START-Whitby Street

Updated 12 September 2022

START Whitby street is a community based substance misuse service delivered by Foundations and the local authority partner organisation. Foundations delivers the clinical service including substitute prescribing, blood borne virus testing and a needle and syringe provision. The partner organisation offers psychosocial interventions and other recovery-focussed support.

This inspection was carried out on the clinical elements of the service, provided by Foundations. The rating applied is specifically for the clinical care they provide as part of START Whitby Street.

Foundations has been registered with the Care Quality Commission since September 2020. The service has been registered to carry out the following regulated activities:

• Treatment of disorder, disease or injury
• Diagnostic and screening procedures

The service has a registered manager in place.

The service has not been previously inspected.

Updated 12 September 2022

We rated it as 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 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 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 training, 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.
• 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 majority of governance processes ensured that procedures ran smoothly.

However:

• Staff did not routinely undertake physical health observations unless they presented as being unwell which meant there was the potential that physical health issues were not being identified at any early stage so they could be addressed quickly. However, this was resolved soon after we raised it with the provider.
• The service did not monitor how well it followed the Mental Capacity Act. At the time of our inspection, there were no audits or other checks in relation to how well staff applied the Mental Capacity Act into their day to day work. However, the provider started to undertake audits of the use of the Act soon after we raised the issue.
• Staff were not trained in managing violence and aggression. However, the provider took steps to arrange training for all staff soon after we raised this as an issue.
• Staff were not aware of the service’s risk register which meant they did not know if the items included on it matched their own concerns about issues which could negatively impact the service.

Updated 12 September 2022

Updated 26 September 2019