52 North Hill

The Zone is a charity based in Plymouth city centre which provides a range of support services to young people. It provides two distinct services that are registered with CQC known as Icebreak and Insight. Insight is an early intervention service for adults aged 18 to 65 who are experiencing their first episode of psychosis. Insight is a secondary mental health service working in partnership with Livewell Southwest CIC. Icebreak is for younger people aged 16 to 22 who are experiencing severe emotional distress that is influencing their day-to-day lives and mental well-being. This service is for clients who may have an emerging personality disorder.

The Zone was last inspected in October 2021. The service was rated good overall with a rating of good for the safe, effective, caring, responsive and well led domains. There were no requirements made at that inspection. We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

In June 2020 the service registered 52 North Hill with CQC separately to registration for the Zone. This required 52 North Hill be inspected as a new service.

The service wanted a larger meeting space for both Insight and Icebreak clients. Although Insight staff and clients both can use North Hill the space is predominately but not exclusively used for Icebreak staff and clients.

The service intends to reregister North Hill as a satellite to the Zone.

This is the first rating of this service. We rated it as good because:

• The service mostly provided safe care. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff managed waiting lists to ensure that clients who required urgent care were seen promptly. Staff followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the clients. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The teams included or had access to a full range of specialists required to meet the needs of the clients. Managers ensured that staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated clients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of clients. They actively involved clients and families and carers in decisions about care.
• The service was mostly easy to access. Staff assessed and treated clients who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. The criteria for referral to the service did not exclude clients who would have benefitted from care.
• The service was well led.

However:

• The service did not always ensure clinical premises where clients were seen were safe and clean.
• The service did not ensure that all client files contained an up to date risk assessment that was stored in a consistent place in the IT system.
• The governance processes did not always ensure procedures relating to the work of the service ran smoothly.