The Care Quality Commission
  • Community
  • Community substance misuse service

Archived: The Gate

Overall: Outstanding read more about inspection ratings

John Dobbin Road, 158-166 Northgate, Darlington, County Durham, DL1 1QU (01325) 267230

Provided and run by:
NECA

All Inspections

4-5 November 2019

During a routine inspection

We rated this service as outstanding because:

  • There was compassionate, inclusive and effective leadership. Leaders and managers demonstrated high levels of experience, capacity and capability to deliver the highest standards of care. Staff were proud of the service as a place to work and spoke highly of the culture. There was strong and effective collaboration, team-working and support with a common focus on improving quality of care.
  • There were consistently high levels of constructive and meaningful engagement with staff and people who used the service. People who used the service had access to an extensive range of opportunities to provide feedback on the service and the care they received. Staff used this feedback to make meaningful changes to the service to meet client’s needs.
  • Feedback from people who used the service was continually positive about the way staff treated them. Clients and carers felt staff ‘go the extra mile’, and the quality of care and support provided exceeded expectations.
  • There was a strong, visible person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
  • The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.

7-8 December 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • The service environment was clean, tidy and well maintained. Health and safety checks including fire and legionella testing were up to date. There were appropriate arrangements in place for disposal of clinical waste and vaccines for the treatment of blood borne infections were stored safely in a fridge.
  • Prescription pads were stored securely and there were safe systems in place for the destruction and loss of prescriptions to prevent fraudulent use of the forms and prescribed medicines.
  • Staff sickness absence figures were low. Staff absences were rare and the service had not used bank or agency staff within the 12 months prior to the inspection visit. Staff absences could be covered by staff at other NECA services.
  • Staff either had completed mandatory training or were due to complete it within the next few weeks.
  • The Gate’s service for young people operated an out of hours service if required and worked with the police during evenings to do outreach work with young people misusing alcohol.
  • Care records contained well-documented risk assessments and physical health checks. Clients at the service had a recovery plan in place, which was regularly updated.
  • Safeguarding training was mandatory for all staff. The service had systems in place to reduce the risk of clients passing on their medication to another person for illicit purposes.
  • Clients and carers told us that staff were kind, caring and respectful towards them. Staff spoke with clients in a friendly manner and the clients appeared comfortable speaking to them. Family members and friends could be involved in clients’ care and treatment. Clients were able to take an active involvement in the development of their care planning arrangements and had been given or seen a copy of their care plan.
  • Between October and November 2015, the service conducted a client feedback survey and the results were overwhelmingly positive.
  • The service’s policies around prescribing medication followed the National Institute for Excellence in Care and the Drug Misuse and Dependence: UK guidelines on clinical management book (more commonly known as the Orange Book) guidance.The service had a process in place for dealing with clients who had dropped out of treatment unexpectedly.
  • NECA confirmed there were no serious incidents at The Gate requiring investigation and no serious case reviews at the service within the last 12 months. All staff at The Gate were able to report incidents and lessons learned from incidents were shared amongst the team to inform best practice.
  • The service had its own Duty of candour policy. Staff gave examples of being open and honest with clients when incidents or mistakes happened. They were aware of the need to keep clients fully informed and provided information throughout any investigations or complaints made.

28 November 2013

During a routine inspection

As part of this inspection we spoke with three people who use the service. They told us they were given enough information by staff about what the service would do and what they could expect. One person told us, "Being able to walk in and get what you need is fantastic'. Another person said, "I have had enough of being dependent on drugs and coming here puts my mind at rest and helps me to know that I'm safe."

People told us that they had provided either verbal or written consent before any treatments/ tests had been carried out, and told us they were confident their information was stored securely. One person said, "My privacy is paramount to the staff here. I know that they will keep all of my information confidential."

The service worked collaboratively with other statutory health and social care agencies.

The staff we spoke with made positive comments about the service provided at The Gate and the support they received to carry out their roles.

The service had effective ways of checking and monitoring the quality of its service which included the views of people who used it.

9, 25 January 2013

During a routine inspection

As part of this inspection we spoke with six people who used or had used the service. They told us they were given enough information by The Gate, so they knew what the service would do and what they could expect.

People told us they felt they were treated with dignity when attending The Gate. One person said, 'I felt everyone respected me. All the staff, including the reception staff, were so helpful.'

The service worked collaboratively with many other health and social care agencies. It had clear procedures for dealing with the protection of people and children. All the people we spoke with said they felt 'comfortable' when using the service. One person said, 'I felt very safe at The Gate. They taught me not to be so angry and to respect myself and other people.'

The provider, North East Council on Addiction (NECA), employed a wide range of health and social care professionals who provided the assessment and treatment of people who used the service. The staff we spoke with made positive comments about the service provided at The Gate and the support they received to carry out their roles.

The service had effective ways of checking and monitoring the quality of its service which included the views of people who used it.