Transforming Choice

Our rating of this service improved. We rated it as outstanding because:

• We rated caring and responsive as outstanding due to the excellent person-centred care, full client involvement and staff going the extra mile to support client’s holistic needs during and after the programme.
• Feedback from clients was exceptionally positive. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
• Client’s individual needs and preferences were central to the delivery of tailored services. The service was easy to access.
• Staff were all committed to involving and empowering clients in all aspects of their recovery. Staff and clients worked together to name, co-produce and develop existing and new services.
• The service worked proactively to manage people’s addictions and also the wider implications of long-standing addiction including considering the physical health and mental health impact.
• Staff supported clients fully on discharge according to their individual needs. Staff worked proactively and in partnership to develop alternative and aftercare pathways for clients.
• The service provided safe care. The premises where clients were seen were safe and clean. The service had enough staff. 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.
• 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.
• The service was well led, and the governance processes ensured that its procedures ran smoothly.

However:

• Although outcomes for people were good, national guidelines do not recognise a reducing alcohol regime as a fully effective detoxification programme. We have therefore limited the rating of the ‘effective’ key question to good, even though other evidence in the effective key question met the outstanding characteristics. Some research studies using small sample sizes do recognise a reducing alcohol regime as an effective treatment especially for people with complex health and housing needs. Due to the pandemic, the provider had still not been able to have its model clinically reviewed for effectiveness.