- Residential substance misuse service
The Recovery Lighthouse Worthing
All Inspections
07 July 2021
During an inspection looking at part of the service
We inspected The Recovery Lighthouse in Worthing on 7 July 2021. Recovery Lighthouse is a 13 bed residential rehab that provides medically monitored detoxification and/or rehabilitation programs to adults with substance misuse issues including alcohol and/or opiate dependency.
This was an unannounced focused inspection following concerns being raised about the safe care and treatment at the service. Because of its limited scope, we did not rate at this inspection. You can view previous ratings and reports on our website at www.cqc.org.uk.
During the inspection we found a number of areas of concern. Following this inspection, we wrote to the provider and told them that we required them to provide us with assurance that they would make immediate and ongoing improvements, otherwise we would use our powers under Section 31 of the Health and Social Care Act 2008. Section 31 of the Act allows CQC to impose conditions on a provider's registration. The provider responded to us and provided an action plan. CQC reviewed the provider’s action plan and felt that the actions the provider was taking reduced the risks sufficiently enough that urgent enforcement action was not necessary. However, CQC will continue to closely monitor the service on a weekly basis until the risk had further reduced.
What we found:
The service did not consistently provide safe care and treatment. Staff did not consistently monitor and manage risks to safeguard clients from harm. Identified risks did not always have a management plan created for staff to know how to minimise a client’s risk. Clients detoxing did not consistently have physical health checks completed.
Medicines were not managed safely, and staff did not have clear guidance on how to manage medicines safely and when to appropriately administer as required (PRN) medicines.
Managers did not ensure that staff received appropriate specialist training in substance misuse, detox or mental health. Mandatory refresher training was not consistently completed by staff on time. Staff told us they did not consistently receive regular supervision of a good standard. This meant the provider did not ensure staff had the knowledge and skills to meet the needs of the clients.
Staff did not consistently manage unplanned discharge well and did not always ensure people whose needs it could not meet were appropriately supported on discharge from the service.
The service was not consistently well led, and the governance processes did not always ensure clients were safe or that staff were supported. Lessons were not always consistently learnt or shared to improve the service.
However:
The provider, following inspection feedback, responded to the concerns raised and put measures in place to ensure clients were safe while they took action to improve the service.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment.
They provided a range of treatments suitable to the needs of the clients.
8 January 2019
During a routine inspection
The service was last inspected in 2016, at which time we did not rate independent substance misuse services.
Following this inspection:
We rated Recovery Lighthouse as Good because:
- The service was well staffed, with well trained and experienced staff to care for clients. Staff put into practice the service’s values, and they had contact with managers at all levels, including the most senior.
- The service was clean, comfortable and homely, having recently been redecorated and refurnished to a high standard.
- All clients had holistic care plans, stored on an electronic case management system with all other relevant records.
- Clients spoke very highly about their experiences of the service, their relationships with staff and the impact the service had on their lives.
- There were policies in place to manage risk, including to clients leaving treatment prematurely and clients who were at risk of self-harm. All clients had risk assessments and detailed risk management plans for every identified risk.
However
- Medical admissions records, including assessments, were stored in paper files separate from the electronic system and were not always complete.
- While the service had safe policies in line with national guidance to support people undergoing detoxification programmes, staff did not consistently request or obtain medical summaries from clients’ GPs prior to starting treatment.
10 August 2016
During a routine inspection
We do not currently rate independent standalone substance misuse services.
We found the following areas of good practice:
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The service had enough trained and experienced staff to care for this number of clients and their level of need. Staff put into practice the service’s values, and they had contact with managers at all levels, including the most senior.
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The service had safe policies and practice in line with national guidance to support people undergoing detoxification programmes.
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Clients were highly complementary about the support and care they received during their detoxifications.
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There were policies in place to manage risk including for clients who wanted to terminate their detoxification early.
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The service had strong links with community services to support clients during and after their detoxification programmes.However, we also found the following issues that the service provider needs to improve:
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Although toilets and bathrooms had signs on doors indicating which gender they were for, men and women used all toilets and bathrooms regardless.
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Staff did not monitor the temperature in the room where the controlled drugs were stored.
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Staff searched clients’ belongings when they were admitted to the service, however there was no search procedure in place and clients were not told this would take place prior to admission.
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It was not easy to follow the medicine reduction regime for some clients as medicine administration was not clearly recorded across all medicine recording documents.
- There was no system in place to service the service’s digital blood pressure monitor.
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The service did not use treatment outcome tools to measure the effectiveness of the treatment they provided.
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There were no leaflets offering information about advocacy or treatments available in the service.
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The service did not set key performance indicators to measure their performance.