Francis House

Updated 19 March 2019

Francis House, in Southampton, is one of three substance misuse residential rehabilitation and detoxification services provided by Streetscene Addiction Recovery Service.

Francis House has 18 beds and offers a 24-hour service for males and females. Clients receive treatment for substance misuse problems. There were 14 clients receiving treatment at the time of our inspection. The majority of the funding arrangements are through statutory organisations. However, the service does accept self-funders.

At the time of the inspection there were six clients receiving treatment for substance misuse problem at Francis House.

Francis House has been registered with the Care Quality Commission since 20 January 2011. The service is registered to provide accommodation for persons over 18 years of age who require treatment for substance misuse. There is a CQC registered manager in place.

The previous inspection was in February 2016 where the service was not rated. There was no breach of regulations at that inspection.

Updated 19 March 2019

We rated Francis House good because:

• Clients who used this service were active partners in their care. Staff were fully committed to working in partnership with people and making this a reality for each person. The service had a strong recovery ethos with staff devoted to ensuring that clients had excellent outcomes. Clients praised the staff in helping them open-up and talk about areas of their life they had previously kept to themselves.

• Staff were highly motivated and inspired to offer care that was kind and promoted clients’ dignity. Staffing levels were safe and there were plans in place to cover vacancies, sickness and annual leave. There was a positive culture within the house, staff felt respected and valued as members of the team and there was support from the registered manager. Staff received supervision and an annual appraisal.
• Staff had good knowledge of safeguarding procedures that helped them protect vulnerable adults from abuse. Staff reported incidents as they arose and learnt from accidents and incidents in the house.
• The service provided care based on National Institute for Health and Care Excellence guidance. Both one to one time and group work was provided. Staff monitored and addressed physical health of clients in the house. Staff received mandatory and specialist training and they had a good understanding of the Mental Capacity Act.
• Francis House was visibly clean and there were arrangements in place to ensure the service was kept clean and tidy. The manager completed environment health and safety checks, this included an assessment of ligature points.
• There was no waiting list for the service. In the event of clients relapsing, staff tried to work around triggers for relapse. The service had a range of rooms for clients, including living rooms, a large dining room and a multi-faith room. There was wheelchair access and access to outside space. Staff provided care according to ethnic, cultural differences and personal preferences. Staff supported clients to access and attend external support groups.
• Clients knew how to complain. Policies were in place to guide staff within their work. Managers and staff conducted audits. The provider maintained and discussed the organisational risk register. Clients had regular opportunities to give feedback about the service, including; house meetings, evaluation forms, suggestion box and a feedback book.

However:

• Staff did not complete comprehensive risk assessments for clients admitted to the service and there was no evidence of crisis planning. Staff did not complete individualised care plans for clients accessing the service. Staff did not document discharge plans. Staff kept a lot of information in their heads and this was not translated into the documentation. There were blanket restrictions in place.
• Medicines were not always prescribed safely due to staff not using medicines reconciliation processes as routine. This means that staff did not routinely check that the medicines they were giving were the ones prescribed by the GP.
• The service did not have sufficient governance systems in place to ensure sufficient oversight and risk management of incidents and safeguarding. Managers therefore did not monitor to look for trends, this meant that if the same incident kept on occurring then there was no oversight to look at the reasons why or for example, if there was a gap in staff training.

Updated 19 March 2019