People using the service told us they were happy with the care and support they received and staff asked for their permission in providing this. One person told us, "The staff are polite and nice and are available if I have any questions”. Another said, “They are very effective in the support they give me.”

Care records were up to date and provided a comprehensive assessment of people’s needs and appropriate care planning. People’s physical, emotional and social needs were addressed and care plans were developed in discussion with people who use the service.

There were effective arrangements in place to safeguard people from abuse.

Effective, non-discriminatory recruitment and selection processes were in place, with appropriate pre-employment checks being carried out.

There was an effective system available for people to raise concerns or complaints. People we spoke with told us there had been no reason for them to raise a complaint

We carried out an inspection of Aspinden Wood Centre on 18 August 2011. During that inspection people we spoke with told us that they were happy with the care that they received and that the staff were kind and caring. Although these views were borne out by some of the care, treatment and support they received, we found concerns in the following areas of service provision: care and welfare; safeguarding; staffing; supporting staff; notifications; and records.

Following the inspection, the organisation provided us with an action plan to tell us what they were doing to make improvements. We visited on 25 July 2012 to see whether they had made these improvements.

At our recent inspection all of the people we spoke with told us that they were given a good standard of service and received the care and support they needed. One person told us that “the staff are polite and helpful.” Another told us that the staff treated them well and they were happy at the centre.

Overall, we found that the concerns we identified previously had been addressed and the centre was now meeting the essential standards of quality and safety

During our visit we spoke to some of the people who live at the home. They told us that they were happy with the care that they received. They said that the staff were kind and caring. One person told us, ‘looking back over the years this is a good home’. Another person told us, ‘staff go out of their way to be helpful and the manager’s door is always open to us’.

The staff who we spoke to told us that they enjoyed their work. They said that they were well supported. They received the training they needed and felt confident in doing their jobs. One member of staff told us the work was challenging but rewarding, especially as their relationships with the people using the service developed and they were able to help them improve their lives.

We do not currently rate independent standalone substance misuse services.

This was an unannounced inspection to follow up on whether the provider had made the required improvements identified during our previous inspections, including the requirements set out in the warning notices served following our inspections in June and October 2017

Following our inspection in June 2017 the provider agreed voluntarily to suspend admission to new clients until improvements had been made.

The warning notice served following the October 2017 inspection required the provider to make improvements to the environment by 19 February 2018.

As the issues had previously been so wide ranging, at this inspection we looked at all our key questions; is the service safe, effective, caring, responsive and well-led.

At this inspection, we found that the provider had made a number of significant improvements and had addressed all the issues identified in the warning notices from the inspections in June and October 2017.

Whilst the provider was on a journey to improvement new systems and processes to ensure the safety and quality of services was not fully embedded and further work was required. In addition, we identified a new concern about the lack of robust pre-employment checks for new staff. We found the following areas that the provider needs to improve:

• Governance systems were not fully embedded; as a result, the provider could not assure itself that it was delivering a good quality service. The provider was not following all of the new systems and processes it had developed.

• The new model of service delivery was not yet fully embedded into day-to-day practice and the measurement of outcomes needed further work.

• The provider did not have formal systems in place for staff, clients or carers to give feedback regarding the service.

• Further work was needed to ensure that there was a positive culture of safeguarding within the staff team.

• The provider was not following safe recruitment guidelines. It had not ensured that staff had given a full work history prior to starting employment or that there was a system in place to alert them when disclosure and barring checks were due for renewal. The service needed to ensure that all staff received regular supervision.

• All but two bathrooms and toilets were still in need of urgent refurbishment. Further improvements were needed to ensure that cleaning records were routinely maintained and that communal toilets were regularly checked to ensure they were clean.

• The provider did not provide information to all clients in an accessible format. Several clients had verbal or written communication needs that were not being met.

• The provider had not ensured that discharge plans were in place for all clients who wanted to leave the service or who were not considered suitable to stay.

• Not all incidents of verbal abuse towards staff were being reported.

However, we found the following improvements had been made since our last inspection in October 2017:

• At our last inspection in October 2017, we found that the systems to ensure the cleanliness, hygiene and maintenance of client bedrooms and bathrooms were not effective. The bathrooms were in need of refurbishment. At this inspection, we found cleanliness had improved and two bathrooms had been refurbished.

• New systems had been introduced to ensure the safety and well-being of clients and staff. Staff were monitoring the ‘wet room’, which was the communal living area where clients were able to smoke and drink. An interim measure was being put in place to ensure that the front door to the service could no longer be opened from the outside without staff being aware of who was entering the building.

• Staff were able to tell us what action they would take if the fridge temperatures fell out of range.

• Risk assessments were updated following changes in client presentation.

• The physical healthcare of clients had improved. There was good communication with the GP and a new GP contract in place.

• There were systems in place to ensure that learning from incidents was shared with staff.

• The action plan for fire safety had been addressed.

• At our last inspection in October 2017, we found same sex accommodation guidance was not followed; there was no same sex accommodation policy in place. At this inspection, we found a same sex accommodation policy had been developed and the service was considering how they could implement this.

• The service model had improved, it was now clear that the focus of the service was on harm reduction and recovery.

• The system for supporting clients with their finances had been improved. Staff only supported clients with their finances where there had been agreements put in place because clients lacked capacity.

• The service had made many improvements to its safeguarding procedures,

• Medicines management and administration had improved since our last inspection in October 2017. New staff were in the process of completing medication training and competency assessments.

Following the inspection, we agreed that the provider would assess and admit new clients to the service.