Residential Rehabilitation Services: recommendations on clinical governance

Conclusion

This report shows that RR services play an important role in supporting people with complex needs, but current clinical governance is inconsistent and leaves gaps in safety and quality. Regulation is fragmented, detoxification practices vary widely, staff often lack the necessary clinical training, and limited data makes it difficult to monitor performance or improve services.

The recommendations focus on creating clearer and more consistent oversight, supported by specific clinical guidance for residential settings. They also highlight the need to expand safe detoxification and stabilisation options, strengthen pathways between services, improve staff skills, and ensure better data collection. A stronger approach to harm reduction—such as naloxone provision, relapse‑prevention support, and safer discharge processes—will further reduce risk.

Together, these recommendations aim to build a more coherent, better regulated, and clinically robust system that improves safety, strengthens public confidence, and ensures people receive high‑quality care throughout their recovery journey.