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Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 January 2019

We rated ReNew as requires improvement because:

  • The service did not support clients to formulate a structured and goal driven plan to guide, measure and evaluate their progress towards recovery. Most clients did not have an up to date, personalised, recovery orientated plan and there was limited evidence to suggest staff considered interventions to support the client’s needs with a holistic approach.
  • The service did not ensure that a client’s information was not shared without their consent. Not all clients had an information sharing agreement. The service submitted monthly data to the National Drug Monitoring System for these clients without agreement. This also meant that staff may have, or could potentially share client information with external organisations or people without consent from the client.
  • Staff did not clearly record the details for identified risks and it was unclear in the client’s electronic records whether all risks had been fully considered due to missing information. Plans to manage or mitigate risks were not always clear in terms of timeliness or whether the actions had been carried out. However, staff discussed risks daily through morning meetings to ensure immediate concerns were addressed.
  • Staff satisfaction and morale was varied. Some staff felt that managers did not always listen to their questions and there was a lack of involvement. They were unclear in the direction and structure of the service. They felt communication was limited, this was particularly in relation to the new service model.

However:

  • Staff followed the appropriate guidance in prescribing and detoxification for clients. They followed good medicines management processes and considered a client’s physical health needs. They supported clients into mutual aid as per best practice. Clients attended a range of groups which were underpinned by evidence based psychosocial interventions. Staff had a good knowledge of safeguarding and referred their concerns appropriately.
  • Staff treated clients with dignity and respect. They were dedicated to providing effective treatment and showed kindness and understanding in all interactions. They knew the organisation’s values and their behaviours reflected these.
  • Staff were suitably experienced and qualified. Their training levels in mandatory units was high and they had good opportunities to further develop their skills in a specialist area to enhance the delivery of treatment. The service welcomed innovation from staff and considered their wellbeing.
  • The service had effective systems in place to record and investigate incidents. Staff knew how and what to record. Investigations were carried out identifying lessons to be learnt which were fed back to staff. Following incidents, staff were supported as needed.
  • ReNew had developed good links and pathways with external agencies. These included pathways to encourage Hepatitis C treatment, pathways with the hospital to support clients from accident and emergency into alcohol detoxification treatment and initiatives with the police to meet community needs and improve provisions for vulnerable groups.
  • Staff took active steps to engage with diverse groups and ensure that those hard to reach clients were provided with harm minimisation advice.

All locations were clean and tidy with suitable facilities to promote recovery, comfort and dignity. Health and safety requirements were adhered to.  Appropriate client information was available.  

Inspection areas

Safe

Good

Updated 11 January 2019

We rated safe as good because:

  • All locations were clean, tidy and well maintained.
  • Staff training levels in all mandatory units were high.
  • Staff followed good medicines management practice. This included prescribing, storage, dispensing and prescription management.
  • Staff were knowledgeable and had good support in both safeguarding adults and children. They knew when and how to refer a concern.
  • Staff recorded, investigated and learnt lessons from incidents. They were supported after a serious incident and provided with feedback.

However:

  • Some staff and clients felt the reception area at Trafalgar House to be unsafe due to the number of clients and the area’s layout.
  • Staff did not always fully record risk assessments completely or with sufficient detail on the electronic system. Actions in risk management plans lacked specific detail of how or when actions would or had been carried out.

Effective

Requires improvement

Updated 11 January 2019

We rated effective as requires improvement because:

  • Most clients did not have a structured up to date, personalised, recovery orientated plan.
  • There was limited evidence that staff considered interventions to support a client’s recovery in a holistic manner.
  • Staff did not complete all required boxes in the comprehensive assessment.
  • Supervisions and appraisals were not always effective in supporting and directing staff.

However:

  • Staff followed the appropriate best practice when prescribing medications to clients and considered physical healthcare.
  • Staff were appropriately experienced and qualified; they had opportunities to develop their skills to provide specialist treatment for the client group.
  • ReNew had good working links with external agencies to contribute to meeting community needs and improving provisions for vulnerable groups.

Caring

Requires improvement

Updated 11 January 2019

We rated caring as requires improvement because:

  • The service did not always ensure that a patient’s confidentiality was maintained.
  • Staff did not reflect how a client was actively involved in their interventions towards recovery and clients were unable to access a copy of any plans.

However:

  • Staff supported clients with a supportive and non-judgemental manner.
  • The service offered support for families and carers.

Responsive

Good

Updated 11 January 2019

We rated responsive as good because:

  • Staff offered clients an appointment for a comprehensive assessment either on their day of referral or within the same week depending on the client’s availability.
  • Staff took a proactive approach when clients missed appointments or unexpectedly dropped out of treatment.
  • ReNew were responsive to meeting the needs of all groups of people who use the service.
  • Clients knew how to complain if needed and felt their complaints were listened to.

However:

  • Staff did not deliver a group programme for clients attending Gypsyville.

Well-led

Good

Updated 11 January 2019

We rated well-led as good because:

  • Managers were involved in planning the new service model and its implementation.
  • Staff knew the organisation’s values and their behaviours reflected these.
  • ReNew had systems and processes in place to monitor and manage their objectives, drive improvements and meet the required standards.
  • Both staff and clients had opportunities to give feedback about the service

However:

  • Some staff felt managers and senior leaders were unapproachable and not visible.
  • Some staff and clients felt that communication was limited. This was particularly in relation to the new service model.
Checks on specific services

Substance misuse services

Requires improvement

Updated 11 January 2019