You are here

East Kent Substance Misuse Service - Thanet Good

Inspection Summary


Overall summary & rating

Good

Updated 21 May 2019

We rated East Kent Substance Misuse Service Thanet as good because:

  • The service had enough staff and provided safe care in a risk assessed and clean environment. Staff assessed client risk in collaboration with clients and relevant professionals.
  • Staff followed the service’s prescribing and treatment policy and National Institute of Health and Care Excellence guidance in relation to clients receiving medically assisted treatment.
  • Staff developed holistic, recovery-oriented, client centred care plans following completion of comprehensive assessments. A range of treatments were available to clients to meet their needs in line with national guidance.
  • The team comprised of and had access to a range of skilled and trained professionals to meet clients’ needs. The service manager and team leader ensured that staff received training, regular clinical and managerial supervision and annual appraisals. Staff worked together as a multi-disciplinary team and with professionals in the wider community to deliver treatment and aftercare.
  • Staff treated clients with kindness, respect, and understood the individual needs of their clients and their family members or carers.
  • The service used internal and commissioned key performance indicators to monitor service outputs and outcomes.
  • The service was well led and the governance processes in place ensured that the all processes ran smoothly.However:

• We reviewed five risk management plans and only one of them included risk management for a client in the event they exited from treatment early.

• There was no evidence in the five care plans we reviewed that clients had been offered a copy.

Inspection areas

Safe

Good

Updated 21 May 2019

We rated safe as good because:

  • The service environment was safe, risk assessed, clean, and had good infection control procedures in place.
  • The clinic room was clean, tidy and well equipped with medicines stored in the lockable fridge.
  • The service had a range of skilled and trained professionals to deliver care and treatment.
  • The service had a receptionist and a staff member on duty in reception which ensured that all clients visiting the service could access assessment and support at first contact.
  • All clients were risk assessed during the admission process to the service.
  • Staff followed the service’s prescribing and treatment policy for clients receiving medically assisted treatment which was in line with national guidance.
  • There was a safeguarding lead at the service who staff could speak to for advice.
  • Staff had effective policies, procedures and training in relation medicines management.
  • Staff had access to clinical information and it was easy for them to maintain quality clinical records.
  • The service had a robust procedure to reporting and responding to incidents.

However:

  • We reviewed five risk management plans and only one of them included risk management for a client in the event they exited from treatment early.

Effective

Good

Updated 21 May 2019

We rated effective as good because:

• All clients received a comprehensive assessment, physical assessment where appropriate, and agreed a care plan following admission to the service.

• Physical health monitoring was undertaken for clients undergoing detoxification, including electrocardiograms to monitor cardiac health, blood borne virus testing, nutrition and vein care.

• The service provided evidence based interventions that met National Institute of Health and Care Excellent guidance. These including providing clients with a needle and syringe programme, appropriate psychosocial interventions, and offering comprehensive assessments.

• Staff supported clients with housing, benefits and employment issues.

• The service provided naloxone to opiate using clients. Naloxone is a medicine which rapidly reverses the effects of an opioid overdose.

• All staff received regular clinical and managerial supervision and annual appraisals.

• Staff from difference disciplines worked with a range of external agencies and professionals including GPs, midwives, police, pharmacies, district council, probation, the community mental health team, young person’s drug and alcohol service and supported housing providers to provide comprehensive and holistic care for clients.

However:

  • There was no evidence in the five care plans we reviewed that clients had been offered a copy.

Caring

Good

Updated 21 May 2019

We rated caring as good because:

• Staff we observed were non-judgemental and treated clients with respect when discussing their care. Staff were compassionate and keen to maintain clients’ dignity.

• We spoke with two clients who told us that staff treated them with respect and supported them to understand and manage their care.

• Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided.

  • Clients could complete feedback forms about their experience of the service. The drop-in service was open to carers for support and advice.

  • Carers were fully involved in clients’ care, with support from the carers’ lead, if clients gave permission for this.

Responsive

Good

Updated 21 May 2019

We rated responsive as good because:

• The service offered a daily drop in so that people meeting the service’s entry criteria could be seen without an appointment. A late clinic took place one evening a week to reduce barriers to accessing treatment.

• Clients’ recovery and risk management plans reflected a range of clients’ needs including clear pathways to other supporting services including housing and maternity care.

• Where appropriate staff ensured that clients had access to education, training and work opportunities.

• The service had a lift for access and had equipment to evacuate people with mobility support needs from the building in an emergency.

• The service offered appointments and groups at three satellite services in Ramsgate and Broadstairs. Where possible, staff arranged home visits for clients with complex needs or who found it difficult to attend the service.

• The service had a hearing loop in the office, access to sign language practitioners and interpreters to support clients with communication support needs to engage.

• The service had a complaints policy which was explained to clients at point of engagement with the service.

Well-led

Good

Updated 21 May 2019

We rated well-led as good because:

• Service leaders had skills and knowledge to perform their roles and provide clinical leadership.

• Staff told us that they knew who the most senior managers in the organisation were.

• Team objectives were based on the organisation’s vision and values which staff understood.

• Staff we spoke with told us they felt respected and valued at work and worked within a happy team where they were supported by managers.

• All staff we spoke with knew how to use the provider’s whistle-blowing process and felt they could raise concerns without fear of victimisation.

• The service used key performance indicators set by their commissioners to gauge performance and productivity.

• There were clear frameworks of what needed to be discussed at service level to ensure that essential information, such as learning from incidents, was shared and discussed.

• The service had clear quality assurance management and performance frameworks in place.

• Staff maintained and had access to a service risk register.

• Staff, clients and their family members had the opportunity to give feedback on the service and its development.

• Staff met regularly with external stakeholders including local ambulance service, hospitals, and commissioners to review all drug and alcohol related deaths to identify learnings, trends and opportunities to reduce these incidents.

• The service was continuously improving and innovating by analysing internal client surveys about early treatment exits, opiate overdose reversal medicine (naloxone) effectiveness, and clients with 15 years or more treatment history.

Checks on specific services

Substance misuse services

Good

Updated 21 May 2019