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Inspection Summary


Overall summary & rating

Good

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.
Inspection areas

Safe

Good

Updated 1 March 2019

We rated safe as good because:

  • All premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose.
  • The service had enough staff, who knew the clients, and received training to keep people safe from avoidable harm.
  • Staff assessed and managed risks to clients and themselves. They developed risk management plans and responded promptly to sudden deterioration in a client’s health.

  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The service managed client safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave clients honest information and suitable support.

However:

  • Although staff do not undertake lone visits they were given personal alarms. Not all staff checked these on a regular basis so would not know if they would work in an emergency.

Effective

Good

Updated 1 March 2019

We rated effective as good because:

  • Staff provided a range of care and treatment interventions suitable for the patient group. They ensured that clients had good access to physical healthcare and supported clients to live healthier lives.

  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers made sure they had staff with a range of skills need to provide high quality care. They supported staff with supervision and opportunities to update and further develop their skill. Managers provided an induction programme for new staff.

  • Staff from different disciplines worked together as a team to benefit clients. They supported each other to make sure that clients had no gaps in their care. The teams had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

  • Staff supported clients to make decisions on their care for themselves proportionate to their competence. They understood how the Mental Capacity Act 2005 applied to young people aged 16 and 17 and the principles of Gillick Competence as they applied to people under the age of 16. Staff assessed and recorded capacity or competence clearly for clients who might have impaired mental capacity or competence.

Caring

Good

Updated 1 March 2019

We rated caring as good because:

  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported clients to understand and manage their care, treatment or condition.

  • Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided.

  • Staff informed and involved families and carers appropriately. They held a regular weekly group for carers and provided family support through the young person’s service.

However:

  • Managers had contacted local advocacy providers to improve access to this independent support for clients but did not display information on how this could be accessed.

Responsive

Good

Updated 1 March 2019

We rated responsive as good because:

  • The service was easy to access. Its referral criteria did not exclude people who would have benefitted from care. Staff assessed and treated people who required urgent care promptly and people who did not require urgent care did not wait too long to start treatment. Staff followed up people who missed appointments to ensure they were safe.

  • The teams met the needs of all people who use the service – including those with a protected characteristic. Staff helped clients with communication and information.

  • The service provided a welcoming environment for clients at both sites. Staff were available to greet clients and knew most clients well. Clients could access food donated by a local company and staff always offered drinks on arrival.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff. Staff used this to help develop the service and continually improve good practice in the support they offered.

Well-led

Good

Updated 1 March 2019

We rated well-led as good because:

  • Managers had the skills, knowledge and experience to perform their roles, had a good understanding of the services they managed and were visible in the service and approachable for clients and staff.

  • Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

  • Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well.

  • Teams had access to the information they needed to provide safe and effective care and used that information to good effect.

  • Managers worked closely with other organisations (schools, public health, local authority, voluntary, public health and independent sector) to ensure that there was an integrated local system that met the needs of young people living in the area.

Checks on specific services

Substance misuse services

Good

Updated 1 March 2019

see detailed findings