Change Grow Live Barnet

This means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At the last inspection, the provider was required to ensure staff completed mandatory training in basic life support. Training records now confirmed compliance, and all relevant staff had completed this training. Leaders had also taken steps to strengthen learning from incidents by using flash meetings and governance forums, which had been updated to include an incident section. However, during our inspection the flash meeting we observed was brief and did not record or discuss incidents, so the incident‑review function was not demonstrably embedded.

The service continued to demonstrate strengths in several areas. Staff understood safeguarding responsibilities and escalation routes, and training compliance was high. Clinical leads held Level 3 safeguarding and refresher plans were in place. Risk assessments and recovery plans were present in care records and regularly reviewed, and prescribing decisions showed multidisciplinary input. Medicines were managed safely, with standard operating procedures aligned to national guidance and consistently applied in practice. Records confirmed physical health monitoring for higher-dose methadone prescriptions, and naloxone and emergency medicines were available. The environment was clean and well maintained, with infection prevention measures in place. Incident reporting was embedded, and staff acted promptly to manage risks, including de-escalation and liaison with emergency services when required. Governance forums supported learning from incidents, and staff described structured discharge pathways and joint working with other agencies to maintain continuity of care.

However, areas for further improvement were identified. Some of the incidents we reviewed, identified actions that did not have completion dates and there had been no checks to confirm whether actions were completed or effective. Plans for unexpected exit from treatment were not documented in care records, meaning staff may not act quickly or consistently if the key worker was unavailable. Accessibility for people with mobility needs remained limited, and some staff reported uncertainty about panic-alarm use in group sessions, although leaders had reiterated procedures. Caseloads remained high, with recovery workers managing 80–100 cases, although an action plan to address this was in progress. Supervision compliance for volunteers was low, and administrative support was limited.