We rated Oasis Runcorn as good because:

• The service had up to date health and safety assessments. The environment was clean and mostly well maintained. We saw staff adhering to infection control principles.
• Staff were trained and there were sufficient numbers to meet clients’ needs.
• Risk assessments were comprehensive and up to date. There were plans in place for clients who decided to leave the programme before its completion. Staff administered and managed medication effectively. All staff knew how to report incidents, and understood the duty of candour.
• Care records were comprehensive, holistic, and completed in a timely manner. All relevant information pertaining to the client and the treatment programme was outlined in the records, and included input from the client. The service was following best practice and national guidance with relation to treatment. Care records were up to date and had been amended according to events involving the client. All staff had completed mandatory training, were up to date, and records were maintained in personnel files. Multi-disciplinary team approach was evident, with input from care managers external to the service. Staff were trained in the Mental Capacity Act.
• We saw good interaction between staff and clients at the service, with respect being shown to all parties. Clients felt comfortable with staff at the service, and felt they could talk to them as many staff members were former clients in treatment programmes. Clients told us they felt supported and safe at the service. Care records showed that clients could understand and knew what treatment they were getting and why. Client consideration to change treatment path was available. We saw evidence of family involvement. Client forum minutes and client interviews indicated that clients were happy with the service.
• The referral and assessment process for the service was comprehensive. Clients who entered the service and found that the treatment was not suitable could change their treatment option, with possible transfer to another service if deemed necessary. Discharge planning started on admission to the service, with plans in place for possible unexpected exit from the programme. Clients were encouraged to contact families and try to integrate them into their treatment programme. Equality and diversity was promoted at the service. There had been 19 formal complaints in the 12-month period prior to the inspection, and 300 compliments had been received in the same period.
• Managers at the service provided key leadership, with the skills, knowledge and experience required. There was a clear definition of recovery within the model followed at the service, and staff were aware of it. Staff said they felt valued and supported, they were happy working in the service. Staff survey results were very positive. Staff appraisals indicated career development and consideration of training courses that might be helpful. Leadership training was available to all staff at the service. Key performance indicators were used to identify and promote good practice, and to identify aspects that required action. The provider actively arranged conferences and learning opportunities for staff.

However:

The environment did not fully cater to clients’ needs. There was no separate lounge area for female clients.  

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The environment was clean, well maintained and functional for its purpose. The staff had conducted environmental risk assessments for fire and health and safety. There were clear policies in place for the management of medications and we saw that medication practices at the service adhered to these policies.

• There was a well-established staff team at Oasis Runcorn. Staff and clients confirmed that there was always enough staff on duty to maintain safety and carry out the required care and treatment.

• Staff were able to identify signs of abuse and knew how to report these both internally and to the local authorities. There were clear incident reporting procedures, staff were aware of how to report incidents and a duty of candour policy was in place.

• Comprehensive assessments took place prior to admission to the service. Care plans and risk assessments were in place that met the needs of the clients.

• The service used National Institute of Health and Care Excellence guidelines to inform their delivery of care and practice. The service monitored their clinical outcomes through treatment outcome profiles.

• Staff understood the principles of the Mental Capacity Act, should clients not have capacity due to intoxication the staff would maintain their safety until they regained capacity. The service had an equality and human rights policy.

• Clients we spoke with were positive about the staff telling us that they were supportive, respectful and non-judgemental. We observed positive interactions with clients, and staff were supportive of clients both practically and emotionally. Clients felt involved in their care, and identified their own goals for admission.

• The service had eligibility criteria and assessed referred clients to ensure that only individuals who were in a position to benefit from the treatment offered were admitted. Discharge plans were considered from the point of referral.

• The needs of all individuals were taken into account. Clients could access a variety of leaflets in differing languages and staff had access to interpreters. The cultural and spiritual needs of clients were met in a number of ways such as supporting clients to attend places of worship. Groups and activities were structured and met the needs of the clients.

• The provider had a complaints procedure which staff and clients knew and were confident that concerns raised would be addressed promptly.

• Staff morale was good and there was a positive team environment. Staff worked well together and felt supported by managers and colleagues. Senior managers within the organisation attended the team and were known to staff. There was an open and honest culture and staff were confident to raise concerns. There had been no staff turnover since Oasis Runcorn assumed responsibility for the service in October 2016.

• There were governance processes to monitor and support the delivery of care. The service monitored the quality of care through internal audit and submissions to the national drug treatment monitoring system. Key performance indicators were reported against quarterly. Compliance with mandatory training and supervision was recorded. There were processes to report, review and learn from adverse incidents and complaints. There was a range of policies and procedures to support and guide staff.