During our visit to Howard House we spoke with five people who used the service. We also spoke with five members of staff and met with the registered manager.

People actively sought to take part in the treatment programmes offered. We found written consent had been obtained from people for all aspects of care and treatment.

People received care and treatment that was individual to their needs. People had developed their own treatment plans with staff support and advice. A person we spoke with said "The programme is how I want it to be".

People we spoke with felt safe. A person we spoke with said "I feel safe. I suffered anxiety when I came in. That has faded by significant amounts". We saw that staff had received appropriate training to spot signs of abuse.

Not all appropriate checks had been made before staff began work. Some staff did not have references to enable the provider to judge whether they were of good character.

People who used the service were asked for their views and their views were taken into consideration. People held weekly meetings and discussed various topics with staff. When people asked for weekend activities we saw they had been provided.

During our inspection we spoke to four service users who told us that they were very happy with the care,treatment and support that they received from staff.

Service users were all aware of their care plans and told us that they had been involved in decisions around their care,treatment and support. These plans were reviewed during weekly key worker sessions. Service users told us that they had goals they wanted to achieve and these were recorded in their plans.

We observed that staff were positively supporting service users who were participating in activities,for example staff were motivating and encouraging people in meal preparation and form filling.

We spoke to staff who told us that they were supported by their manager and had regular supervision.Staff said they were appropriately trained in respect of their roles and that they were able to apply for appropriate training via their manager.

We rated SMART Howard House Project as good because:

• The service had made improvements following our last inspection in 2016. This included training staff in search techniques and attaching photos of clients to medication charts.

• The service was clean and welcoming.

• All staff were up to date with their mandatory training which included safeguarding, infection prevention and control, Mental Capacity Act and first aid.

• The service delivered treatment for alcohol and/or opiate detoxification in line with national institute for health and care excellence guidelines. There were clear policies and procedures in place to ensure that treatment was delivered safely.

• The service had strong links with community services to help ensure that clients were well prepared before starting treatment and that they would be supported once they were discharged from the service.

• All clients had comprehensive and holistic recovery plans in place.

• Risks were well managed and discussed in daily briefing sessions.

• Staff treated clients with kindness, dignity and respect. Clients gave very positive feedback about the support they received from staff.

• Staff morale was high and staff were well supported by their managers.

• There was a clear incident reporting procedure in place and learning from incidents was shared across the organisation.

However:

• Staff used both paper and electronic files to record client information, but practice was inconsistent. This meant it was unclear where to find information for some clients.

• There was no clear process in place for maintaining the gym equipment in the service. This meant that clients were at potential risk of injury when using equipment that was not appropriately maintained.