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We are With You - Cornwall Good

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Good

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.
Inspection areas

Safe

Good

Updated 16 April 2019

We rated safe as good because:

  • The premises in Truro and Liskeard where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose.
  • The service had enough staff, who knew the clients and received training to keep clients safe from avoidable harm. Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
  • Staff assessed and managed risks to clients and themselves. They developed risk management plans for all clients and responded promptly to sudden deterioration in a client’s health. Staff followed good personal safety protocols.
  • Staff followed best practice when storing, dispensing, and recording the use of medicines. Prescribing clinicians regularly reviewed the effects of medications on each client’s physical health.
  • The service managed client safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave clients honest information and appropriate support.

However:

  • We could see and smell damp in the building in Penzance.
  • The building in Penzance had a floor in the staff office which beginning to slope.

Effective

Good

Updated 16 April 2019

We rated effective as good because:

  • Staff assessed the needs of all clients during the early sessions following entry to treatment. They developed individual recovery plans and updated them when needed. Recovery plans reflected the assessed needs, were recovery-oriented and staff updated them when appropriate.
  • Staff provided a range of care and treatment interventions suitable for the client group. These followed national guidance for the treatment of substance misuse.
  • The service included a full range of specialists required to meet the needs of clients under their care. Managers made sure they had staff with a range of skills needed to provide high quality care. They supported staff with appraisals, supervision, opportunities to update and further develop their skills. Managers provided an induction programme for new staff.
  • Staff worked together as a team to benefit clients. They supported each other to make sure that clients had no gaps in their care. Staff had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

However:

  • The completing of personalised early exit from treatment plans was inconsistent. New clients had plans recorded on a new form introduced three months prior to the inspection. However, clients who were receiving care before this change did not always have plans recorded. Are services caring?

Caring

Good

Updated 16 April 2019

We rated caring as good because:

  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported clients to understand and manage their care, treatment or condition.
  • Staff involved clients in recovery planning and risk assessment and actively sought their feedback on the quality of care provided. They ensured that clients had easy access to advocates when needed.
  • Staff informed and involved families and carers appropriately. The service provided support to families and carers so that they could understand the treatment a client was receiving.

Responsive

Outstanding

Updated 16 April 2019

We rated responsive as outstanding 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. Their role was to work flexibly to engage clients with a primary substance misuse need who were frequently attending the local emergency department to put in place a package of care to support them. This included providing clinical treatment, recovery support and assisting in engaging with other services.
  • The service actively reviews complaints and how they are managed and responded to, and improvements are made as a result across the services. People who use services are encouraged to provide feedback and be involved in its review.
  • People’s individual needs and preferences were central to the planning and delivery of individual packages of care. The teams met the needs of all clients who used the service including those with protected characteristics. Staff helped clients with communication, advocacy and cultural support.
  • Clients could access services easily. Referral criteria did not exclude people who would have benefitted from care. Staff assessed and treated clients who required urgent care promptly and clients could be seen on the day they contacted the service by a duty worker.
  • Clients could access services in a way and at a time that suited them as the service was open six days a week and during evenings.•Staff followed up clients who missed appointments in line with the policy.
  • The service had a warm and welcoming atmosphere. Clients had contributed to the decisions regarding access to the premises in an effort to make them open and welcoming.
  • The service had an outreach service which engaged proactively with street drinkers known to and unknown to the service.
  • The service made great efforts to engage the local community where the services were based. Staff cleaned drug paraphernalia from local streets at the request the local people. Staff used donations from local shops to provide food for groups and activities run by the service.

Well-led

Good

Updated 16 April 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles.
  • Leaders had a good understanding of the services they managed and were visible in the service and approachable for clients and staff.
  • Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.
  • The service’s governance processes operated effectively at team level and performance and risk were managed well.
  • Teams had access to the information they needed to provide safe and effective care and used that information to beneficial effect.
Checks on specific services

Community-based substance misuse services

Good

Updated 16 April 2019