Archived: Compass - Enfield

Updated 9 August 2016

Compass-Enfield is provided by Compass - Services to Tackle Problem Drug Use and is registered to provide the following regulated activities:

• Treatment of disease, disorder or injury

• Diagnostic and screening procedures

The service has a registered manager in place.

Compass-Enfield provides a drug and alcohol treatment service for adults in the London Borough of Enfield. The service provides advice and information, detoxification, substitute prescribing and psychosocial groups.

Compass - Services To Tackle Problem Drug Use has two services within the London Borough of Enfield, which work together. Compass-Enfield provides a fully integrated drug and alcohol treatment service for adults, including maintenance care and treatment for people that were nearing the end of treatment. People that attended a similar Compass service called the Claverings transferred to Compass-Enfield when they were near to the end of treatment.

The service had 130 people on their caseload. People were seen on a weekly and monthly basis depending on the stage of their recovery or treatment.

Staff managed a needle-exchange service from the site, which operated throughout the week.

We inspected Compass-Enfield twice in 2013 and reports were published in 2013 and 2014. The service had a comprehensive inspection in November 2015. This inspection found the provider was not delivering safe care and treatment to people who used the service. Due to the safety concerns identified, we issued the provider with a warning notice under Section 29 of the Health and Social Care Act 2008. A separate requirement notice was issued to the provider requiring them to improve their governance systems.

Updated 9 August 2016

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• The provider had two separate care record systems in place, which included an electronic and paper system. The system did not operate smoothly as staff did not have access to a working scanner to ensure information was saved in local authority held records.

• Overall, communication with local GPs had improved and communication was documented within some of the care records. Staff supported patients to engage with GPs, although documentation was not recorded in 19% of 122 care records listed.

• A new system had been introduced into the service, which indicated when clients should receive a medical review. The system included a number of indicators but did not include indicators for a person who was symptomatic (HIV positive or hepatitis positive) and required reviews more frequently.

• The clinical room door was found open on one occasion. This was raised to the service manager in order to address as this presented a potential risk to patients.

• The service had a contingency plan in place, which described how clients could receive help if the service was closed. This advised people to access the local accident & emergency department. However, the plan needed to be reviewed to ensure they met clients’ needs.

However, we also found the following areas of good practice:

• The provider had made improvements and these new systems needed time to embed. However, the improvements ensured safe care and treatment was being provided. Positive improvements were made in order to meet the requirements of the warning notice and the separate requirement notice that was served after our last inspection in November 2015.

• The service had carried out a full care record audit since our last inspection in November 2015 and had made improvements on completing risk assessments and care plans. Most people who used the service now had up-to-date risk assessments and care plans.

• The provider had reviewed the prescribing policy and added in the requirements of an initial prescribing appointment, which included a doctor taking a full history and carrying out a physical examination. The provider had introduced a new medical assessment template.

• The provider ensured that people who used the service were being medically reviewed on a regular basis. Out of 14 care records reviewed, only one care record did not demonstrate that the medical assessment had been completed. People who used the service were being offered blood bourne virus (BBV) testing.

• The provider implemented a new medical review template form, which included the withdrawal side effect rating scales called severity of alcohol dependence questionnaire

• Staff had received training in record keeping in March 2016 in order to ensure that staff were aware of the importance of recording information.

• The service was monitoring client outcomes using the care planning outcome tool.

• Discussions had taken place around childcare responsibilities and safeguarding of vulnerable children.

• Overall, the supervision records had improved significantly since our last inspection in November 2015 and records demonstrated that staff performance was a priority.