Liberty House Clinic Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We rated effective as good. We assessed 3 quality statements. Staff provided a range of treatment and care for people based on national guidelines. Some people were supported to have involvement in the development of their care plans, however additional care plans were not always created when needed.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People we spoke to told us they felt involved in their recovery. There was a plan on the board in the communal area which shared information about what was happening each day which people found helpful.

Staff did not always create comprehensive care plans to support more complex presentations. There were instances where people with complex needs did not have additional care plans in place specific to those needs. This suggested a need for more thorough planning and management strategies for people with complex needs. Audits of clients’ records demonstrated some good compliance but there remained room for improvement. Despite high levels of compliance observed in the audits from August 2023 to January 2024, there were key areas identified for improvement. These included the lack of detailed narrative in client records, omission of physical risk of detox in care plans, and incomplete observations. Staff recorded generic responses to non-compliance with treatment. When non-compliance was identified, the actions taken notes were generic and lacked specificity. This suggested a need for more targeted and concrete actions to address non-compliance issues.

People’s care needs were not always routinely reviewed. We looked at care plans and saw not all details were up to date. Staff monitored and recorded when care plans had not been completed fully and we saw that leaders reviewed this and attempted to improve compliance. There was a clear auditing processes in place for people’s records which identified some gaps in compliance. These gaps included a lack of comprehensive assessments, a lack of specific care plans for complex issues, generic responses to non-compliance with treatment, and incomplete documentation.

People were supported to care for their physical health and staff escalated concerns to the off-site medical staff if required. Some people were involved in developing their care plans, however not all care plans we reviewed reflected the voices of people who used the service.

While staff delivered care in line with national guidance, the model of care delivered at the service was not always aligned with best practice. Doctors assessments were carried out virtually, rather than in person, and incidents continued to take place at the service, including incidents of seizures. Staff developed a care plan for each person that mostly addressed their mental and physical health needs.

The service had processes in place to ensure people received care, treatment and support that was in line with national guidance. Staff provided a range of care and treatment suitable for the people in the service. The therapy programme was based on the 12-step model, which is a recognised programme for people with addictive behaviours. People were provided with 1-1 and group therapy based on the 12-step model.

People generally felt that staff worked well with them to support their needs, however some people and their carers expressed concerns over their discharge plans not being put in place until shortly before they were due to leave the service.

The service had 3 doctors who worked with the service to assess new admissions and provide remote support with the possibility of coming to the clinic if they needed to. The doctors informed us that they were involved in governance meetings at the service and told us that staff were good at referring issues to them if they had concerns. Therapists liaised with support workers to share relevant information about people to improve the service provided in therapy sessions. Teams had effective working relationships with other teams in the organisation. Staff collaborated with other similar locations operated by the same provider. Staff did not have many working relationships with external teams and organisations, because most clients were generally only in the service for a short period of time. However, we saw evidence of liaison with other agencies such as a housing department and local GP in the process of discharge planning.

We observed a handover meeting between therapists. The environment was crowded and noisy, making discussions hard to hear. Frequent interruptions occurred as people entered the room to make requests, causing therapists to pause their discussions. Despite this, therapists managed to share information and group details amongst themselves. However, the method of sharing important group information to the support team was unclear and appeared to be carried out through a review of record entries.

The service had a system in place for different staff groups to work together for the safety of clients. For example, the service operated a secure, shared electronic client record system where records could be accessed by staff virtually, including the doctors who did not work on site. However, systems and processes to access physical and mental health records from external organisations were not robust and staff did not always have access to all of the information they needed.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.