Archived: Addaction - Coventry

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• Nurses cleaned the clinic rooms however there was no rota for this or records to show how often they cleaned them. The service used one room for clinics, which was not fit for purpose as it had a carpeted floor, and no handwashing facilities, which increased the risk of infection.

• Not all areas of the building were clean and well maintained. The upstairs waiting area was unclean and the sanitary waste bin in the disabled toilet was over flowing.

• The needle exchange worked well however it contained out of date needles and syringes. We spoke to staff about this but it remained unresolved at the end of the inspection. It was not clear how staff audited this area

• Staff did not always update risk assessments with new information about a client’s current situation. Recovery plans lacked detail and were not always recovery focussed. Staff did not always record a full history of a client’s substance misuse. This made it difficult for staff to support clients when workers had periods of absence.

• The service used paper records, an electronic recording system, and personal files on the computer system to store records. Some paperwork was kept in staff drawers and pigeonholes. The system for storing paper records made it difficult to locate files and this could affect client’s safety and care.

• The service was based in a large building set over three floors. The building was in need of some updating inside. The rooms did not have soundproofing and client conversations could be overheard. The needle exchange had a partially obscured window, which meant other clients could see inside. This meant the service could not maintain the confidentiality and privacy of clients using the service.

• The service did not provide separate facilities for clients with children within the building. If a client had to bring a child with them, they would wait in the reception area. This was busy and an area the service had identified as a potential risk.

• The service was not notifying the Care Quality Commission of incidents that required notification under their registration.

However, we also found the following areas of good practice:

• Staff received regular supervision and an annual appraisal. The records from these contained detailed action points. They covered a range of topics including case management and safeguarding.

• The service had built strong relationships with external organisations such as housing, local charities and the community mental health teams. This enabled clients to build support networks outside of the service giving them a holistic approach to recovery.

• The service provided a range of treatment options including one to one support, group therapy, and community detoxification programmes. They did not have waiting lists and clients could drop in for support.

• The staff had a good understanding of the needs of their clients and showed commitment and a passion for their work and the clients they supported.