The Care Quality Commission
  • Community
  • Community substance misuse service

Archived: Addaction - Stratford

c/o Stratford Healthcare, Arden Street, Stratford Upon Avon, Warwickshire, CV37 6HJ 07917 186481

Provided and run by:
We are With You

All Inspections

14 July

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • The service had enough staff to care for the number of clients and their level of need. Vacancy rates, turnover and sickness absence were all low. The service did not use bank or agency staff, but was able to rely on a dedicated permanent staff team who had a thorough knowledge of the service and the clients. All staff and volunteers had gone through the appropriate checks to ensure they were safe to work with vulnerable adults.

  • The environment was visibly clean, well maintained and supported the safety of staff and clients. It was friendly and welcoming, and part of a general health clinic.

  • The service appropriately assessed, recorded and managed any risks from or to each client. It raised and referred safeguarding concerns to the relevant agencies. It had mechanisms in place for reporting and learning from incidents and complaints.

  • The service assessed all clients at the start of treatment, using appropriate assessment and monitoring tools and ensured holistic and recovery focused support plans were in place.

  • The service had a suitable range of project workers and clinicians to support clients. This included doctors and nurses who led regular weekly clinics. The service provided group sessions and support for clients to aid recovery. It worked with partner agencies to help clients get further support before and after discharge, and worked with community mental health teams to support clients with a dual diagnosis of mental health and substance misuse. The service also promoted awareness and protection for problems associated with substance misuse, such as hepatitis.

  • Staff showed a good understanding of clients’ fluctuating mental capacity and of the need for informed consent to treatment. Clients were very appreciative of the support, understanding and respect shown by staff. They felt staff listened to them and fully discussed their care and treatment with them. Clients were fully involved in their treatment and recovery. They were able to access advocacy and other support services through a partner agency. The service supported clients in recovery to become recovery champions, which helped them and peers toward recovery.

  • There was no waiting list. The service saw clients promptly and was able to commence assessments and treatments promptly. There were weekly evening and outreach services for clients who found the standard times and location a problem. Appointments ran on time and were very rarely cancelled. The service had a policy and procedure for re-engaging with clients who did not attend for appointments.

  • Staff were passionate about their work, and everyone worked together in a positive, co-operative and supportive manner. Absence rates were low, and morale was high. Staff were supervised, appraised, inducted and received proper training. They knew how to raise concerns and were confident to do so if needed.

  • Governance groups oversaw the work of the team to ensure quality and performance was maintained. Staff were involved in audits. The service met and regularly exceeded national and local performance targets in treating clients. The service responded to complaints appropriately.

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

  • The room used for needle exchange was too small for staff to comfortably close the door. This potentially compromised the dignity and privacy of clients who came to exchange needles.

  • The provider should ensure that the dignity and privacy of clients is maintained, by ensuring doors are shut when interactions such as urine testing are taking place.

  • Data provided by the service did not clearly reflect training that had been undertaken by staff.

30 December 2013

During a routine inspection

The eight people we spoke with told us that the service was very good. People told us, 'They are brilliant, including the reception staff. They treat everyone as individuals' and 'I've changed how I think. I am so much more positive. Staff are absolutely brilliant.'

The three care plans we looked at were personalised and relevant to the issues that people had identified as important to them. People had discussed the things they wanted to change about their lives and chosen the steps they would take. People we spoke with told us, 'My support worker suggests things I could do, but it's up to me to engage' and 'It has been my quest, my journey.'

The provider took measures to keep people safe. Support workers we spoke with told us they received training in safeguarding. Support workers explained the actions they would take if they had concerns about people's safety or well-being.

Staff we spoke with told us they were supported by the manager. A support worker said, 'The manager is available to speak to at any time between our supervision meetings.' We saw the manager kept a record of their regular one-to-one meetings with staff, so they could check that agreed actions were taken.

The manager's quality assurance system included checking that people's needs were regularly reviewed and seeking feedback from people who used the service. People we spoke with told us they completed four weekly progress reports and questionnaires about the quality of the service.

16 January 2013

During a routine inspection

We spoke with five people who used the service, who all told us that it was a good service. They told us that they led their own support programme and that staff encouraged them to set their own goals and timescales for their recovery. One person we spoke with said, 'The support is really good, you just have to ask for help.' Another person said, 'The staff are understanding, you are treated like an individual.'

People told us they had a recovery plan and that they had decided the steps they needed to take to achieve their goals. One person we spoke with said, 'I see my written plan, I signed it.' Another person told us, 'We review my plan every three months and agree what to do.'

The provider checked that staff were suitable to work with vulnerable people, and provided appropriate training and support to staff. Project workers told us they had regular one to one meetings with their manager. A project worker told us, 'I feel supported, you can discuss anything straight away, you don't have to wait till your supervision is due.'

We saw that staff's and people's confidential records were kept in locked cabinets. The manager regularly checked that staff kept accurate records of how they supported people who used the service. One person we spoke with said, 'I know I can see my records if I want to.' The provider kept records of staff's training and staff had access to the records so they could make sure their training was kept up to date.