Archived: Providence Project - Rebbeck

Updated 13 December 2016

Providence Projects Rehab Group provides residential rehabilitation and substance misuse and alcohol detoxification services.

The service provides all therapy and detoxification treatment in two community-based treatment centres. Clients use the primary treatment centre when they are at the beginning of their treatment or need to receive medicine. The secondary centre was for clients who had progressed further through their treatment.

Accommodation for clients is within eight houses in walking distance of the treatment centres.

The service provides accommodation at the following locations:

• Rebbeck Road provides accommodation for four clients
• Windham, Percy, Knole and Connaught each provide accommodation for five clients
• Gordon, 6 and 16 each provide accommodation for six clients.

All of the accommodation caters for males and females. Apart from Rebbeck and Windham, each of the properties has one twin bedroom in addition to single rooms. Staff use these to provide peer support to clients who would benefit from sharing a room with a client further through their treatment programme.

Staff visit the accommodation on a daily basis to carry out regular checks and in response to concerns that arose. Staff assess clients prior to admission and develop an individual care package tailored to their needs. These can vary in length dependent on the client’s circumstances. Treatment can include medical detoxification under supervision from a local GP surgery and psychological therapies from trained counsellors.

Charities and statutory organisations such as local authorities fund treatment for clients. Other clients are able to self-fund.

CQC has registered the service to provide accommodation for persons who require treatment for substance misuse.

CQC previously inspected Providence Projects Rehab Group on 6 – 7 August 2013. On this occasion, the service was compliant with the Health and Social Care Act 2008 (regulated activities) regulations 2010.

Updated 13 December 2016

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We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• The provider had a formal agreement with a local doctor and GP surgery to provide prescriptions for opiate detoxification and medical treatment for clients. The practitioner regularly prescribed medication for opiate detoxification that guidance states is not a first line treatment and should not be used routinely. The service did not use formal rating scales to measure client’s withdrawals in line with best practice during opiate detoxification. This meant staff were unable to accurately and impartially assess the efficacy of the treatment given.
• The service placed clients at potential risk of harm. It did not provide safe supervision overnight for clients in the early stages of alcohol detoxification to ensure their safety.
• The service used structured formulaic care plans that did not capture client’s views although clients did tell us they had discussed them during one to ones with their counsellors. Staff did not provide clients with nutritional advice and support even though clients’ care plans specified this as a need.
• Governance structures were not robust and had not identified and managed areas of concern raised during the inspection. The management team was not aware of the potential risks posed to clients by the service’s practices, or that the service did not adhere to best practice guidelines. There was no formal structure for managers to provide one to one supervision of staff or for staff to feedback on the service to help it develop.

However, we also found the following areas of good practice:

• The service completed a thorough admission process including a risk assessment prior to prescribing treatment.
• There was good communication between the provider and services that referred clients to them. Referrers we spoke to were positive about the care given.
• Clients felt supported and cared for by staff. They stated that the programme provided by the service kept them safe and supported their recovery. The service actively engaged with families, providing support and information to enable them to support their relative who was in recovery.