Archived: St John's House

Updated 20 April 2017

St Martins Healthcare services works in partnership with three other organisations to deliver the Calderdale Recovery Steps service. St Martins is subcontracted by another substance misuse provider who is the lead contract holder to deliver the clinical element of Calderdale Recovery Steps. The service provides accessible community based adult drug and alcohol services to adults across the Calderdale area.

Calderdale Recovery Steps is designed to offer seamless, accessible and relevant services which will enable service users to work towards recovery. The service focuses on recovery, harm reduction and services user involvement. St Martins is primarily responsible for delivering the pharmacological interventions for this service, including prescribing for alcohol and drug misuse, as well as the physical health assessments at the beginning of treatment.

St Martins Healthcare Services deliver clinical interventions for Calderdale Recovery Steps from their registered location. St Johns House in Halifax is one of two local ‘recovery hubs where clients can access treatment and care from the Calderdale Recovery Steps partnership, including St Martins. The other recovery hub is in Todmorden, St Martins Healthcare services also provide primary care extended services where clients can access primary care services where the health centre/GP surgery are signed up to the primary care extended services contract with the provider. Primary care extended services is where treatment and support is offered in the local GP practices and is delivered in partnership between the GP and a recovery worker. This means that clients can attend their local GP service for their substance misuse appointments. The GP will lead on prescribing.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This service is registered by the Care Quality Commission to provide the following regulated activities:

Treatment of disease, disorder or injury.

The provider has been registered with the Care Quality Commission since 30 January 2015 and has not yet been inspected.

Updated 20 April 2017

We do not currently rate independent standalone substance misuse services.

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

• Staff understanding of the Mental Capacity Act and its application in practice varied and staff were unclear of their role in the application with the Act. A client’s mental capacity had not been formally assessed. This meant the client’s ability to make decisions and choices regarding their care and treatment had not been considered. Attendance of training in the Mental Capacity Act was low. The service did not have a Mental Capacity Act policy or arrangements in place to monitor the application of the Act

• Compliance for three out of the nine mandatory training courses were below 75% including anaphylaxis so we could not be sure that staff skills were up to date.

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

• The service had recruitment and selection policies and procedures which supported the safe recruitment of staff. The service had sufficient staff and had not used bank or agency staff in the last 12 months prior to the inspection. It had good lone working systems in place to ensure staff safety.

• Staff received quarterly supervision and annual appraisals in line with the service’s own policy. All staff felt well supported within the organisation. They felt there was support amongst peers and that management supported them well. There was a strong team ethic.

• Staff could identify the different types of abuse and knew how to make safeguarding referrals. The service had effective systems and processes in place to report and monitor incidents. Staff could provide examples of lessons learned when things went wrong and improvements made following incidents.

• Staff had good working relationships with external organisations and worked closely alongside them to support the clients. The service delivered care and treatment in line with national guidance and best practice. Staff attended practice development groups to ensure they kept up to date with current guidance. Staff used evidence based assessment tools to measure clients’ substance misuse and emotional wellbeing.

• Clients told us that staff kept them informed of other services which were available to offer support to them. Clients were happy with the service they received. They said staff understood them, treated them as individuals and as adults. Staff worked with clients’ families as well as the client and offered support where they could. Volunteers were clients who had completed treatment and they told us they felt part of the team and were all happy within their roles.

• The service offered a robust system for contacting clients who failed to attend appointments. It offered one late night clinic per week for clients who were unable to attend during normal opening hours. The service reported there was a rapid access procedure which ensured clients released from prison were seen that day.

• The service had seen an increase in both alcohol and drug clients successfully completing treatment. Quality assurance visits to assess the quality of the care provision had been undertaken by senior managers in the last 12 months.

• Governance systems to ensure monitoring of staff supervision, appraisals, key performance indicators, audits, incidents and complaints were mostly effective. Systems and partnership working at all levels appeared cohesive and seamless, with a strong partnership approach.

Updated 20 April 2017

No Rating Given