8 August 2017
During a routine inspection
We do not currently rate independent standalone substance misuse services.
We found the following areas of good practice:
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The service had enough staff to care for the current caseload of clients, with the average number of clients per each member of staff depending on individual complexities and comorbidities.Staff received timely supervision and appraisals and completion of all mandatory and additional training was up to date.
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The service had a GP medical lead and a non-medical prescriber. The service had volunteers and recovery champions, who were people who had experience of previously using substance misuse services.
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Clients and staff both spoke highly of the positive atmosphere and sense of family across the service with a good rapport between staff and management.
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Clients who we spoke with were positive about their experiences of the service. They felt they were treated with dignity and respect by staff. They felt involved in their treatment planning and decisions while being provided with information about their care programme.
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Staff completed comprehensive assessments of clients, which included risk, which staff used to develop recovery plans. The holistic assessment clients’ captured drug usage, physical, social and mental health care needs.
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The service had introduced a number of innovative approaches. It had also participated in a number of research projects with the aim of improving the health and social wellbeing of clients.
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There were established pathways for referring clients to the service from community detoxification services, GPs, the courts and the police. There were no waiting lists, and clients were usually seen within a few days of referral.
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Staff were able to identify and respond to risks and concerns including safeguarding and unexpected exits from treatment.
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Support and substitute prescribing was provided in accordance with national guidelines.
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Incidents, audits and complaints were reported, and reviewed centrally by the governance team at Addaction. Lessons learned were shared with staff using developmental techniques which focused on individual learning.
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The service monitored its performance and its impact on clients which it shared with commissioners and local partners.
However, we also found the following issues that the service provider needs to improve:
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The service had no provision for monitoring safeguarding alerts they had raised.
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The service did not notify the CQC of the deaths of clients who were being prescribed under a shared care arrangement and where the regulated activity was not being provided by Addaction.