CQC Raises Serious Concerns Over Care at Residential Detox Clinics

The Care Quality Commission (CQC) has published a briefing today (Thursday 30 November) based on inspections over the last two years of the 68 services in the independent sector that have been identified as providing residential detoxification. In it, the regulator has uncovered multiple concerns.

Many of the clinics were found to be not assessing the risks to the safety of the people within their care prior to their admission; were not following recognised national clinical guidance on how to treat people who are withdrawing from alcohol or drugs; were not storing, dispensing and handling medicines appropriately and were not carrying out full employment checks or sufficiently training their staff.

Nearly three in four (72%; 49) of the providers that CQC had inspected were found to have been failing in at least one of the fundamental standards of care that anyone should have a right receive.

The regulation on ‘safe care and treatment’ was where CQC found the most breaches: 43 providers (63%) were not meeting this particular standard at the time of their first inspection.

Examples of what CQC found on its inspections include:

• Staff administering medication, including controlled drugs like methadone, without the appropriate training or being assessed as competent to do so.
• Staff giving paracetamol to people within their care more frequently than every four hours despite them already having, or being at a greater risk of having, liver damage due to their heavy alcohol use.
• Staff not having planned how they would manage a person’s epileptic fits during their withdrawal (e.g. by prescribing anti-seizure medication) despite knowing from their medical history that they were at risk of having seizures.
• Staff lacking appropriate training in basic life support, consent and mental capacity and safeguarding.
• Some units carrying out Disclosure and Barring Service (DBS) checks for newly employed staff but not at routine intervals afterwards.

Four of the services are no longer operating following the concerns raised by CQC on its inspections.
 
Rosanna O’Connor, Director of Drugs, Alcohol and Tobacco at Public Health England, said:  "Our evidence review of drug treatment services earlier this year found they were largely performing well. But we welcome the light this report shines on the clinical practice in some residential detox services, which were falling short of keeping those in their care safe and providing the best springboard for recovery.

"While residential detox makes up a small part of the overall treatment system, seeing about 1% of all in treatment, they do have a vital role. It’s crucial these services are in line with best practice, as the Clinical Guidelines on drug treatment clearly sets out. This helps ensure not only safety but gives some of the most vulnerable and disadvantaged people the best chance of getting their recovery on track.

"PHE has already been working with these services to help them improve and we will continue to provide this support."