Bromley Drug and Alcohol Service

Updated 31 October 2022

Bromley Drug and Alcohol service is part of the national provider Change Grow Live who deliver a not-for-profit drug and alcohol treatment service. The service provides specialist community treatment and support for adults and young people affected by substance misuse who live in Bromley.

Bromley Drug and Alcohol service offers a range of services including, initial advice, assessment and harm reduction services; prescribed medicines for alcohol and opiate detoxification and stabilisation; naloxone dispensing; group recovery programmes; one-to-one key working sessions; counselling; health and blood borne virus checks and hepatitis C testing. CGL Bromley also provides an outreach service to engage certain groups through a criminal justice team and a young person’s service. The young person’s team provided advice and support to clients aged 5 and above and their families impacted by substance misuse.

This was the first inspection of this location, which has been running an integrated substance misuse service in Bromley since 1 December 2018. During this time, the service has established partnerships with health and social care, probation services, GPs and pharmacies to provide help and support to clients within the London Borough of Bromley. At the time of our inspection, the service had 11 recovery coordinators, two team leaders, one admin staff, one data lead, one volunteer and peer mentor Lead, one quality and safeguarding lead, four clinical staff and one service manager.

The service received most of its funding from the local authority and the Office for Health Improvement and Disparities and had recently received funding for four new roles; one recovery co-ordinator, one health care assistant, one data administrator and one recovery motivator.

The service is registered for the following regulated activity:

• Treatment of disease, disorder or injury.

At the time of inspection there was a registered manager in place who was due to leave the service and the new service manager was in the process of becoming the new registered manager.

What people who use the service say

Clients told us that staff were kind, caring, non-judgemental and genuinely interested in their wellbeing and recovery.

One client commented that ‘after initial assessment it was a relief to find a place where you were heard, understood and not alone.’

A recently discharged client said that ‘staff had treated me with compassion and sympathy and their support and treatment had been life changing.’

The service adapted its contact with clients during the restrictions of the Covid-19 pandemic and facilitated virtual and telephone contact, to ensure that clients still received therapeutic interventions, including counselling. Clients told us that they felt supported during the pandemic and they received advice from staff about their care and treatment, including access to virtual support sessions.

Updated 31 October 2022

We rated it as good because:

• The service had enough staff, who knew the clients and received basic training to keep them safe from avoidable harm. They responded promptly to sudden deterioration in clients’ physical and mental health. Staff assessed and managed risk and followed good practice with respect to safeguarding.
• The service provided safe care. The premises where clients were seen were safe and clean, well equipped and fit for purpose. The service had appropriate COVID-19 measures in place. The service managed client safety incidents well.
• Managers investigated incidents and shared lessons learned with the whole team. 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 mental and physical health
• Staff developed 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. They ensured that clients had 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 ensured that these staff received training, supervision and appraisal. 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, including those with protected characteristics. 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 treated concerns and complaints seriously, investigated them and learned lessons from the results.
• The service was well led. Leaders had the skills, knowledge and experience to perform their roles, and were visible in the service and approachable for clients and staff.

However:

• Risk mitigation plans were not found in seven client records, although staff were able to explain how they managed client risks.
• Staff were unaware of how to access ligature cutters in the event of an emergency.
• Care plans could be further improved by ensuring that long term recovery goals were listed.
• Governance processes could be further improved, some key documents were kept up-to-date in an ad-hoc manner, rather than being systematically reviewed and there had been some slippage with the medicines policies reviews.
• Staff compliance with the assessment audit, case record audit and risk and recovery planning was low and one audit had not been completed for the prescription and controlled drug stationery.

Updated 31 October 2022