11th and 12th May 2022
During a routine inspection
Our rating of this location improved. We rated it as outstanding 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 teams, 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 developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a wide range of treatments and interventions suitable to the needs of the clients and in line with national guidance about best practice. The service truly considered the needs of different groups of people using its service and sought to address gaps where people’s needs were not being met. For example, staff identified a lack of support for people who were addicted to prescribed or over the counter medication and worked alongside GPs to implement a support package to work with these clients to reduce and come off this medication. Staff regularly engaged in clinical audit to evaluate and improve 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 a wide range of tailored training, supervision and appraisal. For example, staff took part in peer supervision groups which involved them recording their one-to-one sessions, with the client's permission, and sharing this with a group of peers for in depth reflection and constructive feedback in order to help them improve their practice.
Staff worked extremely well together as a multidisciplinary team and with relevant services outside the organisation.
Staff treated clients with compassion and kindness and respect, and truly understood the individual needs of clients. There was a strong person-centred culture which was incorporated into all aspects of the service. Feedback from people who used the service was overwhelmingly positive and we were told that staff always go the extra mile to support clients. Staff actively involved clients in all decisions and about their care and clients were regularly consulted and involved in the running of the service. This included clients and staff collaborating to produce an information leaflet on microdosing, client involvement when interviewing staff and meaningful consultation with clients. Staff identified groups of people with specific needs and developed pathways to provide tailored support and helped those clients overcome barriers that were stopping them from achieving their goals.
The service was easy to access, staff made reasonable adjustments to enable clients to access the service in a way that met their needs and preferences. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
The service was extremely well led, and the governance processes ensured that its procedures ran smoothly. Staff felt really well supported by managers who they felt were very approachable. Collaborative work between the service and its partner organisations was highly effective and focused on meeting the needs of the clients. The service was highly innovative and ensured it was up to date with and involved in, new ways of working. The service had effective systems in place for gathering feedback from those who used the service which were used to improve the service. The service gathered and used data effectively and brought in external agencies including universities to review different aspects of the service to help improve its effectiveness.
However:
The service had not checked the panic alarms since the middle of March 2022.
Not all care plans had been updated every three months in accordance with the providers policy.