Care and treatment was focused on the individual and addressed the person's previous offending behaviour, while building on their strengths. One of the men we spoke with said the project “helped me change as a person.” Care plans focused on promoting interaction with other people, both in the project and externally. People using the service told us they had become aware of the importance of making connections. One of them said “When you make commitments to people, you’re invested in them.”

There were a number of risk assessments for each person, with plans for reducing the identified risk.

Douglas House Project worked in partnership with the NHS mental health trust and the probation service to address the clinical and social care needs of the people using the service. The project promoted a coherent pathway, from before the person moved in until they moved on to independent living, by working closely with referring agencies and organisations in the community.

There were effective recruitment and selection processes in place for permanent staff and for workers who provided cover. The project was staffed at all times, but the high turnover of staff during the previous year had presented challenges to the project in maintaining sufficient numbers of appropriately skilled and experienced staff on duty.

There were systems in place to monitor the service. People using the service contributed their views about the running of the service and these were acted on.

The men using the service we spoke with said they were given information before coming to live there so that they understood the conditions of living at Douglas House Project (DHP). One man said, "I knew what I was coming to".

Care plans and risk assessments were developed in the light of comprehensive information about people’s individual needs. People told us that they were engaged in their treatment by being supported to identify and address the issues that had led to them coming to live at DHP.

People were assessed to determine their ability to self-medicate and those at risk had their medicines administered by staff.

The people we spoke with praised the staff. One of the men said “they’re brilliant” and another said “they support you if you don’t understand something”.

A member of staff said that in addition to good support staff received from the team and regular individual meetings with their manager, there was weekly group supervision with a mental health professional at which the challenging situations that arose at DHP were discussed.

There were quality assurance systems in place. The people living at the service told us the service was well run, except for delays in repairs.

We rated Douglas House Project as good because:

• People’s risk assessments were comprehensive and detailed.
• Care records were generally comprehensive and included physical and mental health needs. They were reviewed regularly and appropriate referrals were made.
• Staff received appropriate induction, supervision and appraisal.
• Staff received specialist training specific to the care and treatment of the service user group. This included a National Vocational Qualification (NVQ) in Life skills.
• The service held regular meetings for staff support.
• Staff interaction with people using the service were respectful and kind.
• Community meetings were held weekly and actions were taken in response to people’s feedback.
• A social enterprise initiative was set up for people using the service to gain work experience.
• There was a great commitment towards continual improvement and innovation. The service had won an Enabling Environment award from the Royal College of Psychiatrists.

However:

• Safeguarding concerns were not always consistently identified or addressed robustly.
• Drug and alcohol tests were sometimes carried out at the reception area where other people could see. This did not promote the dignity and respect of the service user.