Archived: Birchwood Residential Treatment Centre - Birkenhead

Updated 3 February 2017

Birchwood Residential Treatment Centre – Birkenhead provides support and treatment for up to 20 men and women who require drug or alcohol detoxification and stabilisation. The service provides medically managed detoxification by registered nurses, two of whom are non-medical prescribers. The nurses are directly employed by an NHS trust, follow the trust’s policies and procedures, and link into the trust’s substance misuse service.

Birchwood Residential Treatment Centre - Birkenhead is provided by Arch Initiatives. The ownership of Arch Initiatives changed in July 2016. The provider of the service is still Arch Initiatives, but they are now owned by the Kaleidoscope Project. The Kaleidoscope Project provides a number of services across England and Wales.

There was no registered manager at the time of our inspection, and there was an acting manager in post. This post was due to be recruited to shortly. The service was registered to provide the regulated activity: accommodation for persons who require treatment for substance misuse.

The last inspection of this service was carried out in July 2013. The service was compliant with the five standards inspected.

Updated 3 February 2017

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Staff were suitably skilled and experienced to provide care, treatment and support for clients. Staff received regular supervision, had completed most of their mandatory training, and had had an appraisal.
• There were established referral pathways from the substance misuse teams, the local hospital and GPs. The service was part of a detoxification pathway, and clients had access to inpatient/residential or community substance misuse services on discharge. There were clear treatment pathways for clients, the most common being for clients requiring detoxification from alcohol, opiates or stimulants.
• Clients had a comprehensive assessment of their needs from which a recovery plan was developed. The assessment included the client’s substance misuse history, their physical and mental health needs and any risks.
• Medication was prescribed by registered nurses who were non-medical prescribers. Clients had their progress monitored throughout their treatment by the use of assessment tools that measured the severity of withdrawal symptoms, and monitoring of their physical observations. Staff were trained and had the necessary medication and equipment to deal with medical emergencies. Medication was stored and managed safely.
• Clients were provided with verbal and written information about the treatment programme, and the restrictions on admission to the service. There were daily community meetings for clients where clients contributed to the day-to-day running of the service. Clients were invited to submit feedback forms to give their views of the service. Clients had access to an advocacy service.
• Incidents, audits and complaints were reviewed locally, and action taken in response. The building and its equipment were clean, safe and well maintained.
• Clients had single rooms, and there was an accessible room with bathroom on the ground floor for clients with limited mobility. The building and its equipment were clean, safe and well maintained.

However, we also found the following issues that the service provider needed to improve:

• Recovery plans were not always written in a person centred way and did not include the client’s views. All clients were aware of their recovery plans, but they gave mixed views about how involved they had been in the process of developing the plan.
• It was not clear how staff followed the principles of the Mental Capacity Act for clients who may lack capacity to make decisions about their treatment.
• The governance arrangements were in a period of transition. There were two incident report systems – one for Arch Initiatives and one for the NHS trust. The Arch Initiatives system was in transition following the change of ownership in July 2016, and there was not a system for ensuring that incidents were tracked and followed up.

Updated 3 February 2017

See overall summary.