Drug and alcohol rehab centre placed in special measures after user attempted to harm themselves

Inspectors from the Care Quality Commission made the decision to place Salus Withnell Hall and CAIS at Salus – both under one roof at Withnell Hall in Bury Lane, Whitnell – in special measures after coming across a number of concerns earlier this year.

One incident for CAIS at Salus, which specifically offers drug and alcohol detox, saw one service user attempt to harm themselves through self-ligature, resulting in emergency assistance called to help.

Inspectors said this was something staff “could have been avoided” if full risk assessments had taken place.

It was known that the user was found to be at risk of self-harm – but the matter was “not explored” and there was “no evidence that the risk was addressed or mitigated”.

A second user also had a history of seizures during previous withdrawal episodes, but no care plan was put in place to minimise the likelihood of this happening again during their stay.

“This meant staff were not always aware of the potential risk to or posed by clients,” inspectors noted.

There were positives, with users treated with compassion and kindness – but because no comprehensive assessments of risks and needs were carried out, a “true ethos” of respect and support couldn’t be demonstrated.

Inspectors also said that this showed staff didn’t fully understand individual needs and develop adequate recovery plans.

But staff themselves said they felt respected and valued by management, with inspectors saying they worked well as a team.

Staff also respected users’ privacy and dignity, and treated them with compassion and kindness.

The service was rated inadequate overall – as well as inadequate regarding safety, effectiveness, and leadership.

Salus at Withnell Hall, a 27-bed psychosocial rehabilitation service, was also found to have numerous failings.

Staff hadn’t fully assessed users physical and mental health needs to ensure their needs could be met, with inspectors noting that the risk management plan "was not implemented in an appropriate way" for one user who posed a risk of "self-harm or suicide".

They added that staff did not “check sufficiently” on this user, especially during the night.

Only one out of nine staff had received first aid training and there was not enough staff on duty throughout the night and at weekends.

But rehab users were encouraged to live healthier lives, with them temporarily registered with a local GP who visited weekly.

The service also had positive feedback from clients and inspectors noted good examples of staff working well with outside agencies.

The service was rated inadequate overall as well as in categories regarding safety and leadership.

It was rated requires improvement for effectiveness and responsiveness, and good for care.

Both inspections took place in January this year, with the findings published in July.

And while some areas of improvement have been acknowledged, Salus Withnell Hall said it has challenged a number of ratings in the reports. It also stressed that the findings are now dated due to a “delay” in publishing the reports.

A spokesman said: "We have noted the findings of this Care Quality Commission inspection in full. We are pleased that the inspectors have recognised the overwhelmingly positive feedback from our clients, who they find are effective partners in their own care and who are treated with compassion and kindness.

"We are also pleased that inspectors saw good examples of staff working with outside agencies and partners in the community. They go on to note that eighty-three percent of patients beginning their detoxification at Salus Withnell Hall go on to complete it, with the support of a full therapeutic activity programme.

"While we acknowledge some of the areas marked for improvement, we take issue with a number of the ratings in this inspection report and have accordingly submitted a formal challenge.

"It is also a matter of regret that the publication of this report has been significantly delayed. Accordingly the findings, which remain under challenge, are substantially dated. We will, of course, continue to work with the CQC in discharging their concerns.

"Salus Withnell Hall is committed to a continuous programme of improvement and is now working with long-established treatment charity, CAIS, to further develop the services offered at the facility.

"In the face of continuing cuts to substance misuse services and the closure of dozens of similar units across the UK, the owners have worked hard and invested heavily to maintain a welcoming and safe facility for individuals experiencing drug or alcohol problems.

"Salus Withnell Hall remains open for individuals seeking treatment. We are confident that residents will receive a high standard of care and will be supported on a sustainable journey to recovery. Any prospective resident, or other interested party, is welcome to visit us to see for themselves the excellent therapeutic environment and to meet our experienced and committed team."

Professor Ted Baker, the CQC’s Chief Inspector of Hospitals said both services will be kept under review with further inspections expected.

Professor Baker noted if there is not enough improvement "we will move to close the service”.