Archived: We are With You - Shropshire

Updated 1 March 2019

Addaction are a national charity who provide a range of services. They currently deliver 81 services across England and Scotland. They work with adults and young people in community settings, prisons and residential rehabilitation.

Addaction Shropshire are part of the Shropshire Recovery Partnership which offers information, advice and support for adult and young people with drug and alcohol issues. Shropshire Recovery Partnership is based at Crown House in Shrewsbury but offers services from hubs around the county, including Oswestry, Whitchurch, Ludlow and Bridgnorth. Addaction Shropshire’s role within the recovery partnership is to deliver clinical services such as substitute prescribing, needle exchange, blood borne virus testing and vaccinations for hepatitis. They are responsible for qualified staff such as doctors, nurses and independent prescribers. The partner organisation is the lead in the partnership and delivers one to one and group work. They employ the recovery workers. This part of the service is not regulated by the Care Quality Commission and was not included in the inspection.

Young Addaction Shropshire is in a separate building, Fletcher House, in Shrewsbury. This is solely managed by Addaction. The young person’s service is for those aged 10 to 18 and for care leavers up to the age of 25, young people in supported housing projects up to the age of 25 and young people under the care of community mental health teams up to the age of 25.

Both the adult and young person’s service is commissioned through the local authority and is free for people to use.

Addaction Shropshire has a registered manager.

They were previously inspected in June 2017. The services were not rated as the Care Quality Commission has only rated substance misuse services since July 2018.

The service had the following breaches in regulation:

Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment

• All staff could access clinic room keys from an unsecured key safe located at reception.
• Clinic room and fridge temperatures were not consistently monitored and recorded.
• Staff had not taken necessary action to ensure that vaccines remained safe to use when fridge temperatures went outside of the accepted range.

Regulation 15 HSCA (RA) Regulations 2014 Premises and equipment

• Daily checks of the defibrillator had not been regularly completed and recorded.

Regulation 17 HSCA (RA) Regulations 2014 Good governance

• Addaction had not introduced measures to ensure that buildings and fire risk assessments were present and responsive to building work at Crown House.
• Documentation to support prescribing decisions and client recovery was often missing from records or incomplete. This included risk assessments, risk management plans, unexpected exit from treatment plans and recovery plans.

We found that these breaches had been resolved before this inspection.

Updated 1 March 2019

We rated Addaction Shropshire as good because:

• The service provided safe care. The premises where clients were seen were safe and clean. The service did not have waiting lists and clients who required urgent support were given priority and seen promptly. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• The teams included or had access to the full range of specialists required to meet the needs of the clients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multi-disciplinary team and with relevant services outside the organisation.
• Staff understood the principles underpinning capacity, competence and consent as they apply to young people and managed and spoke with confidence about how this applied to the young people they supported.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients and families and carers in care decisions. Clients were supported to take responsibility for their own recovery and staff supported them in a non-judgemental way to achieve this.
• The service was easy to access. The reception area was friendly and welcoming and reception staff and volunteers were available to greet clients. The service used a duty system with a dedicated team available to respond to phone calls and make initial assessments. The service did not exclude people who would have benefitted from care.
• The service was well led and the governance processes ensured that procedures relating to the work of the service ran smoothly.

However:

• Although staff did not routinely do lone visits in the community all staff had personal alarms to use in an emergency but not all staff checked that these worked on a regular basis.
• The adult service did not have good links with advocacy services. They had started work to improve this but there were no signs displayed for clients to know how to access this type of independent support.

Updated 1 March 2019

see detailed findings