Archived: The Vicarage

Updated 6 March 2017

First Contact Clinical is a community interest company. They are commissioned by South Tyneside Borough Council to provide structured treatment to adults who have a drug and/or alcohol dependency. The service forms part of a wider treatment system, which includes harm reduction services provided by another service, and a single assessment process which all commissioned agencies are part of. Clients are assessed through the single assessment process and those who have a drug or alcohol dependency are referred to First Contact Clinical for substitute prescribing and psychosocial interventions.

First Contact Clinical deliver pharmacological and psychosocial interventions from The Vicarage, which is located in the centre of South Shields. Prescribing clinics are also delivered from Flagg Court Health Centre, a primary care centre that houses a number of GP practices and community services. Psychosocial interventions and mutual aid groups were delivered from local GP practices and community venues.

First Contact Clinical have been registered within the CQC since 2012. The Vicarage has been registered as a location with the CQC since 5 August 2016, and is registered for the treatment of disease, disorder or injury. The service has a registered manager.

This is the first time the service has been inspected by CQC.

This was an announced inspection. We carried out this inspection using our new approach of asking five key questions about the quality of the service. See the section on ‘How we carried out this inspection’ below.

Updated 6 March 2017

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The premises, including clinic rooms, were well equipped, clean and well maintained. Staff had access to a range of necessary medical equipment to carry out physical examinations.
• Staff had the necessary skills and competencies to deliver safe and effective treatment and care. This included medical and non-medical prescribers.
• Staff completed risk assessments for all clients and these were regularly reviewed. Staff demonstrated a high level of knowledge about clients and discussed risk and risk taking behaviour at treatment reviews.
• There were excellent systems in place to review and learn from incidents and changes to the service had been made as a result of these.
• There was a duty of candour policy and all managers and staff understood their responsibilities in relation to this.
• Staff used a range of appropriate, validated assessment tools to identify the needs of clients. Staff had forged excellent working relationships with external agencies to ensure the needs of clients were met.
• Clients had individual recovery plans that were holistic and person centred. Clients were actively involved in decisions about their care and treatment including goal setting.
• There were robust prescribing protocols in place which were in line with national guidelines and clients had access to a range of psychosocial interventions and mutual aid.
• Staff were encouraged and supported to attend specialist training to help them to meet the needs of clients.
• Staff demonstrated detailed knowledge of clients and had developed strong therapeutic relationships with clients.
• Clients spoke very highly of staff and felt staff were central to their recovery.
• There were clear criteria for access into the service and no waiting lists for treatment.
• Clients knew how to complain and staff dealt effectively with complaints. There was evidence of learning from complaints and changes had been made to the service as a result.
• Staff morale was high and staff were passionate about their roles and the organisation.
• There was a culture of continuous learning and improvement and staff were actively involved in service reviews and contributed to service development.

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

• There were no formal risk management plans in place for clients, which made it difficult to locate information in care records on how individual risks would be mitigated.
• Only 44% of staff had completed equality and diversity training, which was part of the suite of mandatory training.We do not currently rate independent standalone substance misuse services.