At our last inspection of The Haynes Clinic Limited - Everton Park, in August 2013, we identified non-compliance in relation to staff supervision and appraisals, and service quality monitoring systems. We imposed compliance actions and told the provider they must make improvements in this regard. The provider submitted an action plan and told us what actions they had taken, and confirmed they would be compliant by the end of September 2013.

When we carried out this inspection on 11 November 2013, we found the provider had introduced further systems to support staff, and ensured staff received an annual appraisal and appropriate professional development.

The provider had implemented new documentation to record the audits of quality and safety for this service, and we found actions had been taken to make improvements following comments and suggestions from people who used the service.

During our inspection of The Haynes Clinic Limited - Everton Park on 12 August 2013, we spent most of the day at the clinic. People who received treatment also attended the clinic for their treatment between the hours of 9am and 5pm. We also visited the house when people had returned from the clinic.

We saw that systems were in place to obtain the consent from those receiving treatment, and that treatment was planned and delivered to meet people’s needs.

We saw the provider had made improvements to the areas we previously identified concerns with for maintaining safe premises, and that the accommodation was well maintained and clean.

We looked at the training and support processes for staff and found that staff did not receive regular supervision or appraisals.

We identified that the provider did not have effective systems in place to assess and monitor the quality of the service provided to people living at The Haynes Clinic - Everton Park.

People we spoke with told us that, overall, they were happy with the service provided. One person said, “It’s brilliant”. Another person said, “I would like to thank all the staff for helping me with my recovery”.

However, people also commented that their dignity, diversity and physical needs were not always met or respected. They did not always have sufficient choices and did not receive sufficient information about the service.

Each person had a care plan in place. However, these were not personalised and did not give staff sufficient guidance on the specific care each person needed. For some people, risks had been identified but there was no guidance in place for staff on how to manage the risks.

People told us they received the medicines they had been prescribed. We found that medicines were not being managed correctly. Fire safety checks were not satisfactory so put people at risk. The provider’s recruitment process was not robust enough to ensure staff employed were suitable to work with people using the service.

People told us they did not know who to speak with if they wanted to comment or complain. They said there was no complaint information displayed in the service.

People were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines.

The provider had improved their procedures relating to the recruitment and selection of staff. They had taken action to ensure that staff were suitable to work with people using this service.