Archived: The Wiltshire Integrated Substance Misuse Service - Trowbridge

Updated 3 March 2017

The Wiltshire Substance Misuse Service is delivered by Turning Point and is a specialist community service providing support to people suffering from drug and alcohol problems across three geographical locations. These are Trowbridge, Chippenham and Salisbury.

Funding for treatment is through the commissioning team within Wiltshire Council who work very closely with the provider to ensure the service is supported and of high quality.

The Care Quality Commission (CQC) registered the service to provide the regulated activity of ‘Treatment of disease, disorder or injury’ in April 2013. There is a registered manager in place.

We inspected this service in March 2014 when we placed compliance actions (actions the provider must take) around care and welfare of people who use services, management of medicines, supporting workers, assessing, and monitoring the quality of service provision. The service has completed work to meet all of these required actions.

The service offers collaborative recovery planning, counselling and group work (using the Model of psycho-social Interventions 2014 (MOPSI), a peer mentoring and volunteer scheme, medical reviews, well-being assessments and harm reduction support, community detoxification and community reduction support, access to inpatient detoxification or residential rehabilitation and comprehensive safeguarding interventions.

The service has good partnership working across the county with other agencies, including other organisations providing a range of services, probation, social services,GP’s, police and pharmacies.

Updated 3 March 2017

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Staff monitored risk and safety throughout the treatment period. There was a clear approach to identifying and managing risk. The service worked well with other agencies to assess and manage risk.

• Safety was a high priority and there was an open culture around learning from incidents. There was an excellent commitment to learning and improvement in risk and safety with regards to review of client deaths. There were clear and comprehensive safety management systems in place particularly around prescription storage and monitoring.

• Safeguarding adults and children was a high priority. Staff were proactive in prevention of abuse or allegation of abuse. There was excellent engagement in local safeguarding procedures.

• The environment at each location was clean and well maintained and the layouts protected privacy. Information was freely available specific to substance misuse issues.

• The service was highly committed to reaching out to clients not within mainstream services or easily accessible, particularly within the festival circuit, isolated rural areas and with ex or currently serving military personnel.

• The service prescribed medicine following ‘Drug misuse and dependence: UK guidelines of clinical management’ (2007) and National Institute for Health and Care Excellence (NICE) guidelines. Psychological therapies also followed these guidelines. Staff carried out prescribing reviews on a three monthly basis or more frequently if required.

• Clients were involved in their care. Staff were committed to working in partnership with clients. Staff empowered people who used the service to have a voice and were determined to overcome obstacles to delivering care. Staff completed recovery care plans with clients that reflected their individual needs and preferences.

• The service provided support for issues associated with substance misuse. These included health checks such as testing for blood borne viruses and electrocardiograms (ECGs) for clients on high doses of methadone.

• Staff ensured they completed personalised recovery care plans with clients. They identified their strengths and individual goals to ensure the client’s treatment journey was relevant and personal to them.

• All the locations had supportive and experienced management and leadership. The service had a committed and knowledgeable registered manager. Robust governance systems supported the service to function effectively. Staff told us they were proud of their achievements. There was good multiagency working to ensure they addressed and identified individual needs and there were plans to improve this.