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CGL Halton Integrated Recovery Service Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 5 March 2020

Change, Grow, Live (CGL) is a national charity that provides treatment and support to vulnerable people facing addiction, homelessness and domestic abuse. CGL Halton integrated recovery service is a community substance misuse service, which is registered to provide the regulated activities of 'treatment of disease, disorder or injury' for people who have drugs and/or alcohol support needs. CGL Halton Integrated Recovery Service has two sites: one in Widnes and the other in Runcorn.

We rated CGL Halton Integrated Recovery Service as outstanding 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.

Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had received training on how to recognise and report abuse, and they knew how to apply it.

Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.

People who use services and those close to them are active partners in their care. Staff are fully committed to working in partnership with people and making this a reality for each person.

Clients felt that they had given the tools and knowledge needed to live a better life.

The service was easy to access with regular drop in sessions for members of the public who wished to gain support. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.

The service was meeting the needs of the population, they had recently done a homelessness count and encouraged the homeless population to attended the service to check in so the staff could monitor their health.

Staff provided a range of care and treatment interventions suitable for the client groups, which included Hepatitis C treatment and community detox. They ensured that clients had good access to physical healthcare and supported clients to live healthier lives.

The service supported clients to engage with their communities. Staff offered clients opportunities to volunteer in associated community projects and be supported into education, training and employment.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Leaders had the skills, knowledge and experience to perform their roles and had a good understanding of the services they managed. They were visible in the service and approachable for clients and staff.

Staff knew and understood the provider’s vision and values and these were embedded in the delivery of care. Staff were proud of the organisation as a place to work and spoke highly of the culture being open and honest. Staff at all levels were actively encouraged to speak up and raise concerns.

Clients who were prescribed medication while living with a child or vulnerable adult were also issued with a lockbox for the secure storage of medication.

The service engaged with multiple services when working with a client. Agencies such as the GP, midwives, social workers and probation. The service had named staff members allocated to local schools to provide information to the school and clients.

The service exceeded their goals in helping clients secure and keeping clients in work. In 2018/19, 39% of clients supported found work, the expected percentage was 25%. Sixty-one percent of clients were still in work after six months, 11% more than industry standard.

Inspection areas

Safe

Good

Updated 5 March 2020

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. 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 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.

Effective

Good

Updated 5 March 2020

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.

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 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

Outstanding

Updated 5 March 2020

We rated caring as outstanding because:

People are truly respected and valued as individuals and are empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service.

Feedback from people who use the service, those who are close to them and stakeholders is continually positive about the way staff treat people. People think that staff go the extra mile and their care and support exceeds their expectations

Staff are highly motivated and inspired to offer care that is kind and promotes people’s dignity. Relationships between people who use the service, those close to them and staff are strong, caring, respectful and supportive. These relationships are highly valued by staff and promoted by leaders.

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 supported clients to understand and manage their care and treatment and we could see from the records and clients told us that they were fully involved in all aspects of their care.

Every client using the service had their own personalised recovery and risk management plan in a format which was easy for them to use. These focussed on the client’s preferences, goals and the resources they needed to initiate and sustain recovery.

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 had a wide knowledge of services in their local areas and used this to provide clients with information about what would be available to them in the wider community

Staff enabled families and carers to give feedback on the service via forms and directly to managers and this information was collated to help support service development.

Staff informed and involved families and carers throughout the care and treatment of their clients. This included providing training and support to family members.

People who use services and those close to them are active partners in their care. Staff are fully committed to working in partnership with people and making this a reality for each person.

Clients we spoke to felt that all staff at the service cared for them and that they genuinely cared about them. We observed staff talking to clients about coping mechanisms and providing advice. The clients felt like the staff had gone the extra mile for them and felt fully supported.

Responsive

Outstanding

Updated 5 March 2020

We rated responsive as outstanding because:

The service was meeting the needs of the population, they had recently done a homelessness count and encouraged the homeless population to attended the service to check in so the staff could monitor their health.

The service was easy to access with regular drop in sessions for members of the public who wished to gain support. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.

The design, layout, and furnishings of treatment rooms supported clients’ treatment, privacy and dignity. Where physical access to the Runcorn site for service users was a concern, alternative arrangements had been made.

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.

The service adapted its service to better assist clients, for example the service worked within the community to allow access to needle exchanges out of hours.

Recovery and risk management plans reflected the individual needs and preferences of the client. They provided clear pathways to other services such mental health and social services for clients with multiple and complex needs.

The service worked with clients individually on areas such as housing and debt management with the education, training and employment coach. This allowed recovery workers to focus on support specifically for the clients substance misuse issues

The service had a full-time education, training and employment coach who worked with clients. The service exceeded their goals in helping clients secure and keeping clients in work.

Halton Integrated Recovery Service is co-located with Cheshire police, this has encouraged interagency working, the police had donated bikes to the service that the clients fix while going through treatment. These bikes are then given to clients to help them get to appointments and work.

All the clients we spoke to were confident that they could raise any concerns to the staff and management. Clients knew how to make a formal complaint about the service if they needed to.

Well-led

Good

Updated 5 March 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. The values of the service had been developed in consultation with staff and service users at multiple consultation events. 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.

Our findings from the other key questions demonstrated that governance processes operated effectively and that performance and risk were managed well.

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

Substance misuse services

Outstanding

Updated 5 March 2020