Croydon Adult and YP SMS

Updated 13 January 2023

Croydon Adult and YP (Young Person) SMS (substance misuse service) is provided by Change Grow Live, who deliver a not-for-profit drug and alcohol treatment service nationally. The service provides specialist community treatment and recovery support for adults and young people who live in Croydon. The service mainly provides treatment and support from Lantern Hall, but the young person team is co-located with other services at a separate community site.

Croydon Adult and YP SMS offers a range of services including initial advice; assessment and harm reduction services including needle exchange; prescribed medicines for opiate detoxification and stabilisation; community alcohol detoxification; referrals to inpatient detoxification; naloxone dispensing; group recovery programmes; brief interventions for young people; one-to-one key recovery worker sessions; and doctor and nurse clinics.

The service works in partnership across Croydon with other agencies, including NHS services, social services, probation services, charities, GPs and pharmacies.

At the time of the inspection, the service was supporting and/or treating just over 1200 clients. There were approximately 40 staff.

The service is registered for the following regulated activity: Treatment of disease, disorder and injury. The service was registered on 15 October 2021 having taken over from a different provider. There was a registered manager at the service.

This was the first time we have inspected Croydon Adult and YP SMS.

What people who use the service say

Most people were very positive about the service they were receiving and about the support offered by staff. Care and groups were non-judgemental and met clients’ individual needs. They said staff were friendly, respectful and compassionate.

The service offered clients the opportunity to complete a feedback survey in July 2022 and 37 clients responded. Clients raised some concerns about their experiences in the reception area including waiting times, the environment and décor, and having clearer information on display. At the time of our inspection, some changes had already been made and some were ongoing. One client we spoke with said their experience had improved since they complained about waiting times.

Updated 13 January 2023

The service provides specialist community treatment for adults and young people affected by substance and alcohol misuse who live in Croydon. This was our first comprehensive inspection of this service.

We rated it as good because:

• We rated the service as good for effective, caring, responsive and well-led.
• Staff assessed and managed most risks well and followed good practice with respect to safeguarding. The premises where clients were seen were safe and clean. Young people were kept separate from adult clients.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The team included or had access to a range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
• Staff treated clients with compassion and kindness and understood their individual needs. They actively involved clients in decisions and care planning.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
• The service was well led, and the governance processes mostly ensured that its procedures ran smoothly.

However:

• We rated the service as requires improvement for safe.
• Clients receiving community detoxification for alcohol misuse did not receive face-to-face contact from clinical staff for the first three days of their detoxification as per the provider’s policy. Furthermore, staff did not regularly use the alcohol withdrawal scale tool or always record the contact details of clients’ named person.
• The number of clients on the caseload of some recovery workers was high. Caseloads in the opiate and alcohol teams were over 75 for some recovery workers. Some staff told us this felt high and they could not provide all clients with holistic care.
• Emergency medicines and equipment were not always managed appropriately. Staff did not complete a record to show which emergency medicines and equipment were present, and that they had been checked.
• Meeting minutes did not always contain details of discussions. This meant absent staff could not update themselves on current trends, issues and learning.
• Staff did not always receive supervision in line with the provider’s policy, although staff did feel well-supported.
• Staff did not always update the referral tracker they used to monitor their contact with clients between referral and allocation.
• The service did not have a clear schedule of local and provider-level audits and some actions from audits had not been completed.

Updated 13 January 2023

See summary above.