You are here

CGL New Directions Mansfield Good

Inspection Summary


Overall summary & rating

Good

Updated 9 August 2019

We rated CGL New Directions Mansfield as good because:

  • Services provided safe care and treatment. There were enough staff, who knew clients and received training to keep them safe from avoidable harm. Staff assessed and managed risk well and followed good practice with respect to safeguarding.

  • Services provided a range of treatments suitable to the needs of the clients. This included harm reduction, substitute prescribing, blood borne testing and detoxification. Staff engaged in clinical audit to evaluate the quality of care they provided.

  • Teams included or had access to the full range of specialists required to meet the needs of the clients. Managers ensured that these staff received training and supervision. Staff worked well together as a multi-disciplinary team and with relevant services outside the organisation.

  • Staff treated clients with compassion and kindness and understood the individual needs of clients. Staff actively involved clients in care decisions and designing the service.

  • Services were easy to access. Staff assessed and treated people who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. The service did not exclude people who would have benefitted from care.

  • Services were well led, and the governance processes ensured that procedures relating to the work of the service ran smoothly.

However;

  • When starting treatment, staff requested summaries from GP’s about a client’s health and prescribed medicines. For services users accessing treatment over time, we did not see processes in place to ensure staff routinely requested updates of this information.

  • Recovery plans staff created with clients had a greater focus on the management of risk. Plans were often descriptive of staff interventions rather than focussing on the clients’ strengths and personal goals for recovery. Once completed, staff did not routinely share plans with clients.
  • The provider was making organisational changes to the way staff work performance was appraised. As a result of this, local appraisal compliance rates were low.
Inspection areas

Safe

Good

Updated 9 August 2019

We rated safe as good because:

  • The service had enough staff, who knew the clients and received training to keep them safe from avoidable harm. This included supporting clients with their physical and mental health. The number of clients on the caseload of the teams, and of individual members of staff, was not too high.

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.

  • Staff assessed and managed risks to clients and themselves. Staff developed plans that included how to manage individual client risks and responded promptly to sudden deterioration in a client’s presentation.

  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it. Policy guidance and safeguarding leads were present to support staff.

  • Staff kept detailed records of clients’ care and treatment. The provider’s record keeping system ensured records were clear, up-to-date and easily available to all staff providing care.

  • The service managed client safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave clients honest information and suitable support.

However;

  • When starting treatment, staff requested summaries from GP’s about a client’s health and prescribed medicines. For services users accessing treatment over time, we did not see processes in place to ensure staff routinely requested updates of this information.

Effective

Good

Updated 9 August 2019

We rated effective as good because:

  • Staff provided a range of treatment and care for clients based on national guidance and best practice. They ensured that clients had good access to physical healthcare and supported them to live healthier lives.
  • Staff used recognised rating scales to assess and record severity and outcomes. They also participated in clinical audit, benchmarking and quality improvement initiatives.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers made sure that staff had the range of skills needed to provide high quality care. They supported staff with supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff.
  • Staff from different disciplines worked together as a team to benefit clients. They supported each other to make sure clients had no gaps in their care. Staff had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation. Staff also engaged in initiatives to improve joint working and liaison.

However;

  • Recovery plans that staff created with clients had a greater focus on the management of risk. Plans were often descriptive of staff interventions rather than focussing on the clients’ strengths and personal goals for recovery.
  • The provider was making organisational changes to the way staff work performance was appraised. As a result of this, local appraisal compliance rates were low.

Caring

Good

Updated 9 August 2019

We rated caring as good because:

  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported clients to understand and manage their care, treatment or condition.

  • Staff involved clients in recovery planning and managing risks. Staff actively sought feedback from clients on the quality of care provided. The provider had initiatives to involve clients in designing and running the service.

  • Staff informed and involved families and carers appropriately. Locally, the provider contracted an external service dedicated to supporting families or carers effected by someone’s substance misuse.

However;

Staff did not routinely share completed risk management and recovery plans with clients

Responsive

Good

Updated 9 August 2019

We rated responsive as good because:

  • The service was easy to access. Its referral criteria did not exclude clients who would have benefitted from care. Staff assessed and treated clients who required urgent care promptly and clients who did not require urgent care did not wait too long to start treatment. Staff followed up clients who missed appointments.

  • The design, layout, and furnishings of treatment rooms supported clients’ treatment, privacy and dignity.

  • Staff supported clients with activities outside the service, such as work, education and mutual aid.

  • The service treated concerns and complaints seriously. Staff investigated them and learned lessons from the results and shared these with the whole team and wider service.

Well-led

Good

Updated 9 August 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed and were visible in the service and approachable for clients and staff.

  • Staff knew and understood the provider’s vision and values and how they were applied to the work of their team.

  • The provider recognised the importance of staff well-being. Staff felt respected, supported and valued. They said the provider promoted equality and diversity in daily work and provided opportunities for development and career progression.

  • Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well.

  • Teams had access to the information they needed to provide safe and effective care and used that information to good effect.

  • Staff collected analysed data about outcomes and performance and engaged actively in local and national quality improvement activities.

Checks on specific services

Substance misuse services

Good

Updated 9 August 2019