We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was unannounced. At our last inspection on the 23 December 2013 we did not identify any concerns.
Trevi House (referred to as ‘the home’) provides residential rehabilitation from drugs and alcohol misuse to a maximum of 13 people. Their children, up to the age of seven years, are also placed with them.
The home was managed by a board of trustees. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
There were some concerns identified that could impact on people remaining safe. The recording of actions taken to maintain this were not robust enough. This affected the recording at initial care planning and formal risk assessments. There were also issues around the safe administration of medicines.
There was a strong emphasis on people being safe while at the home. Staff were trained in identifying and protecting people from harm. People, staff and professionals spoke highly of the home. People told us they felt safe, special and challenged to change their lives for the better. We found the home was calm and people had their own designated living areas. There was a sense of Trevi House being both people’s home and a place where people were having treatment to support their detoxification and abstinence.
The home had good infection controls in place to safeguard people.
Staff were trained in their specific areas of responsibility and demonstrated a good understanding of each person and their needs. Supervision and appraisals for staff were robust. Staff also told us they felt valued and able to attend training to meet specific needs as required.
People received personalised care and support specific to their needs and preferences. People told us they felt important as individuals to the staff. Interactions between staff and people were respectful and kindly. The relationship between staff and people was based on mutual respect and were non-judgemental.
The home had systems in place to ensure they were responding to people’s needs in a person centred way. People’s needs were assessed and reassessed as required. Care plans were developed with the person and were reviewed together. People were informed of what they could expect while at Trevi House and what was expected of them.
There was extensive evidence of health and social care professional involvement in people’s care on an on going and timely basis. People told us they received medical support and attention as required and could have appointments with the dedicated GP quickly. Child care was provided for them as required so they could attend this and other appointments.
The registered manager worked proactively with other organisations to ensure they were following best practice. Staff spoke positively about communication and how the registered manager worked well with them, encouraged team working and an open environment. There was strong leadership and governance evident and clear systems of communication in place. The health visitor, midwife and GP all told us that good, timely communication was a strength in how the home was run.