Blossom Street - York Drug and Alcohol Service

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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff assessed the physical and mental health of all clients. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for clients based on national guidance and best practice. Staff from different disciplines worked together as a team to benefit clients.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive assessment of need including history of substance misuse and any mental and physical health needs. Assessments identified client’s recovery capital and support networks. During inspection we observed 2 assessments that were undertaken in a client-centered and holistic way, allowing the client to be involved in decision making about their treatment plan. We observed tools being used to assess severity of substance use and symptoms.

We also reviewed 6 care records which included care plans developed to meet the clients’ mental and physical health needs including history of substance misuse. However, only 2 out of the 6 care plans included clients’ views and the quality of record keeping was not consistent. Although entries were made under the relevant sections there was a lack of evidence to show how the clients’ view ensured the care plan was personalised and a lack of evidence of how care plans were formulated using outcome measures. All included a comprehensive assessment of a person’s physical health needs and clear evidence of use of rating scales and audit such as the severity of alcohol dependence questionnaire.

We saw evidence that staff regularly reviewed and updated care plans when clients' needs changed. Staff responded promptly to any sudden deterioration in a client's health, for example management and response to relapse. Staff continually monitored clients on waiting lists for changes in their level of risk and responded when risk increased.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We saw evidence that 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 and the Orange Book, which identifies drug products approved based on safety and effectiveness. Staff ensured that clients had good access to physical healthcare, including access to specialists when needed. The service had audits in place to ensure staff provided evidence-based care and treatment.

Staff routinely offered blood borne virus testing to clients and supported them to access treatment for any viruses detected. A Hepatitis C specialist nurse attended the service to run clinics to diagnose, treat, and support clients using the service.  

Staff were experienced and qualified and staff told us they were given opportunities to develop their skills and knowledge to meet the needs of the client group. Managers provided new staff with appropriate induction. Managers ensured that staff had access to regular team meetings.

Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and at the time of inspection 100% of staff had received a recent supervision session. In the last 12 months 55.2% of staff had received an appraisal of their work performance. The remaining appraisals were booked with staff and half of these were due to be completed by October 2025. The provider told us that some staff appraisals had been delayed due to an organisational pause on appraisals while they introduced a new recording system and template.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us that meetings were held regularly and effective for sharing information internally. Staff shared information about clients at morning handover meetings. We reviewed 4 records from these meetings, which showed that topics such as staff roles for the day and duty tasks were confirmed that included liaison with other agencies such as safeguarding and social workers.

We received feedback from commissioners and external partners who confirmed effective working relationships and told us that individual staff members worked very collaboratively and in partnership.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff we spoke with understood the importance of ensuring people’s needs were met, including their physical health. We reviewed 6 care records and saw evidence that clients were supported to live healthier lives using recognised rating scales such as the Generalised Anxiety Disorder scale (GAD-7) and patient health questionnaires.

We spoke with service users who confirmed staff supported them to deal with issues relating to substance misuse and their physical and mental health.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service used several methods to monitor and improve outcomes such as regular audits, meetings, surveys and feedback.

The service used recognised rating scales to assess and record severity and outcomes, for example, Severity of Alcohol Dependence Questionnaire (SADQ) and cognition screening with clients. These were reviewed 6 monthly as a minimum. Staff submitted reports about care and treatment outcomes to the National Drug Treatment Monitoring System (NDTMS).

We scored the service as 2. The evidence showed some shortfalls. The service did not always document the assessment of mental capacity or review this. The service told people about their rights around consent and respected those rights when delivering care and treatment.

We reviewed 6 care records and found a lack of evidence in 5 of the 6 records of the assessment of mental capacity on admission and on an ongoing basis to acknowledge the fluctuation of capacity.

All staff completed mandatory training in the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguarding (DoLS) and at the time of our inspection this had 100% compliance. The staff we spoke with had a good understanding of mental capacity and were confident about how to assess it. Staff told us they took all practical steps to enable clients to make their own decisions and provided good examples regarding raising safeguarding concerns.

At the point of triage, the client was asked for their consent to treatment. Staff ensured clients had agreed and signed confidentiality agreements in relation to which parties’ staff could share their personal information with. Staff told us clients were given paper records to give consent regarding their care and treatment and sometimes gave consent via text if this related to a referral or signposting the client to a service.