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Archived: Addaction - Cornwall

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Inspection report

Date of Inspection: 2, 3, 8, 9 January 2014
Date of Publication: 11 February 2014
Inspection Report published 11 February 2014 PDF | 95.92 KB

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 2 January 2014, 3 January 2014, 8 January 2014 and 9 January 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and took advice from our specialist advisors. We were accompanied by a specialist advisor.

Our judgement

There were enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

People who used the service said staff support was to a high standard and staff responded to their needs as necessary. People said when they had first come into contact with the service they were assessed quickly and staff ensured they received appropriate treatment.

Since the service expansion a comprehensive management structure has been developed. This included an area manager, two operations managers (each covering a specific geographical area), and locality managers responsible for different aspects of the service (for example criminal justice, volunteer/peer monitoring/ ‘breaking the cycle’). At the time of the inspection, the person registered as the manager with CQC, was the regional director. We were told this arrangement was currently being reviewed now the service expansion and reorganisation had been completed.

Each office had a team of recovery coordinators. These staff carried a caseload of around 40 people who used the service. These staff would regularly meet with people individually, and would be responsible for ongoing assessment, signposting to appropriate services, writing and monitoring recovery plans with the individual concerned.

There were also life skills workers, and workers assigned to complete the ‘Breaking the Cycle’ family work. There were administrative staff at each of the centres to assist other staff. Nursing staff and other clinicians such as two psychiatrists (a consultant and a staff-grade specialist doctor) were employed. The service contracts, on a sessional basis, with eight general practitioners with a special interest (GPwSI). Six nurse prescribers (NMP) were employed.

There was also ‘peer mentor’ and ‘recovery champion’ programmes. These individuals were often people who had used the service, and now provided people who used the service with peer support. The organisation had an ‘apprentice’ scheme. This was a two year programme which enabled the person to learn the role for example of a recovery co-ordinator.

Many staff said they were very happy with the support they received from colleagues and their managers. For example we received comments which included “it is a great team,” and that colleagues and managers were “very caring about how staff feel….management are approachable and supportive.” We were told there had been some issues around staff morale, sickness and case load since the changes implemented since April 2013. However staff told us the provider was aware of the issues, and managers had been as supportive as possible to address the concerns. We were also told the provider was working to fill any vacancies. We did not find any evidence that the concerns had compromised care or safety. Staff told us for example they thought the people who used the service received good care and support and the team worked in a very ‘person centred’ manner.

We received many positive comments regarding the organisation’s culture. For example one member of staff said the organisation was “good at taking risks and was creative.” They said there were limited barriers to ensure “ideas could be implemented faster.”

We attended a clinical meeting which included most of the recovery coordinators, a nurse practitioner, volunteers and a clinician. The meeting was well organised. There was evidence of good communication among the team and everybody present had an opportunity to express their views and make a contribution. The meeting was business- like but also people had the opportunity to have a joke and share banter.