Archived: CGL Manchester

Ratings - Substance misuse services

• Overall

  Good

• Safe

  Requires improvement

• Effective

  Good

• Caring

  Good

• Responsive

  Outstanding

• Well-led

  Good

Our view of the service

Mental Capacity Act Compliance

• 100% of staff had had training in the Mental Capacity Act. This was eLearning and included Deprivation of Liberty Safeguards.
• Staff did not always have a good understanding of the Mental Capacity Act, in particular the five statutory principles. When asked, staff told us that they were not involved in capacity assessments, and that they would always refer to statutory services to lead on this. However, when explored, staff were making assessments of people’s capacity to engage in services and make decisions, for example when they were under the influence of substances.
• The provider had a policy on the Mental Capacity Act. Staff were aware of the policy and had access to it.
• Staff took all practical steps to enable clients to make their own decisions. Where there were concerns about a client's understanding, records showed that contact had been made with mental health services and safeguarding referrals had been made for individuals who were being taken advantage of, related to their understanding.
• For clients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. Staff assessed people’s capacity to consent to their treatment at point of assessment for the service. There was a prompt sheet for staff to follow, which included clients’ ability to understand the information, retain the information, weigh up the information and communicate their decision.
• When clients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. Records showed staff were involved in ‘managing high risk together’ meetings for clients where several professionals were involved with clients who were living in high risk situations.
• The service did not have arrangements to monitor adherence to the Mental Capacity Act.

People's experience of this service

People’s experience

We spoke with 10 clients. Clients told us the service was responsive to their needs, if they contacted the service for an appointment, this would be arranged promptly, 2 clients we spoke with were having their appointment a day after they had contacted the service. 

Clients understood their treatment and told us that staff explained it clearly to them. Information was provided about treatments to enable people to make informed decisions. 

Clients spoke positively about the additional support they received, including psychological support, assessments for benefits and access to activities that promoted their health and wellbeing.

Clients told us about the groups that they attended including reduction groups, abstinence groups and how helpful it had been to explore their views and opinions and reflect on their behaviour. 

Clients told us the service was flexible in providing appointments early in the morning to accommodate work commitments. 

Clients were given the opportunity to volunteer with the service, as they progressed through their treatment and recovery.

Clients told us they would like more social opportunities with other people who have had the same experience as them. 

Stakeholder experience

We received feedback from 9 stakeholders. All stakeholders told us how responsive the service is, especially for vulnerable clients who make the decision to change their behaviour and engage in services. Stakeholders told us that people can be seen on the same day by CGL staff. 

Stakeholders spoke positively about the groups available to clients, including those to enable people to pursue hobbies and interests, as an alternative to substance use. 

Stakeholders told us about the positive collaborative working that took place between CGL staff and other agencies with the aim of improving the lives of clients, including the delivery of training by CGL staff to partner agencies. They said that the service was responsive to emerging concerns or trends in substance misuse and shared this knowledge with others working with people who use drugs or alcohol.

Stakeholders told us staff were caring and supportive. Staff supported clients to make and sustain change. The teams operated in a trauma-informed and person-centred way to promote harm reduction effectively.

Strong partnership working with other agencies was a shared view by stakeholders. They said that staff demonstrated knowledge and experience in supporting people with complex needs. 

Stakeholders spoke positively about the service’s visible and proactive presence through outreach work, including visiting people in temporary accommodation. 

Suggested areas for improvement included increased recruitment of staff to manage caseloads better, more events for clients and community engagement opportunities and more out of hours groups. Also, the process for external agencies referring to the service and opportunities for professional advice and consultation.