Aissa limited is registered to provide the following regulated activity:
- Treatment of disease, disorder or injury
- Accommodation for persons who require treatment for substance misuse
The service has a registered manager in place.
Aissa limited provided treatment and accommodation for people with substance misuse problems, including rehabilitation and alcohol and opiate detoxification.
This inspection consisted of two visits, one on the 27 October and one on 24 November 2015.
During the inspection visit on the 27 October 2015 serious concerns were identified about the care and treatment of patients going through alcohol and opiate detoxification. There were a lack of staff that held the appropriate qualifications, competence, skills and experience to provide care, treatment and support patients safely. Staff were not trained in completing physical health checks and monitoring deteriorating health. Staff had not completed mandatory training courses, this included safeguarding vulnerable adults and children at risk, assessing needs and the Mental Capacity Act.
Medicines management was poor and unsafe. Medication was being written on medicine administration charts and was not being signed by the prescribing doctor. There were no systems in place to check this was being completed safely. A patient was prescribed medication via email without a medical assessment. Medicines prescribed as required had no maximum daily doses recorded in the records. Patients could potentially be administered more than the maximum permitted daily dose.
Risk assessments and risk management plans were limited in length and not comprehensive. For patients who were suicidal, the risk was not documented in detail for how this would be managed during the admission. None of the care plans included regular monitoring of physical health using a recognised tool. The only physical health monitoring being completed was on admission which included blood pressure, pulse and weight. Staff had no training to carry out physical health observations.
As a result of the serious safety concerns identified we issued the provider with a letter of intent to use Section 31 of the Health and Social Care Act 2008 notice, on 9 November 2015. In response to this, the provider voluntarily stopped admitting patients to the service.
During the second inspection visit on 24 November 2015, Aissa limited had made improvements and changes in response to our concerns. Comprehensive risk assessments and risk management plans had been reviewed. The management of medicines had significantly improved and an external company employed to regularly check and audit medicines. All staff had completed required mandatory training for their roles and responsibilities. A detox policy and procedure had been implemented to describe responsibilities of staff. The policy included care during detox and the requirements of tele prescribing. However, the policy was not comprehensive and required further improvements.
Following the second inspection the decision was taken to allow Aissa limited to start readmitting patients again. The provider understood the areas that required further improvements.