Archived: Addaction - Leominster

We do not currently rate standalone substance misuse services.

We found the following areas of good practice:

• The environment was clean and well presented, clinic checks were undertaken when required and all staff carried personal alarms. Staff levels were in line with estimated levels set out by the organisation. There was no use of bank and agency and each worker had an average caseload of 50 clients.

• Staff followed guidance issued by national bodies, for example, the national institute of health and care excellence, relating to best practice. Addaction offered a range of therapies and treatment options. Staff also supported clients with different aspects or care such as assistance with housing or employment. There was a wide range of staff available including recovery workers, doctors, social workers and a non-clinical prescriber.

• All staff were experienced and had received a formal induction and mandatory training. Staff received regular supervision and annual appraisal. The team met on a regular basis to discuss incidents and new clients. Staff also met regularly with outside agencies including local safeguarding bodies, mental health services and charities dealing with housing and support. Staff had received training in equality and diversity and there was evidence that the individual needs of each client had been considered when creating care plans. There were systems in place to help clients manage transitions to other services and provision was in place to offer relapse prevention and support to clients for a period after they had been discharged from the service.

• We observed staff that were caring and supportive and clients spoke very highly of the staff that they worked with. Staff had good knowledge of their clients and were aware of their individual needs. They were also aware of the need for confidentiality and demonstrated this in their discussions. Clients and carers were encouraged to be involved in the creation of care and treatment plans. There was evidence of discussions with carers and family members from the first point of referral.

• We found evidence that there was monitoring of caseload sizes to ensure that all clients could be seen regularly and in a timely manner. There were also systems in place to ensure that clients that had not attended appointments were followed up. There was a wide range of rooms available to offer treatment and undertake interviews. Information was available about treatments and local support groups.

• Addaction’s values werecompassionate, determined, and professional. Team objectives reflected these and they ran through supervision and appraisal records. Staff had received mandatory training and felt that they had the knowledge and support to be able to undertake their role. Staff morale was high and all staff we spoke to stated that they enjoyed their role. The service used key performance indicators set out by the commissioners and the National Drug Treatment Monitoring Service (NDTMS). Staff used information from treatment outcome profiles to inform NDTMS of the work they had carried out.

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

• The interview rooms did not have adequate soundproofing. Staff stated that they tried to moderate how loudly they spoke when using the rooms to protect client confidentiality. It was not an issue in the waiting area as music was playing so you could not hear conversations in the small rooms.

• The service was using a mix of electronic and paper records and this meant the notes were not easy to follow. The risk assessments had not been updated on one set of records and were missing in another set.

• Care plans varied in quality with two not showing enough detail and history for the clients. Recovery plans were personalised and showed that the clients had contributed to them being completed but the quality of them was inconsistent.

• Staff did not have awareness of incident reporting and we found evidence that they did not always ensure that this was taking place. Staff also did not participate fully in clinical audits. Managers were aware that both of these were an area for improvement and had been working with staff on this.