Background to this inspection
Updated
21 October 2016
Mitcham Park provides residential support for up to eight males who have a history of substance misuse. The service provides therapeutic and practical support to clients to support them to remain abstinent and to prepare them for independent living.
Mitcham Park is registered to provide a regulated activity: accommodation for persons who require treatment for substance misuse. The service has a registered manager in place.
In a recent change in business practice the provider has opened up their service to clients from one local authority to a range of other local borough and purchasing authorities. All clients who use the service had completed a detoxification programme and were abstinent prior to their admission.
The service was last inspected on 23 January and 5 February 2015 and was compliant with essential standards, now known as fundamental standards.
Updated
21 October 2016
We do not currently rate independent standalone substance misuse services.
We found the following areas of good practice:
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The service had enough skilled and competent staff who were assessed through an appropriate recruitment process. Staff received adequate training, support, supervision and professional development. Staff had skills in counselling and long-term experience of working with clients who had substance misuse and mental health issues.
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Every client had a comprehensive assessment to help staff understand their needs, personal histories and issues associated with their substance misuse. The provider had a holistic approach to supporting people with substance misuse issues. Clients valued the structured therapeutic programme with their recovery and goals and service that focused around their individual needs. There were opportunities to engage in a broad range of activities from the local and wider community to support clients with their recovery and community re-integration.
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Staff monitored the heath and wellbeing of clients who promptly responded to any signs of deterioration in their physical or mental health.
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The provider had strong partnership links with multi-agency and community services to assist in providing support and additional services to prepare clients for independent living.All clients had care coordinators and their care was regularly reviewed. Commissioning and health and social care professionals provided strong and clear feedback about their positive relationships with the service. Feedback provided by stakeholders described the service as a valuable resource that consistently provided a high quality, well managed, safe and secure environment for clients who used this service.
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Staff were kind, caring, compassionate and enabling. Staff encouraged clients to fully participate in their care planning and recovery programme, having good insight into how best to support them. Staff took action to promote and protect the needs and rights of clients. Clients were empowered to make decisions wherever possible and staff took a balanced approach to how risks were managed. Staff understood the diverse social and cultural backgrounds who had complex personal histories.
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Clients were informed about the complaints procedure, understood how to make a complaint and had access to external independent advocates.
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Overall the service was well led and there was a clear vision and values that were understood and shared by the majority of staff. The provider had a clear audit cycle which was used to audit and monitor the quality of the service as well as outcomes for clients. The provider monitored staff performance, supported their needs and had a commitment to improve the quality of the service.
However, we also found the following issues that the service provider needs to improve:
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Following an allegation of abuse, the provider did not take action in line with their safeguarding procedure to safeguard a client and prevent the possibility of abuse from happening. The management of the service did not openly communicate with staff and clients about their safeguarding concerns and their response in how they dealt with it.
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While risks to clients were assessed, these were limited to one or two areas of risk and were not comprehensive. The provider had not ensured they did all that was reasonably practicable to mitigate any such risks.
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The provider used alcohol and drug plans with clients who had misused these substances. The plans were used to help clients identify their progress and were a good visual aid. However, there were no plans in place in order for clients to meet their identified needs and future goals.
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A store of used medicines had not been promptly returned or disposed of and could pose a risk to clients.
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The care records for all clients were not kept in an organised way and made it difficult to locate information about them.
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Staff respected the rights of clients to make informed decisions and had some awareness of the principles of the Mental Capacity Act (MCA). However staff lacked an understanding about the legal requirements of the MCA and its use in the service.