6th December 2018
During a routine inspection
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