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CQC Closes Liverpool Addiction Treatment Service

A drug and alcohol addiction treatment facility in Liverpool has been closed by the health care regulator over 'serious issues' with staffing and care quality.

The Care Quality Commission (CQC) has rated We Can Recover CIC, a community interest company (CIC) that provides residential care, detoxification, and rehabilitation for people with non-opiate addictions, as 'inadequate' and suspended its registration following an inspection in November.

A focused inspection was carried out at the facility due to concerns received from people using the service regarding poor staffing levels, an unsafe environment, and a lack of support. Two clients required admission to emergency acute care following alcohol withdrawal-related seizures.

Inspection Findings 

CQC inspectors looked at the key questions of whether the centre was safe and well-led only during this inspection. They found a litany of serious issues, including that staff were not trained in essential skills to recognise and respond to people's health deteriorating due to alcohol withdrawal, and had not received other mandatory training. 

Other key issues identified during the inspection included: 

  • None of the management team had experience in delivering a medically-managed detoxification service.
  • Systems were not robust to ensure safe management of medicines and service users were exposed to serious risk of harm. 
  • Staff did not clean the environment in line with infection prevention and control procedures and follow universal masking procedures during a COVID-19 outbreak.
  • The service did not have enough nursing and medical staff working in the service to keep clients safe 24 hours a day, 7 days a week.
  • Staff did not complete effective risk assessments for each client prior to admission and on arrival.
  • Managers struggled to locate basic information that was associated with the day-to-day running of the service.
  • Staff did not have training on how to recognise and report abuse and the provider did not act in accordance with its own policy.

CQC inspectors also noted that there were some positive findings, including that the quality of the food was reported by clients to be of excellent quality and that staff were friendly and kind.

However, due to the serious issues identified, CQC took immediate enforcement action to suspend the provider's registration until significant improvements have been made, and it currently remains closed. 

Following this inspection, the CQC overall rating for the service is 'inadequate', and the areas of safe and well-led were also 'inadequate'. 

Lack of Qualifications, Competence, Skills, and Experience

Karen Knapton, CQC's deputy director of operations in the north, said: "When we inspected We Can Recover, we found several serious concerns which is why we took immediate action to keep people safe and free from harm.

"We were not assured that staff had the qualifications, competence, skills, and experience to care for clients safely. Support workers, who were caring for people in alcohol withdrawal were not competent, skilled, or experienced in either the assessment and monitoring of withdrawal symptoms or in responding to potentially very serious physical health side effects.

"There was a lack of effective medicines management to ensure clients received safe care and treatment. Staff who administered medicines, were not all suitably qualified and competent to administer medicines safely.

"We observed several ligature risks and it was concerning that staff weren’t fully knowledgeable at mitigating this type of risk especially when some people had a history of suicidal thoughts or attempts.

"It is unacceptable that people using the service reported that showers were out of order, there was no heating or hot water at night, and their bedding hadn't been changed since they arrived. In addition, maintenance issues had not been fixed in a timely manner and there were broken light fittings and televisions, as well as various trip hazards throughout the building."

She said it was also concerning that the service often didn’'t have enough staff on shift to meet people’s needs. "Managers hadn’t ensured all staff, including agency staff, received a full induction and understood the service before starting their shift. We spoke with two agency nurses who confirmed they'd had no induction or prior experience in detoxification or substance misuse services.

"We will continue to monitor the service closely to ensure the necessary improvements are made urgently to keep people safe and free from harm before we agree to lift the suspension. If we are not assured people are receiving safe care, the suspension will remain in place."