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Archived: Tonbridge Recovery Service

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Inspection report

Date of Inspection: 3 December 2013
Date of Publication: 4 January 2014
Inspection Report published 04 January 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 3 December 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service and talked with staff.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There was a structure to the initial assessment which included areas such as mental health, domestic circumstances, any previous offending history and any blood borne virus, such as HIV or hepatitis.

We looked at three assessments. They followed the structure. They were detailed and often contained the words that people had used for example, “I would like to regain my sleep pattern” and (name) having been made aware of the dangers said, “it doesn’t apply to me”. This meant that people had been involved in their assessment. Where necessary there were joint assessments such as where there were thought to be both mental health and substance misuse issues involved.

People needs were discussed in staff meetings. We sat in on one meeting. Staff clearly knew and understood the problems that people faced. There was detailed discussion about various options and we saw that staff were encouraged to contribute to finding long term solutions. We looked at four sets of records. We saw that people had a plan of measurable objectives tailored to meet their treatment needs. These included specifics such as by how much they intended to reduce their consumption of a particular substance. In general these objectives were signed by the person concerned as an indication of their involvement in the plan. People we spoke with confirmed this, for example, one person said,” It’s your own plan but they give you the tools to finish it”.

There was a range of activities as well as formal therapies to help people with substance miss-use problems. The issues were addressed at three levels. There was Foundation for change, for those currently miss-using substances; Foundation for growth for those who had recently stopped using substances and Foundation for life for those who were moving away from the service. Each had its own room within the service allowing people to physically move from one area to another if they progressed. People could wear wrist bracelets (red, amber or green in colour) to indicate where they were in the programme.

There were groups timetabled for each level during the week. People were supported with prescription medicines at various places in their care plan. There were two consultant psychiatry sessions each week for people needing closer assessment or support. There was a prescribing nurse working within the service to manage the day to day administration of medicines.

We observed a therapy group during the inspection. To start with people were often quiet and did not contribute. However the groups were skilfully facilitated. We noticed that people’s body language became more open as they felt more confident. They began to speak about their problems and how they could support each other. We saw also when an individual began to dominate or to drift into less relevant areas the facilitator gently but firmly brought them back to group’s needs. People were clearly supported by each other. One person was worried about how changes to her life would be viewed by friends. A group member said,” If they are your friends they will like the new you”. Another group member was reticent about an experience saying,” I’ll leave it there” but the group facilitator encouraged dialogue and the person disclosed further. There were plenty of comments about the value of group work including, “before I lasted three months (without support) but know I have support” and “the strategy (for distraction) we did on Friday helped through the weekend”.

There were other activities that people found helpful. There was a breakfast club. This was an activity where anyone could drop in. One person said, “it is very good… you can talk to people if you want to. If it wasn’t for the breakfast club in the morning I would be in the supermarket getting lager”.