Archived: Via - Harrow

WDP Harrow is a community-based drug alcohol service. This is the second time that the service has been inspected by the Care Quality Commission. We first inspected this service in May 2018 but did not rate them at the time.

We rated this service as good because:

• The service provided safe care. The number of clients on the caseload of the team was not too high to prevent staff from giving each client the time they needed. Staff demonstrated a good understanding of the risks associated with substance misuse and individual client risks. Staff responded promptly to any sudden deterioration in a client's health. Staff assessed clients physical and mental health prior to commencing any detoxification treatment.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable for clients needing treatment for substance misuse and in line with national guidance about best practice.
• The team had access to the full range of specialists required to meet the needs of clients receiving treatment for drug and alcohol misuse. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation. Staff effectively supported clients to access a local hepatitis C clinic to ensure early detection and treatment of the virus. The service had a partnership with the local hepatology team, whereby clinicians offered liver function testing and then screened clients for referral into the hepatology pathway.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning. Clients fed back positively about the staff and the service they received. The service had strengthened the Capital Card Scheme, which provided rewards to help motivate clients to attend health and wellbeing appointments.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. Staff responded to high risk clients by effectively transferring them to inpatient detoxification services.
• The service aimed to support people in harder to reach communities through participating in community events and online conferences. The service recognised some clients were vulnerable and isolated when the service was closed. Therefore, it had subcontracted with another local organisation to provide safe weekend activities.
• The service was well led, and the governance processes ensured that its services ran smoothly. Staff felt respected, supported and valued by colleagues and managers. The governance structure, information from audits and senior management meetings, and the quality of the service improvement projects demonstrated that leaders understood the needs of the client group and delivered services to meet them.

However:

• Client’s records were not always kept up-to-date. Staff did not always ensure they uploaded the clients’ medicines record from the GP before they commenced treatment.
• Whilst governance processes operated effectively at team level, improvements were still needed. Audits had not included whether GP summary letters were uploaded onto the system when they were received in a timely way.