Archived: London Regional Office

Updated 10 February 2017

Change, grow, live (CGL) changed its name from CRI-Crime Reduction Initiatives (CRI) in April 2016. London Regional Office is registered with CQC to provide the following registered activities: diagnostic and screening procedures and treatment of disease, disorder or injury.

The provider does not carry out any registered activities at the location address. The registered activities managed by CGL from London Regional Office are carried out at 33 separate community sites in London, Essex, Peterborough, Hertfordshire and Northamptonshire. All of the sites have a multidisciplinary staff team who provide advice, support and treatment to adults with substance misuse issues in a community setting. Staff teams have a clinical lead and a manager who takes day to day responsibility for the operation of the service. CGL has a separate commissioning contract with each local authority. Consequently, there are some variations in the range and type of service CGL provides at each site. Services provided include psychosocial interventions, substitute prescribing for opiates and community alcohol detoxification.

There are three CQC registered managers at London Regional Office who each take responsibility for a number of sites. The registered managers are responsible for the quality of the service provided and ensuring health and social care standards are met.

We have not previously inspected London Regional Office. At this inspection, we visited sites at Barking and Dagenham, Newham, Bromley, Corby, Peterborough, Southend and St Albans.

Updated 10 February 2017

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Change, grow, live (CGL) provided safe and effective recovery-focused care and treatment. Clients were positive about the way staff involved them in planning their recovery and the support staff gave them.

• Staff thoroughly assessed risks to clients and identified their needs. Staff developed sound risk management plans and kept these under review to ensure that they met client needs effectively.

• Clients were able to access support and treatment quickly. Staff followed best practice and national guidance when prescribing medicines. Clients were able to access psychological support.

• At each site there was a multidisciplinary team comprising experienced and skilled staff. Most staff said their caseloads were manageable. At most sites the premises were suitable.

• Staff understood and implemented safeguarding procedures for adults and children. Staff liaised with commissioners and other local agencies to ensure they met clients’ individual needs and develop local services.

• CGL involved clients in reviewing and developing services at the local and national services. The service used feedback from clients to make improvements. Clients who had recovered from substance misuse were able to become volunteers at the service.

• Staff and clients understood the vision and values of CGL.

• Registered managers carried out audits of the quality of the service and ensured that teams took action promptly to improve services when required.

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

• CGL had not always sent CQC the required statutory notifications in relation to deaths and other incidents

• At Peterborough, staff were managing their caseloads but we were concerned that they were doing so through consistently working over their contracted hours.

• At Barking and Dagenham, interview rooms were not adequately soundproofed and private conversations could be overheard.

• At Barking and Dagenham, the room used by clients for urine tests was not appropriately designed to provide for clients’ privacy and dignity. The provider was aware of this and there were plans in place to make a more suitable room available.

• At the Bromley site, the cleaning of the toilets used by clients and by staff was inadequate.

• The system to identify when the Disclosure and Barring Service (DBS) criminal records check had been received by CGL was not robust at the time of the inspection. Consequently, it was not clear that rigorous measures were in place to ensure staff worked safely with clients whilst CGL was waiting to receive the DBS check. Senior managers advised us that by January 2017 a new human resource management system would be in place that will have an automatic alert system to flag up when a DBS check has not been received.