• Community
  • Community substance misuse service

Archived: WDP Havering

Overall: Good read more about inspection ratings

Ballard Chambers, 26 High Street, Romford, RM1 1HR

Provided and run by:
Via Community Ltd

All Inspections

25 and 26 February 2020

During a routine inspection

We rated WDP Havering as good because:

  • The service provided safe, effective and high quality care. Staff consistently followed best practice concerning clients’ substance misuse treatment.
  • There were monthly staff meetings focused on discussing clients with safeguarding risks. The safeguarding lead had undertaken audits, resulting in staff consistently undertaking a home visit for clients with young children to assess the safe storage of prescribed medicines. The process for monitoring and auditing safeguarding referrals and actions enhanced the safety of clients and others.
  • The outcome of a mortality review was fed back to the local authority commissioners and the local public health team concerning the increase in older adults using the service. Managers were working with partners to identify ways to enhance clients’ care, including end of life care.
  • Managers had recognised that clients’ access to Improving Access to Psychological Therapies was dependant on them being abstinent from substances for three months. They had arranged for a worker from that service to attend the service two days per week. If a client was in treatment at the service the three-month rule was waived.
  • Leaders in the service had high levels of experience, capacity and capability to deliver high quality treatment and care. They provided compassionate, effective and inclusive leadership of the service and had developed a culture of openness, transparency and continuous improvement.
  • The views of clients and families and carers were viewed as essential to the operation of, and developments in, the service. Groups for clients and families and carers were open and leaders in the service welcomed constructive challenge. Decisions regarding the service were made transparently with clients. If a new idea could not be developed, there was an explanation, and encouragement to identify an alternative.
  • Individual staff members and service user representatives were the joint leads for specific areas of the service. They worked collaboratively to problem-solve and develop the service in those areas. This included areas not usually associated with client involvement, such as safeguarding.
  • Staff described a respectful, supportive culture where they felt valued and motivated to provide high quality care and treatment. Staff were empowered to carry out their roles and there was a strong focus on career development. Staff were very positive concerning the leadership team and were proud to work for the provider.
  • The service had an integrated governance system which provided effective and accurate monitoring and assurance of risks, issues and performance in the service. There were governance processes for all areas of practice. Leaders addressed areas for improvement with staff quickly and effectively.
  • Leaders worked systematically, proactively and effectively with partners. The service led on identifying changes in the local population who misused substances and identifying areas of unmet need. This had included access to psychological therapies, the homeless population and the increasing number of older adult clients.
  • Staff had access to the information they needed to provide safe and effective care and used that information to good effect. Managers had accurate information to monitor the performance of the service. There was a comprehensive governance system.

However:

  • Although all clients’ risk assessments documented potential risks, the full context of those risk was not always described. Leaders had identified this and there were plans to hold workshops after the inspection.
  • A minority of clients’ care plans were generic. Whilst they addressed clients’ needs, they were not personalised or holistic. This had been identified and workshops were due to take place.

30 November to 01 December 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas where the service provider needs to improve:

  • Staff did not always follow the service policy to store, generate and issue prescriptions for controlled drugs and other medicines. Medicines were not stored at a safe temperature or in area where staff could monitor the temperature.

  • Staffing levels did not meet the needs of the clients. There were staff vacancies and although agency staff were used, this still left shifts which were uncovered. Staff had caseloads of between 50 and 60 clients and some staff we spoke with did not feel that that staffing levels were safe since commissioners had approved the redesign of the service. Clients said they were not always told when their key worker changed.

  • Risks and management of risk were not clearly recorded. Staff had not developed management plans for unplanned exits of clients from the service.

  • Mandatory training was not up to date and some staff did not receive regular supervision.

  • The service did not consistently communicate with GPs.

  • The service did not have robust governance processes to ensure the service operated effectively. We did not see evidence of learning from incidents and whilst some staff could describe examples of learning from incidents, others were unable.

However, we also found the following areas of good practice:

  • The service provided treatment for alcohol withdrawal through an ambulatory detoxification programme. Ambulatory detoxification. The service had a policy and procedure that described a client’s suitability for the programme in line with National Institute for Health and Care Excellence National (NICE) guidance .The service had a policy in place for establishing safe starting doses for substitute medicines for clients known as titration.

  • The building was clean and well maintained. The service had a reception area that was spacious and bright. The service had recently lowered the desk to create a more inviting atmosphere.

  • Staff worked together and supported each other well to provide support, care and treatment to clients.

  • Staff had a good understanding of safeguarding adults and children and how to make an alert.

  • We observed that staff demonstrated a welcoming attitude to clients. Clients spoke positively about staff and described them as helpful. Clients could provide feedback about the service and were invited to attend fortnightly service user meetings to discuss issues within the service. Clients knew how to make a complaint about the service. There were no restrictions on anyone accessing the service.

  • The service recorded client outcomes using the Treatment Outcome Profile (TOPs). The service measured outcomes when clients entered treatment and every three months.