Cranstoun Worcestershire

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Clients needs were assessed using a range of recognised tools to meet their individual needs and these were regularly reviewed. Staff held regular multidisciplinary meetings to discuss clients and improve their care. Staff involve clients in their treatments and outcomes. Staff attended regular supervision, appraisals and team meetings were good practice was shared alongside any changes to local and national guidance. The service participated in clinical audit, benchmarking and quality improvement initiatives.

This service scored 12 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

All clients interviewed stated that they had been involved in their assessment and risk management process and support was provided to maximise their involvement. One client stated that the care and risk planning process was an equal partnership split between the client and their worker. Clients told us that their needs had been assessed by competent staff. One client told us that they talked things through with their worker and that they came to mutual decisions. Two clients also told us that they had now had a recovery wheel in place as a result of their assessment. One client spoke positively about staff links with both housing and a psychiatrist.

Staff had completed a comprehensive mental health assessment of each client. Staff developed a comprehensive care plan for each client that met their mental and physical health needs. Staff had regularly reviewed and updated care plans when clients' needs changed. Care plans were up-to-date, personalised, holistic and recovery orientated

Clients receive care, treatment and support that is evidence-based and in line with good practice standards. Clients told us that staff had completed comprehensive assessments with them on accessing the service. Clients told us that staff had worked with them to develop individual care plans.

Clients receive care, treatment and support that is evidence-based and in line with good practice standards. Clients told us that staff had completed comprehensive assessments with them on accessing the service. Clients told us that staff had worked with them to develop individual care plans.

Staff told us they used national and organisational monitoring tools to maintain and improve the health, well-being and safety of the patients. Staff used the electronic client records routes to recovery, which had a goal planner. Staff completed an alcohol audit to identify the clients’ level of dependency on assessment. Staff followed the drug misuse and dependence: UK guidelines on clinical management and provided education for healthy living. Staff referred to the West Midlands detox framework and one staff member worked across the service and the NHS infectious disease team. This helped to ensure appropriate treatment for Hepatitis C.

When clients receive care from a range of different services, it is coordinated effectively and collaboratively to understand and meet peoples needs. One client spoke positively about staff links with both housing and a psychiatrist. Another client spoke about how their workers had worked with other agencies to help furnish his property and buy a television.

Staff share information between services and teams to ensure continuity of care. Prescribers had good links with GPS and other services. The service worked collaboratively with a wide range of services including Multi-agency Risk Assessment Conference (MARAC), probation, the local authority, police, housing, and a range of third sector providers such as soup kitchens and local churches.

Plans for transition, referral and discharge consider clients individual needs, circumstances and ongoing care arrangements. Staff held regular multidisciplinary meetings to discuss clients and improve their care. Staff also held daily flash meetings at which all staff members were present. Staff had made sure they shared clear information about clients and any changes in their care, including during transfer of care. This was evident in discussions about a release of a client from prison and the pending admission of a client into rehabilitation.

Clients were encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing. Clients told us that staff had made sure that they understood their care and treatment. Clients stated staff had given them advice regarding detoxification and the risks of seizures and were provided with needle exchange. Clients were supported with housing circumstances and those who were homeless were signposted to access street outreach.

The service focused on identifying risk to clients health and wellbeing early and on how to support them. Staff focused on harm reduction strategies. Where a client injects substances (and has decided to continue), staff offer education around the safest site and assess existing sites used for evidence of possible infection. Staff also reported that there are a number of contaminated substances which were prevalent in Worcester. Staff advise clients of these and how to avoid infection. Clients had access to a needle exchange. Staff assertively go out into the community to deliver new needles and boxes for the safe disposal of used needles. Staff offer education and advise on smoking, alcohol and drug misuse within safe limits. Staff also advise on the need for hydration and the benefits of taking vitamins.

Clients told us that staff monitor the progress of their care and treatment.

Staff monitored clients care and treatment to continuously improve it. Staff used rating scales (for example alcohol dependency scores), to record severity and outcomes. They also participated in clinical audit, benchmarking and quality improvement initiatives. Managers maintained an incident dashboard which measured activity over a 12-month period, which indicated if outcomes had improved, stayed the same or deteriorated. The dashboard included clinical treatment, infection prevention and control, drug medication and prescription, allegations and actual abuse, self-harm, overdose or suicide attempt.

Clients understand their rights around consent to the treatment they are offered. Clients told us that they were able to make their own decisions in partnership with staff, who provided education and advice.

There were systems and practices in place to ensure clients understood the care and treatment recommended. Staff told us that the service is client led. Staff supported clients to make decisions on their care for themselves. Staff understood the service’s policy on the Mental Capacity Act 2015 and knew what to do if a client’s capacity to make decisions about their care might be impaired. Staff gave clients all possible support to make specific decisions for themselves before deciding a client did not have the capacity to do so. Some clients were subject to a court order requiring them to engage with substance misuse services. Staff worked closely with these clients together with probation and police in order to provide additional support for clients at high risk of reoffending, encouraging their engagement.