The Calico Group - St John’s Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

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 oriented. Staff provided a range of treatment and care for clients based on national guidance and best practice. Teams included or had access to the full range of specialists required to meet the needs of clients using the service. Staff from different disciplines worked together as a team to benefit clients.

Staff understood their roles and responsibilities under the Mental Capacity Act and discharged these well. We saw consent to treatment was recorded in all the care records we looked at.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We looked at eight care records in total during our assessment. Clients confirmed they were involved with setting their own goals, and there were several treatment options available to support them in reaching them, including key work sessions, residential rehabilitation, community detox, group work and referral to external agencies.

Staff completed a comprehensive mental health assessment of the client as well as a physical health needs assessment when the client entered the service.

At the last assessment we found care plans to be incomplete. On this assessment we saw care plans which were personalised, holistic and goal oriented. They included information about the client's health, wellbeing, and lifestyle, to enable clients to receive care or treatment that has the best possible outcomes.

Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence, including blood borne virus testing. At the last assessment we identified the service had only tested 36% of clients for blood borne viruses, on this inspection 64.3% had now been tested, with an additional 16.6% having refused either a first or second test.

Other treatments included substitute prescribing, harm minimisation advice, psychosocial interventions, group sessions, employment support, and smoking cessation. Counselling, and outreach support were also available.

The team included or had access to the full range of specialists required to meet the needs of clients using the service. This included doctors, nurses, prescribers, recovery workers, therapists and support staff. Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the client group. Other staff members had previously worked for other substance misuse providers and some staff had previously been service users themselves.

At the last inspection we found that managers provided new staff with appropriate induction to the service and organisation. However, they did not include substance misuse and alcohol training. On this assessment it was available and 94% of staff had completed it. Other induction modules included health and safety, basic life support, duty of candour, information governance and safeguarding.

Managers provided staff with supervision meetings to discuss case management, and personal development and appraisal of their work performance. The percentage of staff that had had an appraisal in the last 12 months was 100% and the average compliance with supervision was 84%.

Managers ensured that staff had access to regular team meetings. Staff attended a daily huddle where managers discussed who was doing what that day and after that meeting staff could stay behind to seek advice on more complex clients.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge, for example the cuckooing course. Any areas for development were identified during supervision and appraisal sessions or team meetings. Managers ensured that staff received the necessary specialist training for their roles.

Managers dealt with poor staff performance promptly and effectively. The provider had a performance management system in place to enable managers to deal with staff performance issues in a timely and appropriate manner.

There were regular multidisciplinary meetings with each team holding its own alcohol or opiate addiction meetings for example. We observed the daily huddle and risk group meetings. Various cases were discussed including one complex client. It was clear from the discussion that the recovery worker allocated to that client had extensive knowledge of their background and current needs. They were passionate about the care they could offer and were working with several different neighbourhood agencies.

We saw staff sharing information about clients and we observed staff rarely had to check notes before being able to brief each other on the current situation.

We also observed staff having conversations with other services such as GPs, pharmacies, criminal justice services and social services.

Staff supported clients to live healthier lives. We saw evidence in care records that staff had provided clients with advice about healthy lifestyles. We also saw linked in working with other support services, for example during our assessment the smoking cessation service had a dropin service in the foyer of the service

Clients we spoke with felt that staff supported them to achieve positive outcomes, and that staff understood their goals.

Staff used recognised rating scales, such as the AUDIT tool and severity of alcohol dependency questionnaire (SADQ) to assess and record severity and treatment outcomes. They also participated in clinical audit, benchmarking and quality improvement initiatives. Rating scales were incorporated into the electronic care records system and were completed as part of the assessment process and reviewed again at different stages of treatment.

Managers monitored clinical outcomes and created reports for management monitoring. For example, the service monitored how many people had started treatment and how many had been discharged positively or negatively. In the last twelve months of those clients discharged, 50% had successfully completed their treatment.

Staff understood the requirements of legislation and guidance when considering consent and decision making.

Staff supported clients to make decisions. Where appropriate, they assessed and recorded a client’s mental capacity to make decisions in relation to their care and treatment plan.

The service monitored the process for seeking consent appropriately.

We saw consent to treatment was recorded in all the care records we looked at.