4 January 2022 - 11 January 2022
During a routine inspection
Mount Carmel provides residential rehabilitation for people with serious alcohol problems. It does not take people who require detoxification.
We rated it as good because:
- Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of therapeutic treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audits such as record keeping and medicines record keeping, to evaluate the quality of care they provided.
- Clients told us they were highly satisfied with the way staff treated them. Staff displayed a great deal of passion and knowledge of their work and had a good understanding of the specific needs and characteristics of each client.
- The service had free after care for life. Clients we spoke to felt inspired when they met previous clients who had been in the service.
- The premises were safe and clean. The number of clients in the service was not too high to prevent staff from giving each client the time they needed. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
- Staff facilitated a range of activities and therapies every day. For example, choir, sound therapy, group hypnotherapy, equine assisted therapy, dramatherapy, auricular acupuncture, Indian head massage and reflexology.
- The registered manager had the skills, knowledge and experience to perform their role, had a good understanding of the service, and were visible in the service and approachable for clients and staff.
- The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received appropriate training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
- Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
- The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
- The service was well led, and the governance processes ensured that its procedures ran smoothly.
- Clients we spoke to stated that they would recommend the service to others and felt the service provided a realistic routine in preparation for independent living. Clients enjoyed the variety of group sessions the service offered, and good meals prepared by the service chef.
However:
- A review of stock medicines showed that some medicines held on the premises were not within the expiry date and some medicines had been left out in an unlocked room. Staff did not always record whether clients had allergies on their medicine administration records or who had completed the record. Clients who were self-medicating did not have access to locked storage in their rooms where they could keep their medicines safely.
- Some staff we spoke with could not give examples of how the service met the particular needs of people with protected characteristics.
- Staff had access to first aid kits located on each floor of the building, that staff checked these on a monthly basis. However, we found that the dressings in all three kits were past their expiry date but these were discarded once we brought this to the attention of the staff.
- Although staff gave examples of incidents and learning from these that was shared in handover meetings, the service did not document these discussions. There was a risk that not all staff would know about these and therefore implement them effectively.
- The provider did not have a clear framework of what had to be discussed at team meetings to ensure essential information was shared amongst the staff. The records of staff meetings lacked detail. Some staff reported that the service did not have regular team meetings.