CGL Lewisham New Direction

Our rating of this location was good because:

• The service provided safe care. The premises where clients were seen were safe and clean. Staff managed risk well.
• Staff developed holistic, 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. Staff engaged in clinical audit to evaluate the quality of care they provided.
• 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 supervision and appraisal. Staff worked well together as a multidisciplinary team and 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.
• Most clients that we spoke to were happy with the level of service they were receiving and felt well supported by staff.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
• The service was well led, and the governance processes mostly ensured that its procedures ran smoothly.

However:

• The number of clients on the caseload of some key workers was high. Caseloads in the opiate team were over 80 for some key workers. Staff told us this sometimes prevented from giving each client the time they needed.
• The care and treatment records we reviewed contained all the necessary information, but the risk assessments were not always clear about what was a current or historic risk.
• Eight per cent of clients had not received a medical review or a non-medical prescriber review in the last 12 months, in line with the services policy and procedures.
• Some risks that we identified during the inspection, such as overdue medical reviews, were not recorded on the service’s risk register although the provider was aware of this and taking steps to address the outstanding reviews.
• There was no clinical oversight of new self- referrals at the time of inspection. This meant that client risk may not be appropriately identified. The service had implemented a new system following our inspection.
• Psychosocial interventions offered by the service were still running at reduced capacity following the covid-19 pandemic.