Background to this inspection
Updated
5 October 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 15 August 2016 and was unannounced. The inspection team consisted of two inspectors and a specialist advisor who had experience of drug and alcohol withdrawal.
Before our inspection we reviewed the information we held about the home. We considered information we held about the service this included safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. On this occasion we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
The organisation refers to people staying at the service as 'students' so this is how we have also referred to them throughout the report. We spoke with the registered manager, seven members of staff and two students.
We reviewed a range of records about students (past and present students) care and how the service was managed. These included the care records for students, four staff files, training records, policies and procedures, quality assurance audits and incident reports and records relating to the management of the service.
Narconon was last inspected on the 8 December where concerns were identified and the service was rated as Requires Improvement.
Updated
5 October 2016
We inspected Narconon on the 15 August 2016 and the inspection was unannounced. Narconon is registered to provide accommodation with personal care for up to 16 students (adult service users). The purpose of the service is to provide a non-medical detoxification and rehabilitation programme for students who are addicted to alcohol or drugs. Students withdraw from drugs and then take part in a programme of modules with the intention of self-learning. The provider had developed an alternative non-medical/medicated intervention, rehabilitation and care programme for a variety of legal and illegal drugs and alcohol withdrawal.
It should be noted that the only part of the service provided at this location which is registered and regulated by the Care Quality Commission is for ‘accommodation with personal care’ we do not regulate the rehabilitation programme provided or judge their effectiveness.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.
At the last inspection in December 2015, we asked the provider to make improvements in relation to the safe recruitment of staff and the organisation of contemporaneous records. The provider sent us an action plan stating they would have addressed all of these concerns by February 2016. At this inspection we found the provider was meeting these regulations and had acted upon the recommendations made.
Before commencing the programme, staff completed pre-admission assessments in partnership with the students to ensure they could safely support the student throughout the programme. Information obtained from the pre-admission assessment formed the basis of the student’s care plan. However, care plans and risk assessments did not consistently reflect the steps required to mitigate potential risks or how to safely manage student’s mental health needs during withdrawal. Where students may have experienced fluctuating capacity during the withdrawal programme, documentation did not consistently reflect how the principles of the Mental Capacity Act (MCA) 2005 were embedded into the care planning process. Despite concerns with documentation, we saw that students received the care they required. We have made a recommendation for improvement.
Consent was obtained from students before they started their programme. Staff had received training on the Mental Capacity Act (MCA) 2005 and students were made aware of the restrictions in place before completing the programme.
Students were protected from abuse or harm because staff had been trained to recognise, record and report any concerns. Students confirmed they felt safe during their stay at Narconon. One student told us, “I feel really safe and I’m learning to like myself.” There were enough staff on duty and deployed throughout the home to meet student’s support needs.
Staff had been trained to provide appropriate and safe personal care. They had followed the organisations training programme regarding the modules that students go through after withdrawal. Upon employment with Narconon, all staff members had completed the care certificate. Staff spoke highly about the opportunities for training and professional development. Several staff members were being supported to obtain a diploma in health and social care.
The service had been adapted and redeveloped with a range of facilities and equipment which met the needs of the students. Some staff also lived on site on the top floor. The home was clean and well maintained having been newly developed prior to registration in August 2015. A dog also lived on site and students spoke fondly about having the dog around.
Staff went above and beyond to promote and uphold student’s equality and diversity. Students were supported with any religious and spiritual needs during their programme. Staff recognised the importance of family relationships between students and their loved ones and supported students in maintaining those relationships.
Students were supported to maintain a healthy diet and any dietary requirements were catered for. Students spoke highly of the food provided. One student told us, “The chef always exceeds himself.”
There was a system for assessing and monitoring the quality of the service. Satisfaction surveys are sent out to students and their families to obtain feedback. Systems are also in place to involve staff and students in the running of the service.