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Archived: We are With You - Hartlepool Specialist Prescribing Service Good

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Inspection Summary


Overall summary & rating

Good

Updated 26 September 2019

We rated the service as good because:

  • The service provided safe care. The premises where clients were seen were safe and clean. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • 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 and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
  • The service had conducted a client satisfaction survey in June 2019 and the results were very positive. Clients felt the treatment met their needs, were treated in a kind and respectful manner, had trust in their keyworker and would recommend the service to others.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
  • The service was well led, and the governance processes ensured that its procedures ran smoothly.

  • Staff had a good understanding of the Mental Capacity Act and we saw evidence that clients’ capacity was assessed and recorded, and clients were referred to local mental health services when required.
  • The service also had its own GP liaison officer who ensured GP surgeries provided information about clients’ current physical health status in a timely manner.

  • Staff had recently been provided with training in relation to optimal dosing of substitute medicines.

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

  • Staff caseloads within the service were high. The provider reported that the average caseload per team member was 101 clients.
  • Staff did not formally record lessons learned from investigating complaints for future reference.
  • Staff did not always record voided prescription forms in a timely manner. Records indicated that staff did not always record voided prescription forms on the day they were identified.
Inspection areas

Safe

Good

Updated 26 September 2019

We rated safe as good because:

  • All premises 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 basic training to keep them safe from avoidable harm.
  • Staff assessed and managed risks to clients and themselves well. They responded promptly to sudden deterioration in clients’ physical and mental health. Staff made clients aware of harm minimisation and the risks of continued substance misuse. Safety planning was an integral part of recovery plans.
  • 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 kept detailed records of clients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
  • The service used systems and processes to safely prescribe, administer, record and store medicines. Staff regularly reviewed the effects of medicines on each client’s physical health.
  • The service had a good track record on safety. 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 suitable support.

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

  • Staff caseloads within the service were high. The provider reported that the average caseload per team member was 101 clients.
  • Staff did not always record voided prescription forms in a timely manner. Records indicated that staff did not always record voided prescription forms on the day they were identified.

Effective

Good

Updated 26 September 2019

We rated effective as good because:

  • Staff completed comprehensive assessments with clients on accessing the service. They worked with clients to develop individual care plans and updated them as needed. Care plans reflected the assessed needs, were personalised, holistic and recovery-orientated.
  • Staff provided a range of care and treatment interventions suitable for the client group and consistent with national guidance on best practice. They ensured that clients had good access to physical healthcare and supported clients to live healthier lives.
  • Staff used recognised rating scales to assess and record severity and outcomes. They also participated in clinical audit and quality improvement initiatives.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers made sure that staff had the range of skills needed to provide high quality care. They supported staff with appraisals, supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff.
  • Staff from different disciplines worked together as a team to benefit clients. They supported each other to make sure clients had no gaps in their care. The team had effective working relationships with other relevant teams both within and outside the organisation.
  • Staff supported clients to manage their own care and treatment. They understood the provider’s policy on the Mental Capacity Act 2015 and knew what to do if a client’s capacity to make decisions about their care might be impaired.

Caring

Good

Updated 26 September 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 and treatment.
  • Staff involved clients in care planning and ensured that clients had easy access to additional support.
  • The service had recently conducted a client satisfaction survey in June 2019 and the results were very positive. Clients felt the treatment met their needs, were treated in a kind and respectful manner, had trust in their keyworker and would recommend the service to others.
  • Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards clients without fear of reprisals.

Responsive

Good

Updated 26 September 2019

We rated responsive as good because:

  • The service was easy to access. Staff planned and managed discharge well. The service had alternative care pathways and referral systems for people whose needs it could not meet.
  • The design, layout, and furnishings of treatment rooms supported clients’ treatment, privacy and dignity.
  • The service met the needs of all clients, including those with a protected characteristic or with communication support needs.
  • The service treated concerns and complaints seriously.

However, we found the following issue the service needs to improve:

  • Staff did not formally record lessons learned from investigating complaints for future reference.

Well-led

Good

Updated 26 September 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles, 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.
  • Staff felt respected, supported and valued. They reported that the provider promoted equality and diversity in its day-to-day work and in providing opportunities for career progression. They felt able to raise concerns without fear of retribution.
  • Our findings from the other key questions demonstrated that in the main, governance processes operated effectively, and performance was managed well.
  • Teams had access to the information they needed to provide safe and effective care and used that information to good effect.
  • Staff collected and analysed data about outcomes and performance.
Checks on specific services

Substance misuse services

Good

Updated 26 September 2019