Ask Sheila - Archive England

Sheila Scott OBE has now retired and therefore is no longer available to answer your social care questions. However, you might still find the answer you’ve been searching for down below.

06th January 2016

Residential unit for people with substance misuse

Hi Sheila,

I am a registered manager in am adult clinic which is a residential unit for people with substance misuse.

I have a friend who also manages a similar service and she was told by the CQC that clients should have a key for their rooms.

For me this highlights significant problems and risks.

Please could you share your thoughts



Dear Danielle,

Thank you for your question.

You are the Registered Manager and therefore you carry the responsibility for the way the service is managed.

Like you I am surprised that this blanket approach has been suggested by a CQC inspector.

I am not an expert in the provision of services caring for people with a history of substance misuse but these are my thoughts:

  • This is primarily an issue about risk.
  • There are many people involved in the care of your service users.
  • I believe that family, friends and health professionals should be involved in any risk assessment and decision as well of course as the service user.
  • Any decision that is made should be subject to regular review.
  • The outcome may not be the same for each service user.
  • Any risk assessment that you undertake should be wide ranging to cover all the issues and the reasons for the decision.

If you want to discuss this further or if your colleague does please email me again.

Best wishes.


*All information is correct at the time of publishing.

About Sheila

Sheila Scott OBE has now retired and over the years , prior to her retirement she has answered thousands of your social questions. You can still access the many questions below.

For Sheila Scott OBE as the former CEO of National Care Association (NCA), care is Sheila's life. She possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business, and as a leader in the care sector.

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