Bromley Drug and Alcohol Service

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.