Archived: Drug and Alcohol Wellbeing Service (DAWS)

Updated 20 March 2018

The Drug and Alcohol Wellbeing Service provides advice, support and treatment for young people and adults with drug and alcohol problems within the London Boroughs of Hammersmith and Fulham, Kensington and Chelsea and the City of Westminster. It is commissioned jointly by the three boroughs.

The service came into being on 1 April 2016, replacing a range of substance misuse and recovery support organisations across the three boroughs. The service was previously known as the Three Boroughs Recovery and Wellbeing Network but recently changed its name to the Drug and Alcohol Wellbeing Service. Clients using those services were transferred to the new organisation. The service comprises a substance misuse recovery service run by Turning Point and Blenheim Community Drug Project This inspection only looked at the services provided by Turning Point.

The service had three main locations with one in each of the three boroughs, in addition to smaller satellite sites. The purpose of Turning Point’s service is to support the recovery of those living with drug and alcohol problems within the three boroughs and to reach as many people in those communities as possible. To meet this objective the service undertakes outreach work in the local community, including hostels and also provides a Resolution Clinic outside working hours to support clients who need evening appointments because of work or family commitments. Services include brief interventions, one-to-one and group support, including 12-step programmes, peer support services and rehabilitation. The service was commissioned to see alcohol users and conduct community detoxes when required. However the majority of clients were referred to a separate provider for this treatment.

Staff also support clients to access other services, including physical and mental health services, as well as housing and welfare. At the time of our inspection the service was providing support to over 1,000 clients.

Inspectors previously visited the service in September 2016. We did not rate this service at our previous inspection. Following the September 2016 inspection we told the service it must take the following actions to improve the service:

• The provider must ensure that all necessary actions identified by fire safety assessments are completed within the stated time frame.

• The provider must ensure that all medicines are stored at an appropriate temperature and that an appropriate medicines policy is in place for the storage of medicines.

• The provider must ensure that all staff with immediate life support training are up to date with this training.

We issued requirement notices in relation to the following breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014:

• Regulation 12 Safe care and treatment

Updated 20 March 2018

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The provider had made improvements since the previous inspection in September 2016. At our previous inspection, we found that the provider did not have appropriate fire safety arrangements in place, that medicines management wasn’t as robust as it should have been and that staff hadn’t received immediate life support training. At this inspection, we found that the provider had taken the appropriate action to improve the service.

• Staff had addressed outstanding actions from fire safety risk assessments and were aware of what action to take in an emergency. Medical equipment had been calibrated and the environment was clean and tidy. Handwashing facilities were available across all sites.

• Medicines were stored in a secure, organised and tidy fashion at the appropriate temperature. The provider had updated its medicine policy to ensure an appropriate policy was in place for the storage of medicines. Medicines were prescribed in accordance with national guidance.

• Staff were skilled, experienced and knowledgeable about substance misuse and had a good understanding of clients’ needs. The majority of staff had now completed immediate life support training.

• Clients were positive about staff and felt involved in the planning of their treatment.

• The provider had a good outreach and peer mentor programme for clients. A range of employment and education opportunities were available to clients.

• Staff held effective multi-disciplinary meetings and worked well in partnership with external local agencies.

• The provider monitored the length of time it took to assess clients. The majority of clients were assessed within five days of being referred. Client assessments were detailed and comprehensive.

• Staff described senior managers as visible and approachable. The provider had an effective governance framework. Complaints and incidents were investigated in a timely manner with learning and feedback given to staff

However, we also found the following issues that the service provider needs to improve:

• Staff had not undertaken all the mandatory training required by the provider

• Risk assessment were not always consistent, some were informative and comprehensive whilst some did not reflect the client’s current level of risk.

• Not all staff received supervision on a regular basis.

• Staff did not always have the time to undertake the training and development programme that was available due to increases in referral rates and higher caseloads without increased staffing levels.