Archived: Camden Community Drug Treatment Service

Updated 20 November 2023

Camden Integrated Drug & Alcohol Service is a new service delivered by Change Grow Live (CGL), a nation-wide provider who deliver not-for-profit community drug and alcohol treatment services. The provider added this new service as a satellite site under their existing registered location, Camden Community Drug Treatment Service. We report under the registered location.

This was the first time we have inspected the Camden Integrated Drug & Alcohol Service. The site address is Kings Studios, 43-45 Kings Terrace London NW1 0JR.

The service provides information and advice, a group programme, peer mentoring and volunteering opportunities, psychosocial interventions, prescribing services, needle exchange, harm reduction advice, community detox, substitute prescribing, a hostel in-reach service, blood borne virus testing and supports clients to access inpatient detox and rehabilitation as needed.

The registered location, Camden Community Drug Treatment Service, was previously inspected by the Care Quality Commission in August 2022 and was rated good overall. Camden Community Drug Treatment Service provided community drug treatment and support from two fixed sites: one in Camden and one in Kilburn. However, the provider closed this Camden location when the Camden Integrated Drug & Alcohol Service commenced in April 2023. All clients from this Camden location, were also transferred into this new integrated service.

CGL were awarded the contract to deliver this service. The previous provider had held the service for over 50 years. Whilst in the early implementation phase of the new service, CGL notified us of a variety of risks involved with the transfer process of clients from the previous provider. These risks related to continuity of care and safety.

This was a focused inspection, reviewing the care of clients transferred over solely from the previous provider. There were 518 clients transferred from the previous provider.

The service is registered for the following regulated activity: Treatment of disease, disorder, or injury. There was a registered manager at the service.

What people who use the service say

We gathered feedback from 11 clients who used the service. Clients were very complimentary when talking about staff, reporting they were friendly, polite, respectful, and knowledgeable. One client told us they found staff inspiring, and this made them become a peer mentor.

Clients told us the group programme was helpful, with a range of staff and service-user led groups. Clients found the courses around opiate overdose and goal setting workshop, particularly helpful.

Clients told us that they felt the provider managed the transfer of care from the previous provider well, and that clients felt it has been a smooth journey.

Clients told us that the provider encouraged co-production with clients, for example, by employing peer support workers, and involving clients in the decoration of the service. Clients told us that they did not know how to access support during evenings or weekends, when the service is closed. Clients felt that there should be a doctor or prescribing nurse available to help at these times, particularly for those on an opiate detoxification.

Clients told us that they did not know how to access an advocate or what an advocate does.

Updated 20 November 2023

Our rating of this location was good because:

• The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the team, and of individual members of staff, was not too high to 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 were up to date with their mandatory training including safeguarding and basic life support.
• 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 audits to evaluate the quality of care they provided.
• The team 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. New staff were given a comprehensive induction. 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 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 ensured that its procedures ran smoothly. Clients could provide feedback on the service.

However:

• The Camden site was small and not always fit for purpose. The clinic room at the Camden site could not accommodate a clinical bed, and some rooms for groups were in the basement which was only accessible via a spiral staircase.
• Fire alarms were not always tested weekly across both sites as scheduled by the provider.
• There was only one health and safety lead within the service at the time of our inspection and audit outcomes and actions were not always recorded in a central location. This meant there was not a robust system in place in terms of health and safety oversight when the lead was absent from work. The provider was aware and planned to train a second person.
• Records did not always document when clients attended group sessions which meant it was not always clear if they were accessing the psychosocial aspects of the service.
• Records of controlled drugs did not differentiate between individual client’s medicines and stock medicines for the service. Staff did not consistently monitor and electronically record temperatures of areas where medicines were stored.
• Records did not always document if consent had been reviewed regularly and gained from clients, and some clients told us they had not been asked about consent.
• Clients were not always given copies of their care plans. None of the clients we spoke to said they had crisis plans.

Updated 29 September 2022

See summary above.