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Archived: CRI Hertfordshire Drug and Alcohol Services (Hatfield)


Inspection carried out on 6 December 2013

During a routine inspection

We undertook this inspection because concerns had been raised with us regarding the quality of care and the staffing arrangements at the service.

We found that staff had reasonable case loads and that there were sufficient numbers of staff available to support people. All of the staff that we spoke with told us that there had been changes during the preceding months and that they had felt supported by management during this time.

We found evidence that care plans and risk assessments had been completed and that people were involved in their care planning. People who used the service told us they were satisfied with the service. One person who used the service told us, �My keyworker understands me and knows exactly what I need, [keyworker] it�s like we think in sync.� This showed that people were able to express their views and were involved in making decisions about their care and treatment. Another person told us, �It�s a real life line here, what makes it special is that the staff understand me.� Although, some people commented that they were unclear of the structure of their recovery programme.

Inspection carried out on 13, 18 September 2013

During a routine inspection

Concerns had been identified about how people were cared for and treated as part of a previous inspection and this formed the focus of the inspection. Therefore we did not speak people at this inspection.

We had previously identified concerns about how people�s care and treatment had been managed as well as how the service managed safeguarding concerns, medications and how they supported staff.

We found that CRI � Hatfield had made improvements since our previous inspection. We were told that a lot of work had been undertaken to improve the service and we found evidence of this, although we did note some minor points which still needed to be addressed and we discussed these with the manager.

Inspection carried out on 1 July 2013

During a routine inspection

We did not talk to people who used the service during this inspection. This is because we identified concerns with how people were cared for and treated during our review of care plans. This meant that we focused our inspection on reviewing people�s care plans and other documentation.

We identified concerns with how people�s care and treatment was managed and recorded. We found that the care plans contained inconsistent information and that people were not always treated in a way that supported them and met their needs. CRI did not consistently make referrals to the adult or children�s safeguarding team which meant that people who were vulnerable may not have received the support that the needed. We shared our concerns with the local safeguarding team.

We found that staff were not always supported because appraisals did not take place and staff did not have regular supervision meetings. Issues identified during supervisions were not always acted.

Monitoring had been put in place since our previous visit although there was no system in place to track the audits of care plans which had taken place.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the obtaining, safe keeping, recording and management of medicines.

Inspection carried out on 23 October 2012

During a routine inspection

People told us that they were happy with the service provided and that their dignity was maintained and their privacy protected. They were encouraged to ask questions and felt staff had the time to answer them. People reported that staff were good at discussing all their treatment options with them and that they felt involved in determining their support needs. One person told us, before I came to CRI I didn�t know where to turn, I was seen straight away and the service literally saved my life, I can�t praise them enough, they gave me a different outlook on life� and that, �I take up all the sessions available to me and feel very supported, the staff here really care and I mean really care�. Another person told us, �the staff here are great, they take an interest, when I told them I didn�t want to take a certain medication they listened to me and offered me an alternative�.

Overall we found that the provider was patient focused and respected people�s privacy and dignity, they were documenting the care provided. However, we found that people�s medical histories were not adequately recorded. We also found that relevant information was not consistently shared with the person�s GP and that there were no formal arrangements in place to monitor the quality of people�s records.