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Stockton Recovery Service Good

Inspection Summary


Overall summary & rating

Good

Updated 18 January 2019

We rated Stockton Recovery Service as good because:

  • The service was well led by a strong, cohesive, enthusiastic management team with a good mix of skills, experience and knowledge who were working hard to further improve services and engagement with clients and their recovery. They had robust systems to ensure incidents were investigated and lessons learned were discussed amongst staff and changes implemented. Communication within the service and to and from the senior management at provider level was good. It was supported locally by a well-planned set of meetings to ensure information was shared quickly ensuring staff were well informed of key risks and developments.

  • Staff described a supportive team culture and were happy to raise concerns openly. Morale was good and staff were proud of their work and the difference it made to people’s lives. Staff were kind, caring and recovery focused. They engaged well with clients and where appropriate their families and carers. Staff understood and addressed specific needs regarding equality, diversity and human rights.
  • Clients consistently praised the staff and service. They all knew the name of their recovery worker, who they were in regular contact with. They said they felt safe, were made aware of risks and how to minimise these and felt fully involved in their treatment. If they had issues they were happy to raise these directly and were confident they would be resolved. The service provided and had access to a range of interventions to support clients, carers and families.
  • Locally engagement was good, with commissioner’s, other services such as primary care, community mental health teams, local authority safeguarding teams, police, probation and prison services as well as third sector organisations.

However:

  • There were areas of improvement required to manage safety in the service. Not all clients had a risk management plan which addressed every client risk identified. Therefore, it was not clear how staff managed all identified risks effectively. Not all staff had received the required mandatory training to ensure they could respond to physical health emergencies, although training was scheduled to be completed by February 2019.
  • Staff had not been fully appraised for the previous 12 months at the time of our inspection as a new, improved system was being introduced. The new system was planned to be piloted in January 2019 and fully introduced in March 2019.
  • Staff did not consistently record discharge plans in client records although there was good evidence during our inspection of focus on client progress and discharge.
Inspection areas

Safe

Requires improvement

Updated 18 January 2019

We rated safe as requires improvement because

  • Risk management plans were not fully completed to address all risks identified. Key information was missing to confirm how each risk was being mitigated and managed.

  • The service did not ensure mandatory training compliance of basic life support was completed. Only 50% of eligible staff had completed the training at the time of our inspection.

However:

  • Sufficient skilled staff were in place to deliver safe and effective care and treatment to clients.

  • Staff knew how to identify adults and children at risk of or suffering harm. Safeguarding leads supported staff well to ensure all risks were captured and responded to well and monitored on an ongoing basis.

  • The service followed best practice when prescribing, recording and storing medicines. The service worked closely with local pharmacies to ensure clients received the right medication at the right dose at the right time, which in some cases included supervised consumption.

Effective

Good

Updated 18 January 2019

We rated effective as good because:

  • The service ensured staff were competent for their roles. Staff received regular supervision with managers to provide support, identify areas of learning and development and monitor the effectiveness of the service. The staff supervision compliance rate was 93%.

  • The multidisciplinary team of staff worked well together and supported each other to provide good care and treatment. This included where appropriate joined up working with other supporting services such as mental health services for the benefit of the client’s recovery.

  • The service provided a range of care and intervention treatments which followed national guidance on best practice.

  • Staff encouraged clients to live healthier lives as part of the provision of care.

However:

  • The provider had postponed annual staff appraisals for a few months pending the introduction of an improved system. Therefore, some staff had not been appraised within a 12 month period.

Caring

Good

Updated 18 January 2019

We rated caring as good because:

  • Staff treated clients in a kind, caring and compassionate manner providing practical and emotional support appropriately including access to mutual aid groups.

  • Staff understood clients’ needs regarding equality, diversity and human rights e.g. their gender, ethnicity, religion, sexual orientation, age and disability and how these might relate to their substance misuse.

  • Clients told us staff helped them to understand and manage their care treatment and condition. They said they felt safe, had been made aware of the risks and felt fully involved in their care.

Responsive

Good

Updated 18 January 2019

We rated responsive as good because:

  • There was no waiting list and staff were able to see clients at short notice.

  • Staff encouraged clients to attend local community groups and activities for additional support. There were also successful less structured groups held within the service to provide additional engagement and support opportunities.

  • Clients told us they were consistently encouraged by staff to maintain relationships with their families, carers and those dear to them to support their recovery. Care plans evidenced the names of significant others.

  • Staff ensured clients and carers were able to raise complaints. Information in relation to raising a complaint was displayed in all locations. Complaints were reviewed in line with the provider’s policy. clients told us they felt confident to make complaints if it was needed.

However:

  • Not all client care records documented discharge planning. Although, discharge emphasis was noted in group discussions attended during the inspection regarding client progress and next steps to discharge. Staff told us they planned for discharge and clients told us they were fully involved in their care with the aim of abstinence and discharge.

Well-led

Good

Updated 18 January 2019

We rated well-led as good because:

  • The service was well led by the services manager, project managers and team leaders who had sufficient skills, knowledge and experience to perform their roles together and had a good understanding of the services and localities they managed.

  • Staff felt supported, respected, valued and part of the organisations future direction. Staff said they worked well together and new staff who had joined the organisation as a result of a recent merger described being very well supported during the transition.

  • Staff felt proud of their contribution to the service and how this made a difference to people’s lives. There was also a strong commitment towards continual improvement and innovation to further improve care and treatment to aid client recovery.

  • Staff knew what and how to report incidents and safeguarding and there was good evidence of learning from incidents and subsequent changes being made.

  • The service had been proactive in capturing and responding to clients concerns and complaints. There were creative attempts to involve clients in all aspects of the service.

Checks on specific services

Substance misuse services

Good

Updated 18 January 2019