Bosence Farm

Updated 15 February 2019

Bosence Farm Community Limited is a provider of residential treatment for substance misuse. The service provides a residential detoxification service (called ‘Boswyns’) for up to 16 clients and a ‘second stage’ residential service (called ‘Bosence’) for up to 15 clients and the Bosence Young People’s service.

The Bosence Young People's service was opened in April 2017 and provides treatment and support for up to eight young people who are experiencing substance misuse problems but whose complexity requires a more intensive treatment approach that cannot be met in their communities.

All three services are located on the same site, a short walk from each other along a private driveway. At the time of inspection, there were 13 clients at Boswyns, two one at the young persons service, and 10 at Bosence. Both adult services accept male and female clients. The young persons service accepts either all male or all female groups of young people. The services are situated in a rural location between the towns of Camborne and Hayle in West Cornwall.

This service is registered by the CQC to provide the following services:

• Accommodation for persons who require treatment for substance misuse

• Treatment of disease, disorder or injury.

There was a registered manager. The provider has been inspected five times previously, in 2011, 2013, 2014, 2016 and 2017. Although not rated the service was sked to make some improvement, specifically that the provider should ensure that the dates when liquid medicines are opened are recorded and that the provider should ensure all staff complete mandatory training.

Updated 15 February 2019

We rated Bosence Farm as good because:

• Clients felt safe and well cared for. The clients we spoke with were confident in the abilities of staff and felt that they worked with clients’ best interests at heart.
• The environment was clean, welcoming and fit for purpose.
• Medicines were managed safely. At our previous inspection we found not all staff administering medicines had received training. At this inspection we found that all staff involved in medicines administration had received suitable training. Medicines policies and procedures had been reviewed by the clinical lead and updated. Medicines were stored and administered safely.
• All treatment at the service followed National Institute for Health and Care Excellence (NICE) guidelines in both the prescription of medicines and the delivery of psychosocial interventions  including drug misuse in over 16s: opioid detoxification clinical guideline [CG52] Published date: July 2007 and Drug misuse in over 16s: psychosocial interventions. Clinical guideline [CG51] Published date: July 2007.
• Clients risk and treatment needs in relation to their recovery were assessed prior to admission and care was planned and delivered in line with this assessment. Specific assessments for blood born viruses were undertaken at point of admission.
• The provider recorded incidents and could demonstrate learning from these. Staff we spoke with understood safeguarding and referrals had been made to the safeguarding team.
• Clients in Bosence and the young Persons unit had a full activity program, including evenings and weekends. The key workers worked with clients to complete a comprehensive assessment of their individual needs and compiled a plan to maintain independence.
• The service was recovery focussed with discharge planning being built in to client plans from the outset. Early exit from treatment plans were also put in place early in clients stay to ensure those unexpectedly leaving the service were as safe as possible. These plans involved carers and relatives where appropriate. Links formed with local community support groups to enable clients to continue with support on discharge.
• •Staff demonstrated an understanding of the impact care being provided can have on a clients’ wellbeing. Clients were provided with emotional support at all stages of their treatment through group work, one to one work and peer support.
• The service used the same electronic note keeping system as the local community substance misuse service. This ensured that the service had immediate access to all previous assessments and care plans.

However:

• Some staff felt that there was a lack of positive leadership which was leading to low morale among. clients who were too high risk were being admitted to the service with the potential to lead to poorer outcomes However, this was not supported by evidence from outside referring agencies.

Sleeping areas in Bosence and a 3 bed corridor in Boswyns were not segregated into male and female. This potentially placed people at risk in terms of their sexual safe

Clients in Boswyns did not have a private space in which to have a telephone conversation. Summary of findin

Updated 6 March 2018

Inspected but not rated