Archived: Lifeline Stoke Recovery Service

Updated 30 November 2016

Lifeline Stoke Recovery Service (Lifeline Stoke) is run by Lifeline Project. It provides community-based drug and alcohol services, including detoxification services, recovery groups, relapse management and substitute prescribing. It mainly provides services from two sites in Stoke but the service also uses a number of outreach venues across the city. Lifeline Stoke Recovery Service provides services to adults and young people, and has a specialist service for pregnant women. At the time of our inspection, the service had 1439 clients receiving prescriptions for substance misuse problems.

Lifeline Stoke is funded by Stoke local authority’s public health department. It is registered to provide treatment of disease, disorder or injury. At the time of our inspection, the service did not have a permanent registered manager. A registered manager from another service had submitted an application to add the location to her registration for an interim period until the newly appointed manager’s application was approved. The service had an accountable controlled drugs officer.

Lifeline Stoke is a large service made up of seven teams:

• clinical team

• administration

• early/brief intervention

• families and young persons

• pregnancy drug users service

• criminal justice

• recovery.

The clinical team comprised detoxification nurses, blood-borne virus nurses, non-medical prescribers and medical practitioners.

We had not previously inspected this service. Lifeline Stoke Recovery Service registered with the CQC on 27 November 2015 having taken over services previously provided by three different providers. The provider’s plan was to integrate the three services under a single structure.

Updated 30 November 2016

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Lifeline Stoke mainly operated from two office bases that held a range of clean and well-furnished facilities such as reception, interview rooms and group rooms. Both sites had clean and well-equipped clinic rooms and needle exchange facilities. Interview and clinic rooms had panic alarms fitted and staff knew how to respond to them.

• Lifeline Stoke had a wide range of skilled staff and worked closely with external professionals to meet the full range of clients’ needs. The service also had a successful volunteer programme. The provider ensured minimum staffing levels by using agency and bank staff to cover vacancies, sickness and maternity leave. All staff, including agency workers and volunteers, received induction, mandatory training and regular supervisions.

• Staff undertook comprehensive assessments with clients from which they developed thorough risk management plans and recovery-focused care plans that took into account clients’ social, psychological and physical needs. Discharge planning was central to recovery-based care and treatment, and staff offered aftercare to discharged clients to help them sustain their recovery.

• The provider had information-sharing protocols and good joint working arrangements with other agencies to promote safety. Staff maintained client confidentiality. They conducted interviews in private settings, and stored client information securely.

• Staff had a strong understanding of safeguarding issues, knew how to report incidents and handle complaints. Staff received debriefs and lessons learnt following incidents.

• Lifeline Project had safe medicines management practices that included prescribing, dispensing and storage, supported by appropriate protocols.

• Staff had a strong commitment to person-centred care. They listened to their clients and provided them with appropriate emotional and practical support. Staff identified named workers for each client as a point of contact, and for continuity of care.

• Lifeline Stoke accepted self-referrals and referrals from other agencies and professionals, and staff tried to assess all newly referred clients within 72 hours. Clients had access to telephone contact out-of-hours. Staff offered flexibility in the times of appointments to meet clients’ needs and routinely offered services outside of normal business hours. The provider had a policy that set out procedures to manage clients’ non-attendance and re-engagement.

However, we also found the following issues that the service provider needs to improve:

• The provider did not notify the CQC of the deaths of any clients in receipt of their services. This was breach of regulation. The provider did not always notify the CQC of incidents in line with the relevant statutory requirements.

• At the time of our inspection, 130 clients had not received medical reviews since the new provider took over the service.

• The provider was new to managing clinical services but did not undertake any audits on clinical practice.

• Clients experienced delays in receiving their prescriptions. There was a risk of loss of blank prescription forms when administrative staff retrieved them for printing or when staff accessed the safe for other items.

• There was a lack of coordination and monitoring of lone working practices across the whole service although individual teams had their own safety protocols.

• Some staff had high caseloads that had an impact on the amount of support they offered clients.

• Clients attending Wood House waited for their urine test results in the corridor outside the designated testing toilets. This did not protect their privacy and dignity.

• Most staff did not know who the senior managers were and some staff felt that senior managers did not consult them enough on their plans when they took over the service.