We do not currently rate independent, standalone, substance misuse services.

• During this inspection, we found that the service had addressed the issues that had previously resulted in regulatory breaches following the October 2016 inspection.
• There was a programme of refurbishment and redecoration underway. The service had professionally cleaned the stained carpets. Three of the flats had carpets replaced and we saw evidence that four more carpets were schedule for replacement in August 2017.
• The provider had appointed a cleaner to ensure the cleanliness of all communal areas and to advise clients with the cleaning of their rooms.
• The provider had repaired the faulty window frames and appointed a maintenance worker, who attended the location on a weekly basis to deal with any issues reported.
• The provider informed the Care Quality Commission of all notifiable incidents.
• Following our last inspection in October 2016, we did not require or recommend any areas for improvement for effective, caring, responsive, or well led. Since that inspection, we have received no information that would cause us to re-inspect these key questions.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The service had enough staff to provide safe care and treatment to clients.
• The service kept a stock of naloxone medication on site for use in emergencies.
• Clients received care and treatment underpinned by best practice.
• Patients had up to date care plans that were holistic, personalised and recovery oriented.
• The service had established links with mutual aid and recovery support agencies in the community.
• The service had high client completion of treatment rates.
• We saw positive and respectful interactions between staff and clients.
• Client involvement was central to their recovery plan.
• The service provided a structured activities plan for every day of the week.
• The service provided ongoing aftercare and support to clients following completion of treatment.
• There were established system and protocols in place leading to the effective management of the service.

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

• Soft furnishings and decor needed either replacing or refurbishing in certain areas and some repair work to the building was needed .
• Staff did not always consider wider risks to the community when assessing client risk.
• The service did not inform the Care Quality Commission of those incidents that gave rise to a notification.

We found that The Bridges provided care and treatment that complied with the regulations and outcome areas we inspected. Comments from people receiving care were positive about the service they received. Comments included, “The delivery of treatment that I have been through for the last seven weeks has been fantastic and although I’ve been through a lot of pain with outside issues, I’ve stuck at the programme. One of the best things I’ve ever done.” One person noted “I’ve been homeless, on settees, living in a bush to a concrete floor for years. I’ve no comments or suggestions regarding accommodation but thanks for the chance.”

We saw that peoples' care records included relevant assessments, treatment plans and information pertinent to their care. People were made aware of the treatment, expectations and limitations and they were able to give informed consent to their care. The premises were seen to be fit for the purpose intended and gave a safe environment in which to live and receive treatment.

We spoke with a person using the service who told us that his experience was a positive one. He had a clear understanding of the treatment, expectations and planning the future after leaving The Bridges. He was complimentary about the staff, food and facilities. We did not manage to speak with other residents as many were either off site or attending group therapy during our inspection.