The Care Quality Commission
  • Community
  • Community substance misuse service

Camden Community Drug Treatment Service

Overall: Good read more about inspection ratings

210 Kilburn High Road, London, NW6 4JH (020) 7328 3470

Provided and run by:
Change, Grow, Live

All Inspections

19 and 21 July 2023

During an inspection looking at part of the service

We undertook a short announced focused inspection of the provider’s new service called Camden Integrated Drug & Alcohol Service. The provider added the additional service as a satellite site under their existing registered location Camden Community Drug Treatment Service. We report under the registered location.

This was a focused inspection that covered specific aspects of safe, effective, caring, responsive and well-led. This was due to a variety of risks involved in the transfer of care of clients from the previous provider to this new service. These risks related to continuity of care and safety.

We did not re-rate the overall service following this inspection. It remained good overall. At our inspection in August 2022, we rated the domains of safe, effective, responsive, caring, and well-led as good.

Our rating of this location remained as good because:

  • All premises where clients received care were safe, clean, well equipped, well furnished, and well maintained. The overall decoration was personalised and welcoming. The service had a variety of donated items, such as coats, clothes, shoes, and books which clients could take and use as needed. The service had a variety of facilities for clients to use, such as computers and a self-help kitchen and had arranged regular food shops to be delivered for client use.
  • The service had made timely progress with completing medical reviews for the clients transferred over from the previous provider. At the time of inspection, 75% of medical and non-medical-prescribing reviews were completed.
  • Staff had made good progress towards completing care and treatment records for the clients. 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 audits to evaluate the quality of care they provided.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions about the new service, and co-produced elements of the service.
  • The service was well led, and the governance processes ensured that its procedures and transfer of care plan ran smoothly. Staff felt respected, supported, and valued by colleagues and managers. The governance structure, senior management meetings, oversight of service risks and the quality of the service improvement and transfer of care plans, demonstrated that leaders understood the needs of the client group and delivered services to meet them.

However:

  • Medicines were not always stored in accordance with the manufacturer’s instructions.
  • Some clients on certain medicines, were not appropriately offered electrocardiograms (ECGs).
  • Staff did not always make sure that clients had required physical health observations carried out during keyworker sessions and did not always know about client’s physical health problems.
  • Supervision rates were 69%. Some staff we spoke with reported that supervision sessions had been arranged but were postponed.
  • The service did not always make sure clients could access additional support. Clients told us that they did not know how to access support during evenings or weekends. Clients felt that there should be a doctor or prescribing nurse available to help at these times, particularly for those on an opiate detoxification.
  • The service did not make sure clients could access advocacy services. Clients told us that they did not know how to access an advocate or what an advocate does.

3 August to 8 August 2022

During a routine inspection

Our rating of this location was 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 team, 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 were up to date with their mandatory training including safeguarding and basic life support.
  • 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 audits to evaluate the quality of care they provided.
  • The team 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. New staff were given a comprehensive induction. Staff worked well together as a multidisciplinary team and with 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 the governance processes ensured that its procedures ran smoothly. Clients could provide feedback on the service.

However:

  • The Camden site was small and not always fit for purpose. The clinic room at the Camden site could not accommodate a clinical bed, and some rooms for groups were in the basement which was only accessible via a spiral staircase.
  • Fire alarms were not always tested weekly across both sites as scheduled by the provider.
  • There was only one health and safety lead within the service at the time of our inspection and audit outcomes and actions were not always recorded in a central location. This meant there was not a robust system in place in terms of health and safety oversight when the lead was absent from work. The provider was aware and planned to train a second person.
  • Records did not always document when clients attended group sessions which meant it was not always clear if they were accessing the psychosocial aspects of the service.
  • Records of controlled drugs did not differentiate between individual client’s medicines and stock medicines for the service. Staff did not consistently monitor and electronically record temperatures of areas where medicines were stored.
  • Records did not always document if consent had been reviewed regularly and gained from clients, and some clients told us they had not been asked about consent.
  • Clients were not always given copies of their care plans. None of the clients we spoke to said they had crisis plans.