Archived: CRI Hertfordshire Drug and Alcohol Services (Hatfield)

We found that staff had reasonable case loads and that there were sufficient numbers of staff available to support people. All of the staff that we spoke with told us that there had been changes during the preceding months and that they had felt supported by management during this time.

We found evidence that care plans and risk assessments had been completed and that people were involved in their care planning. People who used the service told us they were satisfied with the service. One person who used the service told us, 'My keyworker understands me and knows exactly what I need, [keyworker] it's like we think in sync.' This showed that people were able to express their views and were involved in making decisions about their care and treatment. Another person told us, 'It's a real life line here, what makes it special is that the staff understand me.' Although, some people commented that they were unclear of the structure of their recovery programme.

We had previously identified concerns about how people's care and treatment had been managed as well as how the service managed safeguarding concerns, medications and how they supported staff.

We found that CRI ' Hatfield had made improvements since our previous inspection. We were told that a lot of work had been undertaken to improve the service and we found evidence of this, although we did note some minor points which still needed to be addressed and we discussed these with the manager.

We identified concerns with how people's care and treatment was managed and recorded. We found that the care plans contained inconsistent information and that people were not always treated in a way that supported them and met their needs. CRI did not consistently make referrals to the adult or children's safeguarding team which meant that people who were vulnerable may not have received the support that the needed. We shared our concerns with the local safeguarding team.

We found that staff were not always supported because appraisals did not take place and staff did not have regular supervision meetings. Issues identified during supervisions were not always acted.

Monitoring had been put in place since our previous visit although there was no system in place to track the audits of care plans which had taken place.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the obtaining, safe keeping, recording and management of medicines.

Overall we found that the provider was patient focused and respected people's privacy and dignity, they were documenting the care provided. However, we found that people's medical histories were not adequately recorded. We also found that relevant information was not consistently shared with the person's GP and that there were no formal arrangements in place to monitor the quality of people's records.