Change Grow Live Barnet

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• 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.

At the last inspection, the provider was required to ensure all clients received a medical or non-medical prescriber review annually. At this inspection, compliance had improved to 90%, supported by clear mitigation plans for missed reviews. These included holding prescriptions at the hub, enhanced communication with pharmacies, and scheduling follow-ups. Additional prescribing capacity had been introduced, and audits confirmed overdue reviews were tracked with actions taken to maintain safety. This demonstrated measurable progress since the last inspection.

People generally received care and treatment aligned with national guidance. Prescribing decisions were clearly documented and shared with GPs, and recovery plans reflected individual goals such as reducing alcohol use, reconnecting with family, or accessing housing support. Multidisciplinary meetings and prescriber forums provided structured oversight and supported consistency in clinical decision-making. Staff worked collaboratively with GPs, pharmacies, housing and criminal-justice partners, which helped maintain continuity of care. People were offered harm-reduction advice and opportunities to engage in recovery-focused activities such as allotments, creative sessions and recovery walks, which they told us helped reduce isolation and promote healthier lifestyles.

However, physical-health assessments were not consistently completed to the required standard. While most records included some physical health information, four of the ten records reviewed lacked key checks such as blood pressure, ECG or liver function tests. In addition, validated alcohol assessment tools such as AUDIT or SADQ were missing or incomplete in four records. Staff told us tool use varied depending on confidence and time pressures, and governance meeting notes confirmed inconsistent application of alcohol screening tools as an area for improvement. These gaps meant the service could not be assured that withdrawal risks and co-existing health conditions were consistently identified and managed.

Trauma-informed care training was recognised as a development priority; however, it had not yet been delivered. Staff told us they aimed to work in a trauma-informed way, but confidence and consistency in applying this approach varied.

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.

The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People received comprehensive assessments covering substance use, mental and physical health, safeguarding and social needs. All 10 care and treatment records reviewed included a full assessment.

Physical‑health assessments were present in most records but varied in quality. In four records, key physical-health checks such as blood pressure, ECG or liver function tests were incomplete or unclear. This reduced assurance that staff had the information needed to make timely and safe decisions about care and treatment. In four of the ten records reviewed, validated alcohol assessment tools such as AUDIT or SADQ were either missing or incomplete. Staff told us tool use varied depending on practitioner confidence and time pressures. Governance meeting notes also identified inconsistent use of alcohol screening tools as an area for improvement. Without these assessments, the service may be unable to accurately assess withdrawal risk or determine the appropriate level of monitoring and support.

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 and prescriber forums. 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 had a structured framework to ensure all clients received a medical or non-medical prescriber review annually, in line with policy. Compliance was reported at 90% at the time of inspection, with mitigation plans in place for missed reviews. These included conducting reviews in absence, holding prescriptions at the hub, and enhanced communication with pharmacies. The provider’s audit confirmed that overdue reviews were tracked, risks assessed, and actions taken to ensure safety, such as issuing naloxone, scheduling follow-ups, and reviewing dispensing regimes. Additional prescribing capacity had been introduced to support delivery.

Trauma-informed care training had been identified as a development priority. At the time of inspection, training had been planned but not yet delivered. Staff said they aimed to work in a trauma-informed way, but confidence and consistency varied.

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.

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 GPs, pharmacies, social care, housing and criminal‑justice partners. In the care and treatment records we reviewed, information sharing with primary care was routine (e.g. letters outlining prescribing rationale and any dose changes), which helped maintain continuity when people attended shared appointments.

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.

People were offered harm‑reduction advice and health checks relevant to their treatment, such as blood pressure measurement, ECGs and liver scans where indicated. Recovery‑focused activities included allotments, creative sessions, recovery walks and a twice‑weekly brunch club, which people told us helped add routine and reduce isolation.

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 (e.g. sexual health) in line with local pathways.

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 monitored key indicators including treatment outcome profiles. A drop in completion of these had been noted and monitoring of completion was subsequently being monitored through a dashboard.

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 10 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 98%. Decision-specific mental-capacity assessments were documented in two records.