CGL Lewisham New Direction

Updated 16 September 2022

CGL Lewisham New Direction is part of Change Grow Live, who deliver a not-for-profit drug and alcohol treatment services nationally. The service provides specialist community treatment and support for adults affected by substance misuse who live in Lewisham.

They offer a range of services including initial advice; assessment and harm reduction services including needle exchange; prescribed medicines for opiate detoxification and stabilisation; naloxone dispensing; group recovery programmes; one-to-one key working sessions; and doctor and nurse clinics, which includes health checks and blood borne virus and hepatitis C testing. At the time of the inspection, the service was seeing clients face to face and remotely.

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

At the time of inspection, around 500 clients were in active treatment at the service. The service had 18 recovery coordinators, two admin staff, four team leaders, six clinical staff, one deputy service manager and one service manager.

The service is registered for the following regulated activity: Treatment of disease, disorder or injury. The service was registered on 24 April 2019. There was a registered manager at the service.

This was the first time we have inspected CGL Lewisham New Direction

What people who use the service say

Most clients that we spoke to were extremely positive about the service they were receiving. Multiple clients told us that they felt the service had saved their life and they were incredibly appreciative of the help and support they had received.

Clients felt involved in their care and treatment. Clients told us that they felt listened to and particular treatments weren’t forced on them by staff.

Most clients told us about issues with contacting the front desk at the service, but nearly all clients said that their key workers were easy to contact and responsive.

One client we spoke to was unhappy with the quality of the service, they told us that they had to repeat themselves to their keyworker on several occasions. They also told us that their key worker had changed multiple times in a short period of time.

Updated 16 September 2022

Our rating of this location was good because:

• The service provided safe care. The premises where clients were seen were safe and clean. Staff managed risk well.
• 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 teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
• Most clients that we spoke to were happy with the level of service they were receiving and felt well supported by staff.
• 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:

• The number of clients on the caseload of some key workers was high. Caseloads in the opiate team were over 80 for some key workers. Staff told us this sometimes prevented from giving each client the time they needed.
• The care and treatment records we reviewed contained all the necessary information, but the risk assessments were not always clear about what was a current or historic risk.
• Eight per cent of clients had not received a medical review or a non-medical prescriber review in the last 12 months, in line with the services policy and procedures.
• Some risks that we identified during the inspection, such as overdue medical reviews, were not recorded on the service’s risk register although the provider was aware of this and taking steps to address the outstanding reviews.
• There was no clinical oversight of new self- referrals at the time of inspection. This meant that client risk may not be appropriately identified. The service had implemented a new system following our inspection.
• Psychosocial interventions offered by the service were still running at reduced capacity following the covid-19 pandemic.

Updated 16 September 2022