Calderdale Recovery Steps Carlton Street

Updated 31 October 2022

Calderdale Recovery Steps is a community substance misuse service providing care and treatment for people who misuse substances in Calderdale in West Yorkshire. It is part of a large national charity called Humankind. The service provides treatment and recovery services to adults and young people. This includes, pharmacological and psychosocial interventions, recovery activities including groupwork and also individual sessions. The adult service is co-located with a recovery organisation in the centre of Halifax and the service for young people takes place in various locations across the catchment area. The adult service also has a number of satellite clinics across the catchment area.

The service was first registered with the CQC in April 2018 to provide one regulated activity: treatment of disease, disorder or injury. There was a registered manager in post when we inspected the service, and this is the second time we have inspected the service since it was registered. When we last inspected the service, in January 2019, we found it good in all the domains, and good overall.

The service was not required to have a controlled drugs accountable officer in place, but they did have a person within the organisation to oversee controlled drugs governance arrangements and report any controlled drugs related incidents.

We carried out this inspection because the provider told us they had moved the service to new premises.

What people who use the service say

We spoke with seven clients, including two from the young persons’ service and four carers. They all told us staff were compassionate, caring and went out of their way to provide person centred care and support. Clients thought that generally, all staff they came into contact with were helpful, responsive and flexible in the way they delivered services. Clients from the young persons’ service said, ‘it was a really good place’ and staff gave them lots of practical help and advice about living a healthier lifestyle. They also got a lot of support with physical health issues. Overall, people felt that staff listened to them and they were involved in their treatment. Clients told us they liked the building and that it was a safe space for them. They said there were lots of activities on offer and their appointments were never cancelled. The only negative comment we received was that sometimes, there was a lack of private one-to-one space available for keywork sessions.

Updated 31 October 2022

• Staff were committed to working collaboratively with other services and with each other. They found innovative ways of delivering more joined up care to clients, particularly those with complex needs and those that struggled to maintain contact with the service. For example, they could dispense methadone on-site to clients at risk of disengaging from treatment. Clients received seamless care that was tailored specifically to their individual needs. Managers proactively encouraged staff to acquire new skills and recognised that staff skills and competence were integral to providing high quality care.
• Staff were consistent in supporting clients to live healthier lives, including identifying those who needed extra support, through a targeted and proactive approach to health promotion and prevention of ill-health. Young people had access to specialist interventions from a dedicated young persons’ service. Teams used assertive outreach and satellite clinics to provide access to treatment in the places where clients lived and socialised. They provided clients with the full range of treatment options suitable to the needs of the clients and in line with national guidance and best practice, for example, they used self-management and recovery training with clients and mapping techniques to help clients engage with care planning. Staff engaged in clinical audit to evaluate the quality of care and continually develop different ways of delivering treatment. They were developing specific risk assessments and targeted interventions to reduce the risk of fatal overdoses related to opioids.
• Clients and carers consistently praised staff for the way they treated clients. Clients from the adult and young persons’ service, told us staff respected and valued them as individuals and thought staff exceeded their expectations in supporting their emotional and practical needs. Staff treated people with compassion kindness and empowered them to be active partners in their own care. They understood the individual needs of clients and supported them to understand and manage their care and treatment. Stakeholders, including clients, carers and commissioners thought staff were passionate, highly motivated and the culture of the service was extremely person centred.
• Staff developed innovative, integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs. For example, they met frequently with local housing providers, criminal justice agencies, the department for work and pensions, adult social care and others in the local authority to identify ways of fostering and sustaining recovery for clients with social and other needs. Clients could access services flexibly and there was a proactive approach to understanding the needs and preferences of different groups of people. Some clients were offered access to prescribed treatment without having to wait, and, if they dropped out of treatment, staff could re-engage them onto a substitute prescribing regime quickly. The service worked in very close partnership with a specialist service user organisation so clients could see other clients in recovery. They had easy access to recovery activities, such as, peer-led group work, fitness classes, walking and other practical skills, including in the evenings and at weekends. They had an on-site café, staffed by clients in recovery, where clients could get a hot breakfast and other refreshments.
• Leaders at all levels of the service were compassionate, inclusive and effective. They demonstrated commitment to system wide collaboration. The governance processes ensured that its procedures ran smoothly, and staff felt supported, valued, and motivated to do their best.
• The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff assessed and managed risk well and followed best practice with respect to safeguarding. Staff were heavily involved in external safeguarding partnership work, which put adults and children at risk, at the centre of safeguarding.

However:

• Staff did not always record what action they had taken when the room had exceeded the maximum safe storage temperature for medicines.
• Staff did not routinely check that all rooms that needed them had panic alarms available.

Updated 31 October 2022