Camden Community Drug Treatment 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 the best available evidence.

At this inspection, we have rated it as good.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We reviewed 11 care and treatment records. Staff completed comprehensive assessments with clients at the time they accessed the service. Assessments covered their contact preferences, their plan, recovery goals, strengths and resources, mental health needs, children and young person information, risk of harm to adults, others and self and social circumstances. They included an assessment of the client’s drug or alcohol dependence level using a recognised evidence-based tool, such as Alcohol Use Disorders Identification Test (AUDIT) and Severity of Alcohol Dependence Questionnaire (SADQ) for alcohol dependency.

Staff worked with clients to develop individual care plans and updated them as needed. Care plans reflected their assessed needs, were personalised, holistic and recovery oriented.

Risk assessments included areas of potential risk, such as overdose or relapse, suicidal ideation, and concerns around children and families mental and physical health. The assessment also included what clients wanted from treatment. Staff reviewed these at least three-monthly, or more frequently when necessary.

Recovery plans identified the client’s key worker. Individual needs and recovery plans, including risk management plans, were updated every 12 weeks, in line with the service’s policy. Care plans included thorough contingency planning, for example in the event of a client’s unexpected exit.

Staff met with clients face to face for assessment prior to prescribing medicines. This initial appointment for medication was with an appropriately qualified member of staff. In the initial assessment staff completed a comprehensive clinical assessment to determine the appropriate medication, assess risk factors and ensure that the treatment is evidence-based and suitable. Following this, the staff member created an initial prescribing plan.

Staff safely supported clients to reduce alcohol and stop their drug and alcohol use through the appropriate use of withdrawal symptoms audit tools and by following national guidance on detoxification.

Where appropriate, we saw staff developed a plan for unexpected exit from treatment, providing information about the risks around re-using substances.

Staff took steps to ensure that clients’ physical health needs were assessed and met. Staff were trained to carry out physical health observations for clients and supported clients to access support from their GP and other services when necessary. During the inspection we saw staff supporting someone to consider the physical health input they may need in that moment and doing this in a kind way, taking into account the client preferences and views.

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. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Care and treatment followed national guidance. Prescribing decisions were clearly documented and routinely shared with GPs. Safeguards were in place for higher-dose opioid substitution therapy, and clinical reviews were structured with multidisciplinary input. In the care and treatment records reviewed, prescribing rationale was consistently recorded, and letters to GPs outlined treatment plans.

Recovery plans were person-centred and regularly updated. Records showed that goals were reviewed in keywork sessions and adjusted in line with progress. In several cases, plans reflected individual priorities such as reconnecting with family, reducing alcohol use, or accessing housing support.

Clinical quality was monitored through regular multidisciplinary meetings, chaired by the consultant psychiatrist and prescriber forums, integrated governance team meetings and clinical audits. These were used to review complex cases, prioritise risk, and ensure treatment remained aligned with national guidance. Staff reported that these forums supported shared decision-making and helped maintain consistency in care.

The service worked well across teams and services to support people.

Teams coordinated care through routine forums, including daily flash meetings, safeguarding surgeries, multidisciplinary meetings (including a dedicated alcohol MDT) and prescriber forums. Staff described joint working with homelessness charities, GPs, local hospitals, housing services, probation, police, courts, prison, secondary and primary care, voluntary sector, employment agencies and social services. In the care and treatment records we reviewed, information sharing with primary care was routine. For example, letters outlining prescribing rationale and any dose changes. This helped maintain continuity when people attended shared appointments.

Most staff we spoke to stated that they enjoyed working at the service and that they were supported by colleagues. Staff also told us that they were able to raise concerns and that these were investigated.

The service supported people to consider their overall health and wellbeing to maximise their independence, choice and control. The service aimed to support people to live healthier lives and where possible, reduce their future needs for care and support.

The service offered harm-reduction advice and health checks relevant to their treatment, such as physical health checks, blood pressure measurements and smoking cessation input.

Staff had considered which recovery-focused activities would work well for their current client group and worked to introduce and deliver these. These included walking groups, acupuncture, arts and crafts, wellbeing and reading groups, and a women’s evening. The service also brought in a hairdresser for dry haircuts and beauty sessions, including makeup. The service held a morning group where they made sandwiches instead of bought sandwiches to promote healthy eating.

Recovery plans referenced smoking‑cessation and healthy‑eating support. Where needs extended beyond the core substance‑misuse offer, staff signposted or referred to other services (for example, sexual health) in line with local pathways. There was a lot of information about what was on offer displayed in the client area.

The service offered health clinics and tests for clients. For example, a Fibro Scan, which is a quick, painless, and non-invasive ultrasound test that measures scarring or fibrosis and fat accumulation. It is a comfortable alternative to a traditional liver biopsy to help monitor or diagnose liver conditions. The service also offered screening or access to screening for Chronic Obstructive Pulmonary Disease (COPD), and lung cancer.

The service routinely monitored people’s care and treatment to support continuous improvement. Outcomes were tracked against clinical expectations and the expectations of people themselves. The service was using the Treatment Outcomes Profile (TOP). This is a monitoring tool to measure the effectiveness of drug treatment. The assessment involved a set of questions for clients at various stages in their treatment journey.

The prescribers completed audits of the maintenance of medication assisted treatment (MAT) in community settings, which focused on the maintenance prescribing for those in MAT stage 3, dispensing regimes and person-centred support. MAT stage 3 meant that the service user was in a stabilised phrase of their recovery of substance misuse. They also completed MAT 1 audits which involved checks on case records relating to recent medications started and titration changes.

Staff with quality lead roles as well as the service manager completed volunteer audits to assess compliance and practice against CGL’s national volunteer policy and procedures. Leads also completed risk management audits to check the implementation of the service’s risk management framework.

The service obtained consent to treatment from clients through a form, and this was scanned into the client record.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us they understood their treatment and how consent applied. In our review of 11 care and treatment records, consent to treatment, information-sharing and confidentiality agreements were present in all cases. Training compliance for the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards was high at 100%.