Archived: Gladstones Clinic Lexham House

We do not currently rate independent standalone substance misuse services.

The service had made improvements since our last inspection in March 2016, we found the following areas of good practice:

• The provider had reviewed their governance processes. Managers from the service now met with colleague managers and members of the senior management team to review incidents, trends, and issues relating to the service. The processes were not fully embedded at the time of this most recent inspection, though work had begun.
• The service now had regular medical input from a doctor during office hours and out of hours. These doctors had specialist knowledge and were experienced in working this client group.
• At the last inspection, we found that the service’s assessment of client risk prior to admission was not robust. During this inspection, we found that the service obtained information prior to admission and now undertook a thorough and holistic assessment of risk prior to clients being admitted to the service. Staff reviewed risk on a regular basis and took action to manage client risk.
• When the service was inspected in March 2016, we found that the provider had not ensured that all appropriate emergency medicines were in date and were available in the service. At this inspection, the inspectors found that the provider had made improvements and emergency medicines were in date and available.
• When this service was last inspected, we found that the staff had not undertaken safety checks of equipment. We found that these were now being undertaken.
• At the last inspection, the inspectors noted that the provider had employed staff without the appropriate pre-employment checks being undertaken. Two staff had not had criminal record checks undertaken. During this inspection, we found that the service now ensured that all staff had the appropriate employment checks. They also undertook a risk assessment of each member of staff prior to them commencing employment. Where risks were identified the managers implemented a risk management plan.

However, we found the following issues where the service provider needs to make further improvements:

• At the last inspection, we identified that there were no up to date training records for staff working in the service. At this inspection, we found that there were now training records. However, not all staff had completed their mandatory training and some aspects of mandatory training completion were below 75%.
• During this recent inspection, we found that there were no records of when the physical health monitoring equipment had been cleaned.
• During this inspection, we observed that the clinic room environment was also being used as an office. Clients had their physical examinations undertaken in a room that was cramped. The room lacked privacy and client’s personal information was on display on the wall and also on desks.
• During this inspection, we found that clients were asked to sign a consent to treatment form when admitted. However, the information contained in the form was not in line with provider’s current policies and procedures.
• The service had yellow clinical waste bins in their clinic room. However, during this inspection, inspectors found that the service was not managing their clinical waste in line with Department of Health (DOH) guidance 2013, which states that clinical waste bins should be collected at least every three months, regardless of filled capacity. The bin had not been collected for over three months.