We carried out a review of the data available to us about Turning Tides Recovery Project on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Turning Tides Recovery Project, you can give feedback on this service.
The service was last inspected in 2016, at which time we did not rate independent substance misuse services.We rated Turning Tides Recovery Project as Good because:
The service was well staffed with a range of well trained and experienced staff. Staff put into practice the service’s vision and values. Staff had contact with managers at all levels of the organisation, including the most senior, who were supportive and visible.
The service was clean and comfortable with a very good range of facilities. Effective systems ensured any issues with the building or facilities were rectified quickly.
There was a proactive approach to understanding the needs and preferences of different groups of people, and to ensuring the service met these needs, promoting accessibility and equality. The individual needs of each client were considered carefully by staff, ensuring their individual preferences and needs were always reflected in how support was delivered.
Staff managed risk well using effective systems and protocols, including clients at risk of relapse. All clients had holistic, personalised support plans, and were encouraged to take an active role in their own recovery and risk management.
The organisation did not subscribe to any specific recovery model and would support any option that suited an individual. It also offered a unique managed withdrawal from alcohol programme, designed by the registered manager in partnership with colleagues from other disciplines. The service managers advised us that this programme had been independently evaluated by a medically qualified detoxification specialist, and approved by Public Health England.
Incidents, complaints and safeguarding concerns were monitored to identify where improvements could be made.
The community ethos of the organisation was very strong and effective. The organisation had very strong community links and a recovery pathway for people to move through. Support was available for as long as people needed it.
The service had excellent links with partner organisations and the wider community, offering a broad range of opportunities to clients to engage, build relationships and undertake training, educational or employment opportunities.
Clients told us they liked the feeling of inclusion, one example being the family feeling of Christmas-time, with gifts being exchanged and a full Christmas dinner prepared and eaten together.
Clients were consulted on all aspects of the running of the service and participated in staff recruitment. The Partnership and Co-Production Team (PACT), which was a group of clients and ex-clients, were significantly involved at all levels of the organisation, including budgets and policy changes, and met regularly with the trustees.
However:
Although the service had an appropriate Mental Capacity Act policy which formed part of the induction, not all staff knew or understood the legislation, how it applied to this service or how to use it appropriately. This may have been because some of the staff were quite new.
We do not currently rate independent standalone substance misuse services.
We found the following areas of good practice:
We considered all the evidence we had gathered under the outcomes we inspected. During our inspection. We used the information to answer the five questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found '
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
The service was safe. People were positive about the support they received and the attitude of staff. They all told us that staff treated them with respect, were available at all times and provided excellent support. One person stated, 'I feel safe here. There is a freedom to the place. You're treated like an adult, which is what I need.'
Each person had a support plan which had, in most cases, been completed by the individual. This identified desired long-term and short-term goals within a holistic framework. This meant that the significant areas of each person's current and future situation had been considered and aims for recovery set.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.
Is the service effective?
The service was effective. People received support in line with their support plan. Relapse prevention plans were in place for people. Weekly keyworker meetings ensured that goals were regularly negotiated and updated to ensure they were meeting people's current needs.
Staff received regular training and support.
Is the service caring?
The service was caring. People were supported through a difficult time in their life in a caring way. Everyone praised the care and support they received. One person told us 'The staff are brilliant. There is always someone to talk to night or day. They do an amazing job.' Another person said, 'This place has saved my life.' 'This has been an excellent experience; everyone is brilliant.' Another person said, 'The staff are superb, I can't fault them. They are there to listen and help and guide. I consider them caring friends.'
Is the service responsive?
The service received weekly feedback from everyone using the service to ensure they tailored the service to meet the needs of the individual. Feedback from the keyworker sessions was positive. The service also ensure that any perceived risk was addressed.
Is the service well led?
The service was well led. Staff told us they felt supported by management and would be able to go to management with any concerns and feel listened and responded to.
During our visit at Delaney House we spoke with the manager, members of staff and six of the people living there. We found that the atmosphere was relaxed and people were getting on with their daily routine without hindrance. People we spoke with told us; 'I am very happy here', 'I made a lot of progress', 'everyone is supportive', 'I have to get up by 9.00 and do my daily chores as agreed I am happy with that', 'staff are friendly', 'this has been a safe haven for me and I am so lucky to be here'.
We found a comprehensive assessment procedure in place that proved people willingness in consenting to treatment and care offered by the service. People said that they had chosen to use the service and abide to the agreements that they had signed for. They were aware of the consequences that could bring their contract to an end prematurely.
Staff we spoke with were knowledgeable about people's needs, behaviours and showed empathy. We found the recruitment process was thorough and involved people using the service. The manager said that the selection process for staff recruitment was to reflect the special needs of the people as well as having staff from diverse backgrounds.
Each person was responsible for collecting their prescribed medication and we found the storage and management of medicines to be safe. People's records were stored in the organisation secured web based client database that conformed to data protection and only accessible to designated members of staff.
People had personalised plans of care, support and treatment. We saw records that showed plans were followed on a daily basis, and that interventions were informed by up to date guidance and best practice. There was clear guidance to support staff dealing with emergency situations.
People told us they felt safe at the home. Staff had been trained in safeguarding and had a good understanding of adult protection issues related to the needs of service users.
Good relations were observed between staff and residents. Staff said they felt well supported and valued by the organisation running the service.
There were arrangements in place to monitor and assess the quality and safety of the service. There were a range of methods to engage service users, families and other stakeholders in the running of the service, and a clear complaint procedure.