We are With You - Chy

Updated 13 January 2022

We Are With You Chy is a residential rehabilitation centre in Truro, Cornwall. The service provides residential treatment to people with addiction issues. The service had 18 beds for men and women aged 17 upwards with no upper age limit.

We Are With You Chy had ‘move on’ flats next door to the service that residents could transfer into after their care. The ‘move on’ flats were supported housing and therefore not registered with CQC.

The service aimed to enable individuals to develop a lifestyle free of substance dependency. It aimed to provide a safe, supported, nurturing and challenging environment where people can be abstinent from substances and learn to lead a fulfilling, meaningful and purposeful life. The service provided rehabilitation only and does not provide detoxification. Residents were largely funded by local authorities. A careers advisor, housing advisor and a nurse regularly attended the service.

We Are With You Chy is registered by CQC to provide accommodation for persons who require treatment for substance misuse. We Are With You Chy has been inspected by CQC on three previous occasions. There was a registered manager in place at the time of our inspection.

At our previous inspection on 08 November 2018 we found that:

The policy the provider had written about searches of residents’ rooms and possessions was brief and lacked detail about safety, for example, instructions for staff on how to avoid needle stick injuries. During this inspection we found that the provider had rewritten their search policy but it had not yet been signed off by director so only a draft policy was in place. Not all staff were aware of this policy and how to keep themselves safe when searching residents’ bedrooms.

There was a problem with the IT system losing access to the network that had been escalated but had not been put on the risk register. This had been resolved.

The provider had brief plans for emergencies but had not fully mitigated disruption to the service and clients’ treatment. Emergency plans were now in place.

An audit prior to our inspection conducted by the service had identified that paper and electronic records did not always match and this meant staff might not always be looking at the most up to date information about a client. All paper records were now scanned onto the shared electronic database so information was up to date and accurate.

The service did not have a procedure for providing carers with information about how to access a carer’s assessment. Carers were still not aware of how to access a carer’s assessment.

Appraisals were generic and lacked individualised goal setting. Appraisals were now individual and specific, although appraisal records were not present for all sessional workers.

What people who use the service say

Residents said the service made them feel safe during the pandemic.

Most residents said they like being part of the cooking and cleaning rota so they took more responsibility. Some residents said they did not like the food or the fact that residents were not qualified to cook. Residents appreciated that their needs were taken into consideration if they had special dietary needs.

Residents said staff set out clear boundaries which they appreciated as part of their recovery.

Residents said that staff never took their power away. They felt it was always their choice. Residents said staff guided and supported them but reinforced it was down to them to put the work in.

Residents said that staff were approachable and there was always staff around. Residents said they were treated with respect, care and understanding. Residents said everyone was treated as individuals. Residents said most of the staff went above and beyond. Staff gave them all the tools they needed and they kept giving.

Residents said the standard of the group sessions, one-to-one’s and the counselling were all first class. Residents liked the RAFT Programme said their key workers were brilliant. Residents said they feel much more positive after being at Chy.

Residents said they had total privacy and staff trusted them to have their phones when not in therapy. Residents said staff always knocked before entering their rooms.

Residents said staff kept them updated, were always reassuring and helpful. Residents said that the service manager was extremely highly thought of.

Ex residents said they were able to go back and seek support from the service when they needed it.

Carers said they were very happy with the service and felt confident with the treatment programme.

Updated 13 January 2022

Our rating of this service stayed the same. We rated it as good because:

The service provided safe care. The environment was safe and clean. The service had enough staff. The service used sessional staff, or community staff from the same organisation, who were known to the service so they did not have to use agency staff. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Staff adopted a very person-centred approach to safeguarding and asked residents how they wanted to proceed. Staff empowered residents to make the safeguarding referral themselves where appropriate.

Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the residents and in line with national guidance about best practice. The provider had developed a treatment program called Recovery and Aftercare from Formative Trauma (RAFT) that was independently validated by the University of Bath. RAFT provided clients with a bespoke treatment plan that aimed to treat trauma underlying addiction. Staff engaged in clinical audit to evaluate the quality of care they provided.

Teams included, or had access, to the full range of specialists required to meet the needs of residents. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with those outside the service who would have a role in providing aftercare. Staff had good working relationships with the community team from the same organisation who provided aftercare to residents leaving the service.

Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

Staff treated residents with compassion and kindness, respected their privacy and dignity and understood the individual needs of residents. They actively involved residents and families and carers in care decisions. To encourage dog owners to attend rehabilitation, the service had heated kennels for residents’ dogs so they could bring their dog with them. Residents said that staff were approachable and that they were treated with respect, care and understanding. Residents said most of the staff went above and beyond to equip them with the tools they needed for their recovery.

The service managed beds well so that a bed was always available locally to a person who would benefit from admission and residents were discharged promptly once their condition warranted this. Staff made sure residents understood their discharge care plan which included harm minimisation and a departure risk assessment. Discharge plans were discussed in team meetings. Post discharge, community workers took residents onto their caseload and followed up with their recovery support.

The service was well led, and the governance processes ensured that service procedures ran smoothly. Staff reported their job satisfaction as high. Staff said they felt their roles were empowering to others and that they had a positive working relationship with their peers. Staff said they felt proud to work for the organisation. Managers recognised that their staff team experienced fatigue and stress during the pandemic. They invested in a full subscription for each staff member to a wellbeing app. Staff could also access the organisation’s employee assistance programme. The service had an effective governance structure and performed well in their audits. The provider’s risk register formed part of a shared regional risk register which fed into a national risk register. Managers completed a separate review of their local risk register in relation to the pandemic

However:

Staff did not always follow the provider’s policies and procedures when they needed to search residents or their bedrooms to keep them safe from harm. The service had a draft standard operating procedure for searching residents’ bedrooms but not all staff were aware of it and how to keep themselves safe.

Staff did not give carers information on how to access a carers’ assessment.

Updated 13 January 2022

Our rating of this service stayed the same. We rated it as good because:

The service provided safe care. The environment was safe and clean. The service had enough staff. The service used sessional staff, or community staff from the same organisation, who were known to the service so they did not have to use agency staff. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Staff adopted a very person-centred approach to safeguarding and asked residents how they wanted to proceed. Staff empowered residents to make the safeguarding referral themselves where appropriate.

Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the residents and in line with national guidance about best practice. The provider had developed a treatment program called Recovery and Aftercare from Formative Trauma (RAFT) that was independently validated by the University of Bath. RAFT provided clients with a bespoke treatment plan that aimed to treat trauma underlying addiction. Staff engaged in clinical audit to evaluate the quality of care they provided.

Teams included, or had access, to the full range of specialists required to meet the needs of residents. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with those outside the service who would have a role in providing aftercare. Staff had good working relationships with the community team from the same organisation who provided aftercare to residents leaving the service.

Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

Staff treated residents with compassion and kindness, respected their privacy and dignity and understood the individual needs of residents. They actively involved residents and families and carers in care decisions. To encourage dog owners to attend rehabilitation, the service had heated kennels for residents’ dogs so they could bring their dog with them. Residents said that staff were approachable and that they were treated with respect, care and understanding. Residents said most of the staff went above and beyond to equip them with the tools they needed for their recovery.

The service managed beds well so that a bed was always available locally to a person who would benefit from admission and residents were discharged promptly once their condition warranted this. Staff made sure residents understood their discharge care plan which included harm minimisation and a departure risk assessment. Discharge plans were discussed in team meetings. Post discharge, community workers took residents onto their caseload and followed up with their recovery support.

The service was well led, and the governance processes ensured that service procedures ran smoothly. Staff reported their job satisfaction as high. Staff said they felt their roles were empowering to others and that they had a positive working relationship with their peers. Staff said they felt proud to work for the organisation. Managers recognised that their staff team experienced fatigue and stress during the pandemic. They invested in a full subscription for each staff member to a wellbeing app. Staff could also access the organisation’s employee assistance programme. The service had an effective governance structure and performed well in their audits. The provider’s risk register formed part of a shared regional risk register which fed into a national risk register. Managers completed a separate review of their local risk register in relation to the pandemic

However:

Staff did not always follow the provider’s policies and procedures when they needed to search residents or their bedrooms to keep them safe from harm. The service had a draft standard operating procedure for searching residents’ bedrooms but not all staff were aware of it and how to keep themselves safe.

Staff did not give carers information on how to access a carers’ assessment.

Updated 10 January 2019