Archived: Southwark Adult Substance Misuse Service

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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

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

This key question was rated as good. This means the service worked well to meet people’s needs.

Staff saw urgent referrals quickly and non-urgent referrals within the service's target time. Staff tried to contact people who did not attend appointments and offer support.

However, we identified a breach of Regulation 16 - Receiving and acting on complaints, due to delays and inconsistencies in complaint handling.

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.

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. Patient records showed that staff directed clients to other services where appropriate and, if required, supported them to access those services.

The service supported people whose aim was to abstain from drugs and alcohol, and equally those who preferred to reduce their use through harm minimisation. Staff we spoke with shared examples of how they based care and treatment around individual needs and preferences. Staff told us how they used a person-centred approach, asking people what they would find helpful and agreeing achievable and holistic goals with them. Several people and carers described excellent, person centred support, including keyworkers who were attentive, understanding, and aware of individual circumstances such as family illness. One person said, “I’m blessed, I’ve got a brilliant keyworker,” and family members spoke positively about being asked how they were coping, highlighting a holistic approach

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.

We saw the service worked in partnership with other services to meet the needs of its patient population. The practice had tailored its services to meet the diverse needs of its community.

Mutual aid organisations such as Alcoholics Anonymous, and Narcotics Anonymous hosted a fellowship meeting at the service every week. Staff encouraged attendance at these meetings and people could continue attending these groups in their local communities once they had been discharged.

Staff enabled people to access education and work opportunities. For example, the service facilitated Individual Placement Support (IPS), a scheme that matched individuals’ skills with employers. People had the opportunity to train as volunteer peer mentors and progress to paid employment. The service supported people with improving skills such as IT, social media, literacy and maths and provided access to formal qualifications worked with other partners to deliver an overdose awareness and naloxone training session for professionals across the borough, with excellent feedback received.

The service made reasonable adjustments for people who were unable to attend in person. Staff told us that housebound service users were offered appointments via Zoom to ensure continuity of care and access to treatment. In addition to remote appointments, staff also carried out home visits where appropriate to further support engagement and meet individual needs.

The service provided appropriate, accurate and up-to-date information in formats tailored to individual needs. Staff made appropriate notifications to external bodies and commissioners. The service regularly submitted its treatment data to the National Drug Treatment Monitoring System (NDTMS). With consent in place, staff regularly updated carers and other professionals involved in clients’ care and treatment about their progress.

Information governance systems ensured confidentiality of patient records. The provider’s electronic record system provided staff and managers with accurate oversight of information relevant to their roles. Staff completed training in this area, with 100% up to date with Data Protection and Information Security Awareness Training.

The service had access to interpreter services. People were informed about how to access their care records.

The service made it possible for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a comments box in the waiting area, for complaints and compliments. Staff told us about a service user forum, although at the time of the inspection not many people or carers were involved with the service user forum.

However, we found shortfalls in the complaints process. Although the provider’s policy requires all complaints to be reviewed within 28 days, this standard was not consistently met. The service has received 15 complaints in the last 12 months. Reviews were not always completed within the required timeframe, and documentation of findings and outcomes lacked consistency. Five complaints were either not signed off or did not contain clear documentation of conclusions and actions taken. These issues highlight the need for improved oversight and more robust quality assurance to ensure all complaints are reviewed, documented, and signed off in line with policy expectations. Since the inspection, the service reported a complete overhaul of their complaints oversight system with the aim of monitoring complaints monthly through governance meetings.

The service actively sought out and listened to information about people who were most likely to experience inequality in experience or outcomes. They tailored the care, support and treatment in response to this.

Staff told us the service was inclusive of people from diverse backgrounds.

The service could provide interpreters for people if required. Staff also made information leaflets available in languages spoken by people who used the service.

The provider had policies in place to ensure people were treated equally. There were opportunities for clients to give feedback about their care and support. There were opportunities for clients to give feedback anonymously via a survey.

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. Staff identified that some people from minority ethnic backgrounds could not complete their medical assessments due to language barriers. In response, interpreters were made available, to improve understanding and trust.

Feedback provided by people using the service, was positive. People said staff treated them equally and without discrimination. Staff understood the importance of providing an inclusive approach to care and adjusted support equity in people’s experience and outcomes. Staff received training in equality, diversity, inclusion and human rights. The service had a 100% completion rate of training in equality, diversity, and inclusion.

We looked for evidence that people were supported to consider their wishes for their future and that this was documented and shared appropriately.

Records showed people were supported to consider their wishes for their future. This included discussions about long-term recovery goals, housing, employment, and family relationships. Staff recorded these preferences in care plans and shared relevant information with other services when necessary to ensure continuity of care and respect for individual choices.

Staff told us they encouraged people to think about what mattered most to them beyond treatment, such as aspirations for education, work, and rebuilding social networks. Where appropriate, these plans were linked to community resources and mutual aid groups to support sustained recovery.

We saw examples where future planning was integrated into multidisciplinary team (MDT) discussions, ensuring that professionals across health, social care, and criminal justice contributed to coordinated support. This approach helped people transition smoothly between services and reduced the risk of disengagement.