St Anne's Community Services - Alcohol Services

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s needs were met through good organisation and delivery. Staff managed admissions and discharges well. Clients did not have to stay in the service when they were well enough to leave. The design, layout, and furnishings of the the unit supported clients’ treatment, privacy and dignity. Staff supported clients with activities outside the service, such as work, education and family relationships. The service met the needs of all clients – including those with a protected characteristic. Staff helped clients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

We have not awarded this service a score for Responsive.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Recovery plans were personalised to the needs of the individual and were reviewed regularly and when changes occurred. They reflected the strengths and goals of clients and included actions to promote their recovery.

We found that risk assessments were updated when levels of risk changed or new and emerging risks occurred, and actions were put in place to mitigate risk.

Discharge plans were individualised and related to personal circumstances.

The service held weekly community meetings, where clients had the opportunity to raise any issues. People told us that they felt listened to at the service.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff ensured that clients had access to education and work opportunities. Staff signposted all clients in the rehabilitation service to an adult learning centre, where they could complete a range of courses related to counselling, health and social care and substance misuse. Managers could give examples of how they had supported a client who was part way through their studies, liaising with the relevant education authority whilst they were in treatment.

Staff supported clients to access their chosen place of worship within the community.

Staff supported clients to maintain contact with their families and carers. Families and carers were encouraged to visit the service and keep in touch with clients.

The programme of activities reflected a good understanding of the work that is required to successfully undertake a detoxification programme and rehabilitation.

Staff we spoke with demonstrated their understanding of the wrap around support that individuals undertaking a programme of recovery might need, such as housing and welfare benefits and social issues they might face.

The service worked with other providers and community organisations to offer joined up care where it was required, for example with community substance misuse and mental health services.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies when it was required, for example to CQC and to the local authority safeguarding team.

Information governance systems included ensuring the confidentiality of client records. The service complied with the Accessible Information Standard.

Staff ensured that clients could obtain information on treatments, local services, clients’ rights and how to complain and so on. There were posters around the unit signposting clients to a variety of internal and external stakeholders.

Staff ensured carers, families and commissioners were regularly updated about the client’s progress where this was appropriate and subject to consent. Carer feedback about communication was positive and carers told us staff contacted them regularly.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

There were no formal complaints in the 12 months prior to the inspection. It was clear that clients knew how to complain or raise concerns, and they told us that they would be listened to if they did so. They also gave us examples of practices that had altered as a result of their feedback, for example in relation to food menus, activities and therapy sessions.

We reviewed a sample of historic complaints and found that these were investigated appropriately. Staff received feedback on the outcome of investigation of complaints and acted on the findings. We did not identify any themes or trends from our analysis of complaints.

Staff enabled clients to give feedback on the service they received. They were encouraged to do so at the end of their treatment programme.

There was a co-production group within the organisation to ensure the voice of clients, carers and staff were used to inform care and make decisions. The group gathered and reviewed feedback, focussing on lived experience which managers said was used to influence service level practice and organisational strategy.

Staff provided carers with information about support groups and carers assessments. Clients had access to and information about advocacy services.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service accepted referrals from the local area and admitted clients in line with specific criteria. Managers worked closely with the local community substance misuse service, which meant they could identify any additional information needed. This enabled the service to plan which member of the multidisciplinary team would visit the person to assess their needs and suitability for the service. All admissions were planned and managers provided staff with admissions information prior to the client’s arrival.

The service aimed for potential clients to be contacted within 2 working days of referral. Data for the 9 months prior to the inspection, evidenced that this occurred in over 90% of cases for both detoxification and rehabilitation clients.

The service also aimed to complete an initial assessment within 10 working days from the date of referral. Data for the 9 months prior to the inspection, evidenced that this occurred in over 90% of cases for both detoxification and rehabilitation clients.

Staff ensured the needs of clients with mobility issues were met. Wheelchair users or clients with mobility needs were placed in bedrooms at ground level. Staff made reasonable adjustments for clients with mobility including walking aids and shower chairs.

There was adequate clinical cover day and night. Staff could support clients in an emergency, and the service was within a reasonable travelling distance to the local acute hospital. The service could access support from mental health services where required.

Staff ensured clients had access to post-discharge care including aftercare, community mental health services and crisis services.

Care records evidenced that staff planned effectively for clients’ discharge. Discharge was never delayed for other than clinical reasons.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Client’s human rights were protected; they were supported by staff who promoted equality and helped them overcome barriers to care.

We did not identify any barriers to care, support and treatment. The service complied with legal equality and human rights requirements, including avoiding discrimination. They had regard to the needs of people with different protected characteristics and made reasonable adjustments to support equity in experience and outcomes.

Staff were trained in equality, diversity, inclusion and human rights and compliance rates were 95%. The service had an equality, diversity and inclusion policy in place.

Staff supported people with specific religious and cultural needs. The service provided a variety of food to meet the dietary and cultural needs of individuals. Staff made sure people could access information on treatment, local services, their rights and how to complain. People were asked, by staff if they had any unmet spiritual or cultural needs, and this was documented in recovery plans.

Interpreters were used to support people with language barriers.

Client’s feedback was collated and reviewed regularly, including any improvements made to service provision when required.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff support clients to make decisions about their care and treatment and their future. They met with them on a regular basis to ensure that treatment was meeting their goals and staff supported clients to adjust where necessary. Staff created personalised recovery plans to account for the client’s needs, wishes and feelings.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. Staff considered a range of possible outcomes for each client based on their individual needs.

Staff supported clients to create and unexpected event plans which included action to take if they relapsed. All clients had these in place, but in one case this had not uploaded been uploaded to the electronic records system. We raised this with managers who told us they would take immediate action to rectify this.

Staff interviews and care records showed evidence of staff working collaboratively with clients to plan for their discharge. There was evidence of signposting to a range of post discharge support services.