At our previous inspection on 16 April 2013 we found there was insufficient evidence that the appropriate processes and checks had been undertaken when recruiting staff. At this inspection we found that improvements had been made and there were effective recruitment and selection processes in place. The staff records we reviewed contained completed application forms. We saw that appropriate checks had been undertaken before people started work, including obtaining references from previous employers, undertaking disclosure and barring service checks and ensuring a person’s eligibility to work in the UK.

At the time of our inspection there were five people living at Freedom Recovery Centre. During our inspection the two people using the service who we spoke with told they felt well-looked after, supported by both staff and other people using the service and would recommend the service to others. One person said: “This is my first time in rehab. As soon as I walked in, I wanted to walk out. But I spoke to (staff) and stayed. Now, I’m doing well. I’m working my programme.”

People’s psychological, emotional and physical needs were assessed and care was planned and delivered in line with their individual care plans. People told us they felt safe and secure, physically and emotionally. One said, “right now, in this house, I feel safe, like there are no threats”.

People described the staff as “supportive” and as having the right attitude and skills. However, although there were policies and procedures in place to ensure robust recruitment and selection processes, for both salaried and volunteer staff, there was insufficient evidence that these procedures had been followed and applied fully and effectively. There were documents missing from staff files, and there was not sufficient evidence that all staff were checked and vetted prior to starting work at the service to ensure that all staff were appropriate to work with the vulnerable client group.

At our previous inspection on 2 May 2012 we found that the provider did not have appropriate arrangements in place to manage medicines.

At our inspection on 7 December 2012 we saw that there were appropriate arrangements in place for the safe handling, storage, administration and disposal of medications. Appropriate medicines policies and procedures had been put in place,. Systems were in place to safely store or dispose of medications, if this was required, and we saw evidence that staff had been trained in the safe handling of medication.

At our previous inspection on 2 May 2012 we also found the provider was not providing care in an environment that was suitably designed and adequately maintained.

At our visit on 7 December 2012 we saw that the provider had taken steps to meet Fire Safety Regulations, including maintaining regular checks on fire fighting equipment. Staff and service users had been provided with training in fire safety and health and safety. The kitchen flooring had been replaced and looked clean and hygienic. Broken tiling had been sealed. The kitchen had been deep cleaned, and was being maintained adequately; kitchen flooring had been replaced and broken tiling had been sealed.

During our inspection we spoke with two of the people living at the service, and with their consent we looked through and discussed their care records with them.

We also talked to staff, clients using the drop-in services, and took into account comments made in service users’ feedback forms and surveys.

People told us that they felt safe and secure at the Centre. One described it as their “safehouse”.

People using the service understood the care and treatment choices available to them. They felt that they had been fully involved in their pre-admission assessment processes, and been given time to make the decision to enter the programme. They understood what was in their care plans and risk assessments, felt their wishes were central to their recovery plans and had been given copies of these plans.

A person using the service told us that describing the Centre as “really good, is an understatement”.

People told us that their care managers, keyworkers and counsellors worked together well, and that all the staff had given them a lot of support and encouragement. Their comments about the daily activities, structured programme, access to and attitudes of staff and effectiveness of the recovery programme were all positive.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Clients’ risk assessments were clear and updated regularly. There were robust processes to report, review and learn from incidents. All staff understood the safeguarding concerns surrounding the client group.
• Clients’ care plans were holistic, detailed and recovery oriented. Clients had personalised goals in their care plans. The service had an aftercare programme that clients could attend for as long as they needed. The service had clear discharge planning protocols in place.
• The service had enough staff to care for the number of clients and their level of need. Staff vacancy rates, turnover and sickness absence were all low. The service did not use bank or agency staff. Staff were regularly supervised and received an annual appraisal.
• Management had clear oversight of the service. Staff attended a daily handover meeting where incidents, care planning and concerns were discussed. Staff took part in regular audits of the service to check that polices and clients’ care plans were up to date. The service took part in an auditing process by an external quality assurance scheme. The service was inspected by the external organisation in November 2016. This meant the service could see the areas where they were doing well and the areas needed to improve.
• The service had clear infection control procedures to reduce the risk of infection in place. The service undertook regular health and safety checks. The service had an updated risk register and business continuity plan detailing how to continue operating the service in the event of a disruption.
• Staff understood the needs of the client group they were supporting. Clients told us that staff treated them with dignity and respect.
• The service created a magazine for and with the clients twice annually. It detailed what activities the service had been up to and information on the substance misuse sector.

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

• Although staff had training in safeguarding vulnerable adults from abuse and understood child safeguarding procedures, the service had not provided training in safeguarding children to staff. Staff were scheduled to undertake child safeguarding training in January 2017.
• Staff were very knowledgeable about the needs of clients with substance misuse problems but did not receive regular training in substance misuse to stay up to date with the developments in legislation and treatment.