6 - 7 September 2016
During a routine inspection
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 a formal agreement with a local doctor and GP surgery to provide prescriptions for opiate detoxification and medical treatment for clients. The practitioner regularly prescribed medication for opiate detoxification that guidance states is not a first line treatment and should not be used routinely. The service did not use formal rating scales to measure client’s withdrawals in line with best practice during opiate detoxification. This meant staff were unable to accurately and impartially assess the efficacy of the treatment given.
- The service placed clients at potential risk of harm. It did not provide safe supervision overnight for clients in the early stages of alcohol detoxification to ensure their safety.
- The service used structured formulaic care plans that did not capture client’s views although clients did tell us they had discussed them during one to ones with their counsellors. Staff did not provide clients with nutritional advice and support even though clients’ care plans specified this as a need.
- Governance structures were not robust and had not identified and managed areas of concern raised during the inspection. The management team was not aware of the potential risks posed to clients by the service’s practices, or that the service did not adhere to best practice guidelines. There was no formal structure for managers to provide one to one supervision of staff or for staff to feedback on the service to help it develop.
However, we also found the following areas of good practice:
- The service completed a thorough admission process including a risk assessment prior to prescribing treatment.
- There was good communication between the provider and services that referred clients to them. Referrers we spoke to were positive about the care given.
- Clients felt supported and cared for by staff. They stated that the programme provided by the service kept them safe and supported their recovery. The service actively engaged with families, providing support and information to enable them to support their relative who was in recovery.