Transforming Choice

Updated 16 February 2022

Transforming Choice provides residential alcohol detoxification and rehabilitation. The service provides alcohol detoxification through a regime of reducing dosages of alcohol. The detoxification process usually lasts five to seven days at the beginning of a 12-week rehabilitation programme. The rehabilitation programme focuses on building coping strategies, life skills, and reintegrating clients into the community.

The service is available to men and women aged over 18 years. There are four cohorts per year, for up to 14 clients at a time. Clients cannot join a programme after it has started.

The service has a contract with a GP (who is also the nominated individual) and nurse from a local GP practice. They assess the client’s medical suitability for the service and administer vitamin injections during the detoxification process.

The service also provides an aftercare service to support clients who have been discharged from the residential programme. There are a further eight bedrooms on the top floor of the building, for clients who have completed the programme to stay until they are able to find accommodation. These eight rooms are rented to clients on a short-term basis and are not subject to inspection by us.

The service is registered to provide the regulated activity: accommodation for persons who require treatment for substance misuse. It was registered in March 2015 and has a registered manager.

Transforming Choice has been inspected twice. We last inspected in November 2019. At the last inspection, we found the service to be good overall and good across all five key questions.

What people who use the service say

We spoke with seven clients. All seven client’s feedback was exceptionally positive. They appreciated that many staff had been through the programme themselves enabling staff to empathise with them. Clients appreciated the model of detoxification gradually with reducing doses of alcohol. Those who had experienced detoxification with medicines much preferred Transforming Choice’s method of detoxification with alcohol as they felt it was more effective and had less side-effects.

Clients described staff as truly caring. Many clients told us they had been homeless prior to coming here. They told us that they had been to many other services but felt that Transforming Choice was the best place which give them hope and support to change their life around. Many believed that their life would look very differently if they hadn’t come here. Clients told us that the 12-week programme provided an excellent start on their road to recovery which provided education on how to deal with cravings and manage thoughts and behaviours. One client said, “The classes are brilliant.”

Clients told us that staff are very respectful, nice and know what they are talking about. Clients felt safe in the service. Clients felt that the service provided truly person-centred care.

Updated 16 February 2022

Our rating of this service improved. We rated it as outstanding because:

• We rated caring and responsive as outstanding due to the excellent person-centred care, full client involvement and staff going the extra mile to support client’s holistic needs during and after the programme.
• Feedback from clients was exceptionally positive. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
• Client’s individual needs and preferences were central to the delivery of tailored services. The service was easy to access.
• Staff were all committed to involving and empowering clients in all aspects of their recovery. Staff and clients worked together to name, co-produce and develop existing and new services.
• The service worked proactively to manage people’s addictions and also the wider implications of long-standing addiction including considering the physical health and mental health impact.
• Staff supported clients fully on discharge according to their individual needs. Staff worked proactively and in partnership to develop alternative and aftercare pathways for clients.
• The service provided safe care. The premises where clients were seen were safe and clean. The service had enough staff. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• 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 and in line with national guidance about best practice.
• The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
• The service was well led, and the governance processes ensured that its procedures ran smoothly.

However:

• Although outcomes for people were good, national guidelines do not recognise a reducing alcohol regime as a fully effective detoxification programme. We have therefore limited the rating of the ‘effective’ key question to good, even though other evidence in the effective key question met the outstanding characteristics. Some research studies using small sample sizes do recognise a reducing alcohol regime as an effective treatment especially for people with complex health and housing needs. Due to the pandemic, the provider had still not been able to have its model clinically reviewed for effectiveness.

Updated 16 February 2022

Our rating of this service improved. We rated it as outstanding.

See the summary above for details