Archived: Lifeline Bolton

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The locations were well maintained and clean. There were arrangements in place to ensure subcontracted clinical services had well-equipped clinic rooms. There were appropriate staffing levels with low levels of sickness and minimal use of agency and bank staff. There was a risk assessment in place on clients accessing mainstream community drug and alcohol services we looked at. The worker supporting clients to use steroids safely had a comprehensive understanding of the risks of inappropriate steroid use. There were arrangements in place to report incidents. Following a serious case review which included identified improvements for Lifeline Bolton, changes had been made to address the concerns raised in the review.
• Staff at Lifeline Bolton offered a wide menu of groups and interventions to support treatment and recovery. Staff delivered recovery-focused care that took into account clients’ holistic needs. Staff used a range of tools to support the delivery of care and to monitor outcomes which followed evidence-based practice and national guidance. Lifeline Bolton staff worked closely with medical and nursing staff who provided the subcontracted clinical services and staff in external agencies. Staff received regular supervision sessions and had received a recent annual appraisal. Staff understood how impaired capacity might affect decisions on care and treatment.
• Clients described receiving a good quality service which helped promote their recovery, met their needs and provided the help they needed. We observed staff providing person-centred care. There was an ethos of not judging clients for their current or past substance misuse. Clients could see where they were in the recovery journey through a road to recovery visual poster. There was an active service user forum which provided feedback from clients on how the service ran and how it could improve. There was a ‘you said, we did’ noticeboard showing how managers had taken action following client feedback.
• Clients were seen quickly and there were no significant waiting lists for the services provided by Bolton integrated drug and alcohol service. Appointments ran on time. The service routinely offered in the evenings and at the weekend. The buildings were well-furnished and welcoming with facilities for disabled people. Staff were reaching out to local mosques to improve awareness of the service and uptake to people from who were Muslim, the majority of whom were from south Asian backgrounds. Clients knew how to make complaints and there was information on making a complaint held in reception areas. There were a small number of upheld complaints which resulted in staff ensuing lessons were learnt and changes to practice.
• Staff were complimentary about team leaders and managers and felt supported. Staff reported morale being good despite the service going through a tendering exercise in the near future. Managers were consulting and engaging staff about the likely planned changes. Managers carried out regular checks to help monitor service delivery, team performance, incidents and risks. Staff were committed to working in partnership; there were regular partnership meetings to discuss and address the challenges of working in a partnership formed by commissioners. The provider had plans to improve quality and develop services including plans to introduce a ‘take home’ naloxone service in the near future.

However, we also found the following issues that the service provider needs to improve:

• There were gaps in the staff recruitment processes with missing information on personnel records. This meant that managers were not keeping records to assure themselves fully that all staff were of good character.
• The case management and risk management responsibilities were held by another organisation and managers recognised the need to continue to address the complexities of the responsibilities in the partnership.
• Although clients accessing the service for steroid use were informed of the risks of abusing steroids, this was not formulated into a care plan and a risk management plan.