East Kent Substance Misuse Service - Dover & Shepway

Updated 6 September 2019

East Kent Substance Misuse Service - Dover & Shepway provides specialist community treatment and support for adults affected by substance misuse and is commissioned to provide treatment for people who live in East Kent.

The service is one of four in East Kent provided by The Forward Trust. The Kent Drug and Alcohol team funded treatment for the majority of clients at the service. The service accepted referrals from a range of professionals or people could self-refer.

The service offered a range of services including initial advice; assessment and harm reduction services including needle exchange; prescribed medicine for alcohol and opiate detoxification; naloxone dispensing (emergency reversal of opiate overdose); group recovery programmes; one-to-one key working sessions and doctor and nurse clinics which included health checks and blood borne virus testing.

There was a registered manager at the service.

The service was last inspected on 8 November 2017 which was its first inspection since it registered with CQC on 1 May 2017. We issued the provider with one requirement notice. This related to the following regulations under the Health and Social Care Act (Regulated Activities) Regulations 2014:

• Regulation 18 HSCA 2008 (Regulated Activities) Regulations 2014 Staffing

This was in relation to our inspection finding that staff did not receive appropriate support, training and development to enable them to fulfil the requirements of their role.

A requirement notice is issued by CQC when an inspection finds that the provider is not meeting essential standards of quality and safety.

On this inspection in July 2019 the previous requirement was met.

The service is registered to provide the regulated activity of treatment for disease, disorder and injury.

Updated 6 September 2019

Our rating of this service is Good. We rated it as good because:

• The service provided safe care. The premises where clients were seen were safe and clean. Although staff told us the number of clients on the caseload of the teams, and of individual members of staff, was higher than usual this did not prevent staff from giving each client the time they needed. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• Staff developed recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice.
• The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
• Staff treated clients with compassion and kindness, and understood the individual needs of clients. They actively involved clients in decisions and care planning.
• The service was easy to access. Staff used a range of strategies to reduce barriers to accessing treatment.
• The service was well led and the governance processes ensured that its procedures ran smoothly.

However:

• We reviewed ten risk management plans and not all of them included individual risk management for a client in the event they exited from treatment early. The service did have a generic protocol for unplanned exit from treatment that all staff were aware of and followed when someone was identified as being at risk of unplanned exit.
• Client involvement in care planning and decision making was not consistently recorded, and it was not always recorded that clients had been offered a copy of their careplan.

Updated 6 September 2019