safe and consistent staffing levels. We observed that the staff were caring and supportive towards clients. All clients we spoke to commented on the positive nature of the staff input towards their treatment.

• The service promoted the importance of physical health within client’s recovery programmes and ensured that clients physical health needs were met.

• The service had a structured treatment and activity programme with clear expectations for clients on how to structure their time to help promote recovery. There was an additional aftercare programme that clients could attend after successful completion of the residential programme.

• The service had good links with the local community and other organisations. This included local authorities, the local mental health team and local community groups. This ensured that the clients were well supported both through Hope House and within the wider community.