CGL Spectrum

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff responded promptly to sudden deterioration in service users physical and mental health. Staff made service users aware of harm minimisation and the risks of continued substance misuse. Safety planning was an integral part of recovery plans. The service used systems and processes to safely prescribe, administer, record and store medicines. Staff regularly reviewed the effects of medications on each service users mental and physical health. The service managed service user 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.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We spoke with 7 service users as part of the assessment. Service users said they felt comfortable raising concerns with their key worker or with the provider. One service user we spoke with said they had witnessed an incident in the waiting room. The service user told us it was handled professionally and with care and that staff made sure all other service users in the waiting area felt safe following the incident.

Leaders told us there was an engagement and re-engagement process in place to ensure service users were supported to access treatment and those who were at risk of, or had disengaged from treatment were supported back into treatment. Leaders told us this new process had been implemented following an incident which resulted in a learning experience.

Staff knew how to report incidents and felt able to raise concerns. Staff told us they debriefed following incidents and were able to give examples of learning from incidents. For example, the extended period of absence pathway, which was used when service user’s key workers would be off for a period of time.

The provider had recently developed an extended period of absence pathway, to ensure service users whose key worker was away from work for a prolonged period had access to support. The new pathway included sending a text message to service users to inform them of their key workers absence and contact numbers should they need to access support.

The provider hosted a mortality review panel, where any service user deaths were discussed with individual keyworkers and any learning shared countywide. In addition to this, the provider held monthly integrated governance team meetings (IGTM) these were county wide. Learning from these meetings was shared, both county wide and across any other CGL sites.

Service users said the referral process was smooth, and they were seen quickly following referral. Service users confirmed they were supported with accessing other agencies for support and one service user described how his key worker went with him to an external appointment to offer additional assistance.

Staff felt communication was effective when people moved between services or teams within CGL Spectrum.

Staff told us they had specialist roles within the integrated team, this included specialist teams including opiate recovery workers, alcohol recovery workers and rapid engagement workers who worked with non-dependent service users. The teams worked closely with the young people’s drug and alcohol teams. Teams delivered a multi-agency approach, including hospital liaison teams, prison in reach teams, integrated offender management team, drug test and arrest teams and joint working with the local mental health trust.

Staff told us there was a collaborative, joined-up approach to safety that involved service users, staff and other agencies involved in service user care.

There were a variety of ways in which service users could be referred into the service. Most referrals were by their GP, or self-referral through a secure online referral system.. Service users could attend a walk-in appointment and receive a triage and personalised assessment on the same day. The service did not have waiting lists, those referred, were offered a time and date to be assessed in a timely manner. Staff saw urgent referrals quickly.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

Service users we spoke with confirmed they were involved in their risk assessment and that risks of continued substance use were discussed with them. Risk assessments included providing service users with medication lock boxes to store medication safely at home and naloxone, a medicine that rapidly reverses an opioid overdose.

Staff told us they carried out risk assessments with service users as part of the initial assessment. Staff also discussed service user risk or any changes in risk during the daily morning meeting at each hub.

Staff assessed and managed risks to service users and themselves well. They responded promptly to sudden deterioration in service users physical and mental health. Staff made service users aware of harm minimisation and the risks of continued substance misuse. Safety planning was an integral part of recovery plans.

Staff completed risk assessments for each service user on arrival, using a recognised tool, and reviewed this regularly, including after any incident. We reviewed 20 service user records and found all records had an initial risk assessment, a risk management plan in place and the most recent risk assessment was up to date.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Service users told us they received regular medical reviews, and they understood the medication they were receiving. Service users who collected medication from a pharmacy confirmed they were involved in choosing a convenient pharmacy to suit their needs and that collection regimes were discussed with them prior to commencing treatment.

Staff told us they adhered to CGL’s policies relating to medicine. Staff said they had access to doctors and non-medical prescribers who issued and reviewed prescriptions for service users. Clinical staff ensured service users were properly monitored when on medicines and supported service users who were on a medical detoxification programme, this included access to 3 health care assistants offering support and monitoring across the 4 hubs.

Overall, 100% of eligible staff had completed basic life support and anaphylaxis training.

Each hub had a clinic room that was clean and fully equipped. Staff monitored the temperature of clinic rooms and medication fridges and knew what to do if the temperature went outside of range. The blood pressure machine, pulse oximeter and weighing scales had not been calibrated to ensure they were working correctly. However, this was resolved whilst the assessment was being carried out.

Service users were offered Blood Borne Virus testing at the start of treatment and throughout their treatment episode. Hepatitis B vaccinations were routinely offered at the point of assessment and at review appointments to all service users.

All staff were trained to administer naloxone in case of an emergency. Staff gave service users naloxone and trained them on how to administer it to reverse opioid overdose.

Medicines and prescription forms were kept securely. Their use was monitored in line with national guidance. The service monitored the temperatures of medicines storage areas. If temperatures fell outside the recommended ranges, staff knew what actions to take.