We rated Addaction Chy as good because:

• Staff treated clients with dignity, respect, compassion and kindness. Clients told us that most staff were empathic, caring and approachable. Staff involved clients and carers in decisions about their care, treatment and changes to the service. Staff supported clients to maintain contact with their families and carers and provided a space for them to meet. The service encouraged dog owners to attend rehabilitation by enabling them to bring their dog with them.
• Psychosocial treatments provided by the service were in line with national guidance and best practice. Staff supported clients to learn basic life skills. The service partly funded clients to access the gym in the community. Staff met clients’ holistic needs by working well with other agencies. This enabled staff to ensure clients had access to GP assessments and care, providing them with healthy living advice and supported them to access services in the community that could support them with work, education, benefits and specialist counselling.
• The service was clean, well equipped, well-furnished and had good facilities. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity and there were adaptations for people with disabilities. Medicines storage and administration was in line with good practice guidance.
• There were enough staff with good cover and on call arrangements. There were no staff vacancies. There was no waiting list for the service.
• Staff kept detailed records of clients’ care and treatment and updated them appropriately. Staff involved clients in care planning and risk assessment. Staff screened clients prior to admission to ensure they were suitable and safe to be admitted to the service. They completed regular risk assessments. Staff planned with clients for if they left the service unexpectedly. Staff developed individual, holistic and recovery plans with clients.
• Staff received the specialist training needed to carry out their work effectively. Through safeguarding training and information, staff understood how to protect clients. Staff had monthly supervision and they took part in research and innovation.
• Staff reported incidents and these were reviewed so the service could learn and develop from them. Staff participated in a variety of clinical audits to ensure the quality of the service. Managers analysed its service outcomes and reviewed how well the service was performing, so they could develop the service. The service treated concerns and complaints seriously, investigating them, learning lessons from the results, and sharing these with all staff.
• Staff worked well together and supported each other. Staff knew the whistleblowing procedure. Managers dealt with poor staff performance when needed. Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff enabled clients to give feedback on the service they received. Clients had opportunities to rate staff and the manager held a quarterly feedback session with clients and acted upon the feedback.
• Addaction Chy had an effective governance structure with systems and processes in place to ensure the service maintained standards and continued to develop. Managers and staff used systematic approaches to continually improve the quality of its services including service performance reviews, audits and client and staff surveys. The service managed risks through a risk register and contingency planning.

However

• The policy Addaction Chy had written about searches of clients’ rooms and possessions was brief and lacked detail about safety, for example, instructions for staff on how to avoid needle stick injuries. However, since our last inspection staff and clients did understand the rationale for searches and the service had produced information for clients on the searches that would take place.
• There was a problem with the IT system losing access to the network that had been escalated but had not been put on the risk register. The provider had brief plans for emergencies but had not fully mitigated disruption to the service and clients’ treatment.
• An audit prior to our inspection conducted by the service had identified that paper and electronic records did not always match and this meant staff might not always be looking at the most up to date information about a client.
• The service did not have a procedure for providing carers with information about how to access a carer’s assessment.
• Appraisals were generic and lacked individualised goalsetting.

We inspected rehabilitation (substance abuse) services provided by Addaction Chy but we do not yet rate these services. The following is a summary of our findings in relation to the five key questions we always ask about a service: Is it safe, effective, caring, responsive and well led?

Addaction is a national charity which provides support to residents to overcome substance misuse. Addaction Chy is a second stage, residential rehabilitation centre for adults who have already detoxed.

We found the service was meeting the needs of its residents. All residents had a recovery plan although three were incomplete. Recovery plans showed residents had had input into the planning of their care and that their history and circumstances were being considered. Family and friends could visit the facility and meet with a resident in private. Risk was assessed and residents were receiving care that enabled them to recover. Incidents were recorded and responded to appropriately. However, two Care Quality Commission (CQC) reportable incidents, while managed appropriately within the organisation, were not reported to the CQC. Staffing levels ensured residents could have one to one care 24 hours per day if needed. There was a range of group interventions on offer and also activities for residents to take part in to aid their recovery. Residents were given the opportunity to complain and managers responded effectively to complaints by trying to resolve them proactively.

Staff were respectful of residents and offered an appropriate level of support. Staff had received training although there were some who had not completed mandatory training. Only the manager had done manual handling and Mental Capacity Act (MCA) training. One member of permanent staff had not completed safeguarding children and adults and none of the bank staff had completed safeguarding children and adults. Three permanent staff plus all the bank staff had not done infection control. First aid and safe medicine handling had been completed by all staff. Staff told us that they enjoyed their jobs.

The service had recently moved into its new premises and maintenance tasks were being undertaken. Management were committed to resolving maintenance issues swiftly. For example, we saw that the manager had been in contact with senior managers and that there were clear plans in place to complete all maintenance issues within a reasonable time period. The environment was not clean in all areas. For example, dust had accumulated in high up areas including on window frames, door frames and some walls. The facility had a positive atmosphere and was well suited to accommodating therapeutic groups. 

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The facilities were clean and well maintained. The service had installed kennels so people could bring their dogs to the service. The environment had a positive atmosphere.

• Experienced staff were available to clients 24 hours per day. Staff were responsive, genuine, caring and respectful in their interactions with clients.

• Clients had comprehensive up to date risk assessments. Recovery plans were of a good standard and they showed clients were receiving person centred care. Clients had individual time with their keyworkers and the group delivered interventions that met their recovery needs. The service had good links with external agencies that provided clients with holistic care.

• There was a programme of therapeutic and leisure activities. Staff provided acupuncture in the evenings.

• The service had good leadership and a clear aim. Morale and job satisfaction were high and staff felt motivated, valued and respected.

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

• The provider conducted searches of clients’ rooms and possessions but they did not have a policy or guidelines for undertaking searches. This had the potential to leave clients vulnerable to improper treatment.