10 Harley Street

Updated 23 December 2022

A&A Consulting Limited is a medically assisted alcohol detoxification service and is delivered to people in their own homes. It has an office registered at 10 Harley Street. It is a nurse-led service and the registered manager was a nurse prescriber. The treatment programme consisted of medicines prescribed to assist with detoxification from alcohol over a 7-10 days period. Staff assessed the level of alcohol dependence before prescribing a specific dosage of medicine over a specified amount of time. Patients had to have a responsible adult with them for the duration of their detoxification. Staff visited the patient’s home each day and were available to be contacted 24 hours a day during the treatment programme.

The service generally had one patient at a time. If there was more than one patient, the service manager employed additional staff for the duration of the that patient’s treatment.

Once referred, clients spoke with staff over the telephone and then a face-to-face home visit was arranged. This was in order to assess suitability for treatment and whether the home environment was appropriate.

The service currently has no clients undertaking treatment. There are no pending referrals or any people on the waiting list.

Currently there is only one staff member who is the registered manager. Other staff were employed as and when required in order to support clients with their treatment plan.

Due to the small number of recent clients, we were unable to obtain a wide range of evidence during this inspection.

What people who use the service say

We spoke with the most recent client. They told us staff were available throughout the duration of their treatment and were very reassuring.

They said, ‘Staff were very caring and monitored how I was feeling’.

Updated 23 December 2022

A&A Consulting Limited, which is based at 10 Harley Street, provides a nurse-led alcohol detoxification service for people in their own homes.

We rated this service as requires improvement.

The service was not working with any clients and there had been only one recent client.

We found the following areas where improvement was needed:

• The service did not have adequate governance arrangements in place and did not display an understanding of what was required. Without good governance systems and appropriate policies in place, a service cannot monitor the delivery of quality care or continuously improve the quality of their services. We saw poor governance arrangements in relation to the recording of safe staff recruitment, lone working, transportation of medicines and information containing personal information, ensuring detailed care records and the proper maintenance of medical equipment used in care.
• The service did not evidence that they made reasonable effort to gather necessary information from a clients GP before starting treatment. This meant all physical health risks may not be known to the staff in order to inform safe treatment.
• Care and treatment records did not include all necessary information relating to the patient’s care. For example, reason for the admission, relapse prevention plans or evidence of daily physical health checks.
• There was no system in place to support patients to make a complaint and no information available about how to do this.

We found the following areas of good practice:

• The registered manager accessed criminal record check information when he employed someone, in line with safe recruitment practices.
• There were clear inclusion and exclusion criteria for clients who wanted to access treatment from the service.
• The client we spoke with described compassion and kindness from the service and felt well-informed about their treatment plan.

Updated 23 December 2022

See summary above for details.