Archived: South Regional Office

Updated 23 November 2018

South Regional Office, commonly known as Change, Grow, Live, is a substance misuse service providing community substance misuse treatment and care from 15 sites across the southern region of England. For this inspection we inspected four of the sites: Gloucester, Southampton, Hastings, Eastbourne.

South Regional Office was registered with the Care Quality Commission (CQC) in 2015 for the treatment of disease, disorder or injury. The sites we inspected offered a range of groups, one to one sessions, alcohol detoxification and substitute prescribing for opiate detoxification. The service has two registered managers: responsibility for the sites was split between them.

The four sites we inspected were commissioned by East Sussex (Eastbourne and Hastings), Gloucestershire (Gloucester) and Southampton local authorities. The service provide specialist community support for adults affected by drug and alcohol misuse. South Regional Office also offers support and information to friends and family members affected by someone’s drug and alcohol use. At the time of our inspection, the four sites were providing care and treatment to 3426 clients.

CQC last inspected the service in May 2017. This was a focused inspection to see if the provider had made the improvements that we told it that it must make in October 2016. These included:

• Ensuring that all staff received mandatory training.
• Ensuring that all staff received regular supervision.
• Ensure that all staff renewed their disclosure and barring service checks in line with the provider's policy.
• Ensuring that all clients had an up to date risk assessment.
• Ensure there was a sink in the doctor’s clinic room in the Chichester service.

At the inspection in May 2017 we found that the provider had made improvement in all of these areas. However, we told the provider it must:

• Notify Care Quality Commission (CQC) of all clients’ deaths (as per regulatory requirements).

At this inspection (September 2018) we found the provider had made the required improvements and were now notifying CQC appropriately

Updated 23 November 2018

We rated South Regional Office as good because:

• At the last inspection in May 2017, we told the provider it must make improvements and notify the Care Quality Commission (CQC) of all client’s deaths (as per regulatory requirements). On this inspection the service demonstrated that it had been providing notifications appropriately. The service had regional quality leads who were responsible for ensuring CQC statutory notifications were submitted.

• Lead nurses conducted monthly clinical site audits to check site cleanliness, safe medicine storage and prescription administration records that were ratified by senior managers. Action plans were then devised and followed up if issues were noted.

• The service had an appropriate number and mix of staff with relevant knowledge and qualifications to fulfil their role. All staff working at the service, including volunteers, had valid Disclosure and Barring Service checks completed before commencing work.

• Staff completed comprehensive assessments of every client at their initial appointment and had appropriate admissions criteria in place to support suitable clients. Assessments included substance misuse history, medical history, safeguarding issues, employment and social history. Staff undertook a comprehensive risk assessment of every client at their initial assessment and regularly updated them as necessary. Care and recovery plans were mostly goal orientated, holistic and included client views and wishes.
• Clients’ physical health conditions were considered as part of initial assessments and regularly reviewed. Blood borne virus testing and vaccination programmes were conducted at all sites.
• The service utilised a duty system with emergency appointments available and had staff members assigned and available for open access drop-in clients daily.
• The service had a safeguarding policy in place and staff demonstrated a good awareness of the safeguarding procedure.
• Staff spoke about clients in a sensitive, caring and professional manner. Clients were very positive about the service they received and said that staff took a genuine interest in their wellbeing.
• The service had a clear confidentiality policy in place that staff adhered to and explained to clients during the assessment process.
• The service had an appropriate ‘did not attend’ policy in place and a missed appointment tool that team managers reviewed before any unplanned discharges were made.
• Staff demonstrated an understanding of the potential issues facing vulnerable client groups and the service employed specialist staff to support these groups.
• Service leaders had the appropriate skills, knowledge and experience to perform their roles and could explain the role and function of their teams well. All management staff received in-house leadership development training.
• There was a clear clinical governance structure in place to ensure that clinical risk was escalated and managed within the service. The service held local integrated governance team meetings that fed into an overarching national integrated governance team meeting where service quality improvement plans were also monitored.

However,

• Overall appraisal rates for all inspected sites were below 65% completion but the service had plans in place to address this.

• In Gloucester, five of the eight care records reviewed did not include client views and it was not clearly documented if clients received or were offered a copy of their recovery plan.
• The Southampton site was not accessible to disabled clients. There was no access to the 1st and 2nd floors where groups were held and the emergency cord in the disabled toilet was too short to reach.

Updated 23 November 2018