St Anne's Community Services - Alcohol Services

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. Staff assessed the physical and mental health of all clients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for clients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of clients on the ward. Staff from different disciplines worked together as a team to benefit clients.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 7 sets of care records during the inspection.

Staff completed a comprehensive assessment of needs including history of substance misuse. Assessments identified client’s support networks and highlighted areas that might need to be improved during the period of treatment.

Staff made sure that clients had a full physical health assessment and knew about any physical health problems. They took appropriate action to address physical health concerns. Clients in the rehabilitation service received a weekly physical health check and detoxification clients were seen daily. Some clients had specific needs in relation to nutrition and hydration, and we saw evidence that these needs had been assessed and that staff knew how to support them.

The service had established links with the hepatology department of the local hospital. A hepatology department is a specialised unit that focusses on the diagnosis and treatment of liver diseases. Staff could contact the department for advice regarding clients and arrange or fast track appointments where appropriate.

Staff developed a comprehensive recovery plan for each client that met their mental and physical health needs. Staff regularly reviewed and updated recovery plans when clients' needs changed. Care plans were personalised, holistic and recovery-orientated and identified the client’s allocated recovery worker who they met with regularly throughout their stay.

Staff responded promptly to any sudden deterioration in a client's health, including physical health risks from alcohol detoxification. Clients told us that there was always a member of staff around to support them if they needed to discuss how they felt.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well

Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by, and were delivered in line with, guidance from NICE. These included therapies and activities, training and work opportunities intended to help clients acquire living skills.

Clients in the rehabilitation service had structured group programmes which included group and individual sessions using a cognitive behavioural therapy model, underpinned by the Cognitive-Behavioural Coping Skills Therapy Manual. This is a structured clinical guide for treating individuals with alcohol abuse or dependence.

The service followed the Routes to Recovery via the Community Framework which is a Public Health England supported framework to enhance substance misuse treatment. This approach enabled staff to use visual mapping tools and help clients set individual goals.

We observed several therapeutic groups and activities and saw that these were well structured and that clients were well engaged.

Clients were able to give feedback on the types of activities that were available and make recommendations for things that would help keep them occupied.

Staff ensured that clients had the opportunity to take part in mutual aid groups to support their recovery now and when they returned to their own communities.

Staff ensured that clients had good access to physical healthcare. This included access to a GP for those that required it.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. Staff routinely audited medicines management, care records, infection prevention and control, group attendance and effectiveness and discharges.

The team included or had access to the full range of specialists required to meet the needs of clients in the service. This included recovery workers, nurses and therapists. Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the client group.

Managers provided new staff with an appropriate induction. Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance.

The percentage of staff that had had an appraisal in the 12 months prior to the inspection was 100%. The percentage of staff that received quarterly supervision was 95%.

Managers recruited and trained volunteers to work with clients in the service. Staff had ongoing discussions with clients about the volunteer programme throughout their pathway, to encourage them to take part where it was appropriate. They also reminded them about volunteering opportunities during aftercare. There were 2 active volunteers in the service at the time of the inspection.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. This included completing a recent competency assessment with registered nurses to assess their skills and confidence in different areas of clinical practice.

Managers ensured that staff received the necessary specialist training for their roles. Planned training for 2026 included knowledge-based training around malnutrition and Thiamine (vitamin) intramuscular injections, which are used to treat or prevent severe deficiency, particularly Wernicke-Korsakoff syndrome, alcohol withdrawal, or malabsorption issues. Managers had also arranged for staff to visit the local liver day unit and meet with a liver consultant to enable them to better support clients with liver disease.

Managers dealt with poor staff performance promptly and effectively in line with the organisation’s policy.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings. Clients in the rehabilitation service attended a review meeting after 6 weeks which was attended the referring agency, key worker and family and friends where appropriate. Managers confirmed that they also held ad hoc multidisciplinary team meetings where appropriate.

Staff shared information about clients at effective handover meetings within the team which took place 3 times a day, with a mixture of clinical and non-clinical staff in attendance. We observed a handover and saw that staff discussed each clients’ current presentation, history and concerns that had arisen. Handovers included a discussion of how clients had presented on return from leave in addition to any new admissions.

Care records and staff interviews evidenced that the teams had effective working relationships with teams outside the organisation including the local authority and social services. Most clients lived locally and remained with their local GP throughout admission.

Stakeholders told us that they had a good relationship with the service and that they shared information effectively when it was required.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported clients to live healthier lives through healthy eating advice, managing cardiovascular risks, screening for cancer, and dealing with issues relating to substance misuse.

Activities helped promote a healthy lifestyle for clients. Clients could attend healthy sleep sessions, mindfulness, and nature and recovery sessions.

Staff offered all clients smoking cessation. Other activities included walks in local parks, couch to 5k, a beginner-friendly running programme, a recovery runners’ group, netball, walking football, and a community gardening group.

The service subsidised costs to support clients to attend the local gym and swimming pool.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There was evidence of severity of alcohol dependence questionnaires being used to assess the severity of alcohol dependence. Staff also uses the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), which is a ten- item scale used in the assessment and management of alcohol withdrawal.

Staff used technology to support clients effectively for example, for prompt access to blood test results and online access to self-help tools.

The service monitored how many clients successfully completed treatment. Data from April 2025 to March 2026 showed that 94% of clients successfully completed the alcohol detoxification programme and that 68% of clients completed residential alcohol rehabilitation.

Data for 2025 showed that 40% of clients that were admitted to the detox service had been admitted previously, with 60% being first time admissions. For the rehabilitation service, 84% of clients were admitted for the first time, with 16% of clients having been admitted previously.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable clients to make their own decisions. For clients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When clients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

One client had an appointee in place to manage their finances. An appointee is a person or organisation authorised by the Department for Work and Pensions (DWP) to manage the welfare benefits of someone who cannot do so themselves due to mental incapacity or severe physical disability.

There was evidence of relevant capacity assessments in place for another client around their medicine and social care needs, with staff taking appropriate action to ensure those needs were met.

Staff ensured clients had agreed and signed consent to treatment forms and they were accessible to all staff involved in the client’s care and treatment.

Staff ensured clients had agreed and signed confidentiality agreements in relation to which parties' staff could share their personal information with. These were accessible to all staff involved in the client’s care and treatment.