15 July and 19 July 2016
During a routine inspection
We do not currently rate independent standalone substance misuse services.
We found the following issues that the service provider needs to improve:
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The emergency pull cord in the disabled toilet did not work. This was a breach of a regulation. You can read more about it at the end of this report.
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The service had not routinely informed the Care Quality Commission (CQC) of notifications. This is a regulatory requirement for all providers registered with the CQC. This was a breach of a regulation. You can read more about it at the end of this report.
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There was a cleaning contract, however, there were no cleaning schedules showing regular cleaning. There was no formal audit to ensure areas including the clinic room were cleaned.
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Recovery plans were not specific in their description of the identified issues. Staff had not detailed how to measure the outcome of the clients’ goals or who was responsible for completing specific areas.
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Staff did not record when clients were given copies of their recovery plans.
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Clinical waste bins were not labelled appropriately.
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The service did not always notify CQC of incidents as set out in the registration of the service.
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The service did not audit client files to ensure staff were recording and managing clients treatment appropriately.
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Staff did not all feel a part of the wider Addaction brand.
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There was a first aid box. Some of the contents were out of date and despite having been checked in June 2016.
However, we also found the following areas of good practice:
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Clients told us that workers were non-judgmental and professional. They told us the staff were supportive and the service was good. Clients told us they enjoyed accessing groups and found them useful in their recovery.
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The service was achieving positive outcomes for clients. The service was meeting local and national treatment outcome profile targets for clients accessing the service.
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The service had built effective links with other organisations including probation services, GPs, the local hospital and client support, and mutual aid services. The service provided outreach work and hospital liaison service to provide support to the community to promote inclusion and access for clients across the county.
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Staff completed detailed and holistic assessments on entry to the service. Risk assessments were comprehensive. Staff provided harm reduction advice and psychosocial interventions to aid clients’ recovery.
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Staff had access to mandatory training and additional specialist training to ensure they were suitably skilled and qualified. Staff had the opportunity to access training and support to develop and progress within their roles and the service.
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Supervision of staff took place frequently and all staff had received an appraisal in the 12 months prior to our inspection. Disclosure and barring service (DBS) checks were completed and professional registration was monitored for qualified staff.
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Staff adhered to national guidance for the prescription of medication. The service worked with local GPs to ensure physical health checks were completed prior to commencement of community detoxification programmes.
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All client and staff areas were visibly clean and tidy and the clinic room in use by the service was well equipped. Staff made recorded daily checks of fridge temperatures used for the storage of vaccinations.
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Staff morale was high. Feedback from staff we spoke with was that the team worked well together and supported each other. Local and regional managers were accessible and all staff felt able to raise concerns if necessary.