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Gloucestershire Drug and Alcohol Recovery Service Good

Inspection Summary


Overall summary & rating

Good

Updated 9 October 2019

Gloucester Drug and Alcohol Recovery Service is a community substance misuse service.

We rated Gloucester Drug and Alcohol Recovery Service as good because:

  • The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Staff developed holistic, 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 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. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
  • The service was well led, and staff said they felt valued by their leaders and worked together well. Many governance processes worked well to ensure good performance.
Inspection areas

Safe

Good

Updated 9 October 2019

We rated safe as good because:

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

  • The service had enough staff, who knew the clients and received basic training to keep them safe from avoidable harm.

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

  • 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.

  • Staff kept detailed records of clients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

  • The service used systems and processes to safely prescribe, administer, record and store medicines. Staff regularly reviewed the effects of medications on each client’s physical health.

  • 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.

    However:

  • Staff in the Cheltenham base only checked one personal attack alarm each month, meaning they could not be sure all alarms were in working order.

Effective

Good

Updated 9 October 2019

We rated effective as good because:

  • Staff completed comprehensive assessments with clients on accessing the service. They worked with clients to develop individual care plans and updated them as needed. Care plans reflected the assessed needs, were personalised, holistic and recovery-oriented.

  • 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 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. The teams had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

  • 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

Caring

Good

Updated 9 October 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 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.

Responsive

Good

Updated 9 October 2019

We rated responsive as good because:

  • The service was easy to access. Staff planned and managed discharge well. 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 9 October 2019

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.

  • We saw that in most areas, there were processes in place to monitor performance and address any concerns that arose from clinical audits.

  • 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.

Checks on specific services

Community-based substance misuse services

Good

Updated 9 October 2019