We are With You - Cornwall

Updated 16 April 2019

Addaction is a national charity that provide a range of substance misuse services. It delivers 81 services across England and Scotland working with adults and young people in community settings, prisons and residential rehabilitation.

Addaction Cornwall provides specialist community support for adults affected by drug and alcohol misuse. It offers one to one support, structured group sessions and needle exchange programmes to people who misuse substances. The service also offers support and information to friends and family affected by someone’s drug and alcohol use. Substance misuse workers support clients. Non-medical prescribers employed by Addaction, GPs with a special interest in addiction and GPs under a shared care agreement all undertake prescribing. Clients undergoing home detoxification are supported by staff from Addaction. Addaction Cornwall is commissioned by the Cornwall Drug and Alcohol Action Team (DAAT). The service also includes a community substance misuse service for young people aged between 11 and 18 years old; known as ‘YZUP’.

The service has a registered location in Truro, with two satellite hubs covering the rest of Cornwall. We inspected the registered location and visited the satellite hubs in Penzance and Liskeard.

Addaction Cornwall was registered by CQC in March 2014 for the treatment of disease, disorder or injury and for diagnostic and screening procedures. Addaction Cornwall has a registered manager.

The service was previously inspected in July 2016. During that inspection we told the provider it must make improvements to ensure clients receive safe care and treatment. We served a Requirement Notice which detailed that the provider must:

•Ensure that physical health monitoring is ongoing for all non-shared care clients before they are prescribed treatment by Addaction. •Ensure comprehensive risk assessments are fully completed and kept up to date. They must ensure information about clients, including risk assessments and care plans is readily available to staff caring for the client, including when they transfer between the criminal justice bureau and the rest of the service. The provider must also ensure staff develop plans with clients for their safety and wellbeing if they unexpectedly exit treatment. •Reduce high caseloads to ensure the well-being of the team. •Ensure that groups meet the needs of the clients using Addaction Liskeard.

During the February 2019 inspection we found that improvements had been made and that the above requirement notices had been fulfilled.

At that time of the July 2016 inspection Penzance and Liskeard were registered as separate locations and were also inspected. These locations have since been deregistered and are now satellite hubs under the registered service in Truro. The service had not been previously rated by the Care Quality Commission has only rated substance misuse services since July 2018.

Updated 16 April 2019

We rated Addaction – Cornwall as good overall because:

• The service had developed an innovative approach to providing integrated person-centred care pathways with other service providers, through the development of a team for people with multiple or complex needs.
• Clients found the service easy to access. Staff assessed and treated clients who needed urgent care promptly. The service provided safe care. Premises where clients were seen were safe and clean. •Staff completed risk assessments for clients in a timely manner and updated these regularly. Clients had risk management plans which they had been involved in developing. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• People’s individual needs and preferences were central to the planning and delivery of individual packages of care. 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. Staff followed national guidance when prescribing medication, which was reviewed regularly.
• The teams included or had access to a full range of staff with the skills needed to meet the needs of the clients. Managers ensured that staff received regular supervision and an annual appraisal. Staff worked well together as a multi-disciplinary team and with relevant services outside the organisation.
• Staff treated clients with respect, compassion and kindness and understood the individual needs of clients. They were non-judgemental in their approach to clients. They actively involved clients and families and carers in care decisions.
• The service was well led and the governance processes ensured that procedures relating to the work of the service ran smoothly.However:
• Staff did not consistently record early exit from treatment plans for clients who had been in the service for more than three months.
• The premises in Penzance was visibly damp.

Updated 16 April 2019