We do not currently rate independent standalone substance misuse services.
We undertook this inspection to check the progress the provider had made in addressing the breaches of regulation identified at the previous inspection in March 2017. The regulations breached were regulation 12(safe care and treatment) and regulation 17(good governance). The provider had made improvements in all of the areas we identified at the last inspection.
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At the March 2017 inspection, we found that the provider did not supervise clients who were prescribed their initial dose of medicine. At the July 2017 inspection, we found that the provider had put plans in place to ensure that clients were supervised whilst taking the first dose of medicine. The service had implemented a new supervised consumption protocol and assessment tool.
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At the March 2017 inspection, we found that clients did not receive the appropriate physical health checks including regular drug screening. At the July 2017 inspection, we found that clients received comprehensive physical health checks during treatment and clients frequently completed drug screenings.
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At the March 2017 inspection, staff did not regularly liaise with clients’ individual general practitioners (GPs). At the July 2017 inspection, most clients had agreed for the provider to communicate with their GPs. When clients refused for the service to communicate with their GP liaison, the service commenced a reducing medicine dose regime with a view to discharge them. This was to ensure their safety.
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At the March 2017 inspection, the provider did not manage medicines safely because the providers systems were disorganised. At the July 2017 inspection, the provider managed medicines safely.The provider had put effective systems in place to ensure that prescription records were maintained.
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At the March 2017 inspection, staff did not comprehensively assess risks for individual clients. At the July 2017 inspection, staff assessed potential client risks and put risk management plans in place to support them.
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At the March 2017 inspection, not all clients received regular medical reviews with an appropriately qualified clinician. At the July 2017 inspection, clients received regular medical reviews with the prescribing doctor or the non-medical prescriber (NMP).
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At the March 2017 inspection, the provider did not have comprehensive policies and procedures in place that covered the care and treatment of clients using a community based substance misuse service. At the July 2017 inspection, the provider had updated the policies, which followed best practice guidance.
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At the March 2017 inspection, the provider did not have robust systems in place to ensure that the delivery of care and treatment was safe.At the July 2017 inspection, the service had put effective governance systems in place to ensure the quality and safety of the service was assessed and monitored.
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At the March 2017 inspection, clients did not always have care plans in place that supported their needs. At the July 2017 inspection, clients’ needs were assessed and care planned.
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At the March 2017 inspection, the service had not updated the training and development policy to reflect the training expectations for all staff. At the July 2017 inspection, the training and development policy clearly outlined the training requirements for all staff.
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At the March 2017 inspection, the provider did not regularly service and clean medical equipment. At the July 2017 inspection, the service manager had put an effective system in place to ensure that all medical devices was serviced and cleaned regularly.
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At the March 2017 inspection, staff did not always record when they had carried out psychosocial interventions with clients. At the July 2017 inspection, staff carried out brief interventions with clients and recorded when this had taken place.
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At the March 2017 inspection, the provider did not document when staff had received an initial work induction. At the July 2017 inspection, the provider had implemented new staff induction forms and recorded when a work induction had been completed.
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At the March 2017 inspection, clients did not have access to a range of leaflets that informed clients about opening times, or community groups such as alcoholics anonymous. At the July 2017 inspection, clients were able to access a range of leaflets that provided information about treatment and community support networks.
At the last inspection in March 2017, we found that the service was providing unsafe care and treatment. We wrote to the provider expressing our concerns and asked the provider to take immediate action. The provider voluntarily agreed to not admit new clients into the service until the service had improved. After this inspection it was agreed that the provider could start to accept new referrals.