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West Sussex Drug & Alcohol Wellbeing Network Good

Inspection Summary


Overall summary & rating

Good

Updated 7 January 2020

West Sussex Drug & Alcohol Wellbeing Network delivers medical and psychosocial interventions in the community for substance misuse. We rated them as good because:

  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
  • Staff developed recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
  • Staff treated clients with compassion and kindness. Staff understood the individual needs of clients. They actively involved clients in decisions and care planning. Clients were also involved in the planning of service delivery.
  • The service was well led. Staff spoke positively about leadership at all levels and talked about how the provider’s vision and values informed service delivery.

However:

  • Risk was not always managed effectively. Risk information, such as safeguarding, was hard to find in the client’s care records and was often lacking enough detail. There was a lack of timely and accessible governance around safeguarding procedures for managers and team leaders. There was no clear local procedure for the management of prescriptions if a client persistently missed their medical reviews.
Inspection areas

Safe

Requires improvement

Updated 7 January 2020

We rated safe as requires improvement because:

  • Client risks, such as risks to or from other people, were not always recorded effectively. Where staff had identified an area of risk with a client, it was not always clear what the management plan was or what actions had been completed.

  • Prescribing practice did not always follow the provider’s own policy or national guidelines around medical reviews or take out prescriptions. Clients were not always present when a review of their prescribed medication took place; there was no documented local procedure for when clients did not attend their medical reviews. Rationales for the safety of take-out methadone prescriptions were not always clear.

  • While there were governance systems in place to monitor safeguarding, they did not allow managers and team leaders to have timely oversight of safeguarding processes within their teams.

However:

  • All premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose.

  • 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.

  • The service had a good track record on safety.  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.

Effective

Good

Updated 7 January 2020

We rated effective as good because:

  • Staff provided a range of care and treatment interventions suitable for the client group and consistent with national guidance on best practice. They ensured that clients had good access to physical healthcare and supported clients 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 appraisals, supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff.
  • Staff offered physical health monitoring. This included appropriate physical health checks during detoxification programs, blood borne virus testing and treatment, vaccinations and physical health assessments with qualified nurses.
  • 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. The teams had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.
  • The service employed a peer mentor coordinator who managed peer mentors across all sites. Peer mentors offered practical help to clients as well as supported with treatment.
  • Staff supported clients to make decisions on their care for themselves. They understood the provider’s policy on the Mental Capacity Act 2015 and knew what to do if a client’s capacity to make decisions about their care might be impaired.

However:

  • Staff delivering psychological therapies did not have access to clinical supervision.
  • The rates of annual appraisals for staff were low.

Caring

Good

Updated 7 January 2020

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 and treatment.

  • Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided. They ensured that clients had easy access to additional support.

  • Staff informed and involved families and carers appropriately.

  • On completion of a psychosocial intervention program, clients were invited to attend a graduation ceremony to celebrate their achievements.

  • Service user representatives were involved in the development of the service.

  • Clients had access to advocates. Staff were aware of the different local organisations that offered advocacy services and posters and leaflets were on display across all sites.

Responsive

Good

Updated 7 January 2020

We rated responsive as good because:

  • The service was easy to access. Staff planned and managed discharge well. Staff worked to re-engage clients who did not engage with the service. The service had alternative care pathways and referral systems for people whose needs it could not meet.
  • The design, layout, and furnishings of treatment rooms supported clients’ treatment, privacy and dignity.
  • The service met the needs of all clients, including those with a protected characteristic or with communication support needs.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with the whole team and the wider service.

Well-led

Good

Updated 7 January 2020

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles, 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 in the work of their team.

  • Staff felt respected, supported and valued. They reported that the provider promoted equality and diversity in its day-to-day work and in providing opportunities for career progression. They felt able to raise concerns without fear of retribution.

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

  • Staff collected and analysed data about outcomes and performance.

However:

  • There was no overarching governance system to ensure that managers had oversight of safeguarding processes.

Checks on specific services

Substance misuse services

Good

Updated 7 January 2020