Archived: Lifeline Bolton

Updated 24 April 2017

Lifeline Bolton is one of the agencies involved in Bolton’s integrated drug services, providing community drug services to the population of Bolton. The service supports clients who have a dependency on either or both alcohol and drugs. The service can offer a range of time bound interventions following medical, psychosocial and harm reduction models these can be tailored to specifically meet the needs of the client.

The Bolton Integrated Drug Service consists of

• Lifeline Bolton who oversees the service and also provides the psychosocial and harm reduction service

• St Martins Healthcare (Services) CIC who provide the community detoxification service and

• Arch Initiatives who provide the referral and triage and case management service.

The service can be accessed by self-referral, referral by general practitioner (GP), referral from the hospital team or other stakeholders and partners including criminal justice organisations. All clients go through a single access point where their care plan and the intervention that was most likely to meet their needs were discussed with them. They were then referred on to detoxification and clinical service, community psychosocial or harm reduction teams.

Lifeline Bolton is registered to provide the following regulated activities: treatment of disease, disorder or injury and diagnostic and screening procedures. Services that came under treatment of disease, disorder or injury included clinical services subcontracted to St Martins Healthcare community interest company. Services that came under diagnostic and screening procedures included the taking, sending off, analysis and communication of blood results for steroid drug users.

At the time of the inspection there was a registered manager in place who oversaw the running of the service and made sure that the service complied with the regulations we inspect against. The service did not store or manage controlled drugs and therefore did not require an accountable controlled drugs officer.

Lifeline Bolton has been inspected once before in May 2013. The service was compliant against the essential standards we looked at on that inspection.

Updated 24 April 2017

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The locations were well maintained and clean. There were arrangements in place to ensure subcontracted clinical services had well-equipped clinic rooms. There were appropriate staffing levels with low levels of sickness and minimal use of agency and bank staff. There was a risk assessment in place on clients accessing mainstream community drug and alcohol services we looked at. The worker supporting clients to use steroids safely had a comprehensive understanding of the risks of inappropriate steroid use. There were arrangements in place to report incidents. Following a serious case review which included identified improvements for Lifeline Bolton, changes had been made to address the concerns raised in the review.
• Staff at Lifeline Bolton offered a wide menu of groups and interventions to support treatment and recovery. Staff delivered recovery-focused care that took into account clients’ holistic needs. Staff used a range of tools to support the delivery of care and to monitor outcomes which followed evidence-based practice and national guidance. Lifeline Bolton staff worked closely with medical and nursing staff who provided the subcontracted clinical services and staff in external agencies. Staff received regular supervision sessions and had received a recent annual appraisal. Staff understood how impaired capacity might affect decisions on care and treatment.
• Clients described receiving a good quality service which helped promote their recovery, met their needs and provided the help they needed. We observed staff providing person-centred care. There was an ethos of not judging clients for their current or past substance misuse. Clients could see where they were in the recovery journey through a road to recovery visual poster. There was an active service user forum which provided feedback from clients on how the service ran and how it could improve. There was a ‘you said, we did’ noticeboard showing how managers had taken action following client feedback.
• Clients were seen quickly and there were no significant waiting lists for the services provided by Bolton integrated drug and alcohol service. Appointments ran on time. The service routinely offered in the evenings and at the weekend. The buildings were well-furnished and welcoming with facilities for disabled people. Staff were reaching out to local mosques to improve awareness of the service and uptake to people from who were Muslim, the majority of whom were from south Asian backgrounds. Clients knew how to make complaints and there was information on making a complaint held in reception areas. There were a small number of upheld complaints which resulted in staff ensuing lessons were learnt and changes to practice.
• Staff were complimentary about team leaders and managers and felt supported. Staff reported morale being good despite the service going through a tendering exercise in the near future. Managers were consulting and engaging staff about the likely planned changes. Managers carried out regular checks to help monitor service delivery, team performance, incidents and risks. Staff were committed to working in partnership; there were regular partnership meetings to discuss and address the challenges of working in a partnership formed by commissioners. The provider had plans to improve quality and develop services including plans to introduce a ‘take home’ naloxone service in the near future.

However, we also found the following issues that the service provider needs to improve:

• There were gaps in the staff recruitment processes with missing information on personnel records. This meant that managers were not keeping records to assure themselves fully that all staff were of good character.
• The case management and risk management responsibilities were held by another organisation and managers recognised the need to continue to address the complexities of the responsibilities in the partnership.
• Although clients accessing the service for steroid use were informed of the risks of abusing steroids, this was not formulated into a care plan and a risk management plan.

Updated 24 April 2017

We do not rate standalone substance misuse services.