Archived: Lifeline York Integrated Recovery Service

We found following areas of good practice:

• The service had ensured that arrangements were in place to cover staff sickness and leave. This was important, as the criminal justice system required some clients to attend the service on a daily basis.

• Staff had a good understanding of safeguarding procedures and knew how and when to make a referral to the local authority safeguarding team. Each team prepared weekly safeguarding information for the team leaders to action.

• Staff had a clear awareness of best practice in treatment and care and used evidence based therapies and interventions to support their clients.

• Clients were actively involved in the planning of their care. Staff used mapping techniques, which enabled clients to identify their recovery capital. The use of mapping tools directly involved clients in their care. Recovery workers used a similar approach to engage and assess young people.

• The service had a clear policy on confidentiality and revisited consent to share information every three months. Staff recognised that clients might change their minds about whom they wanted to share information with as they progressed through treatment.

• Staff provided a late night service twice a week for clients who could not make daytime appointments. Clients could contact staff either by telephone or sit and wait for an unscheduled appointment if the need arose.

• The service had clear governance structures in place. Staff carried out a series of clinical and performance related audits throughout the year. This meant the service manager received information on performance that supported the development of the service.
• The service manager reviewed complaints and incidents in order to learn from them. Negative feedback from clients led to an apology and action to improve the services performance.

We also found the following areas that the provider needs to improve:

• Mandatory training was minimal and some staff lacked in-depth knowledge in key areas of psychosocial interventions. This could affect the care and treatment provided to the client. The provider has acknowledged the lack of core skills training available to staff and was developing training plans to remedy this.

• Some clinical equipment had passed its expiry date. For example, urine test strips, alcohol wipes, saline, eyewash and blood collection bottles. Out of date urine test strips have the potential to affect drug test results, which could impact on decisions made by social services and the treatment provided by the service.

• Staff did not keep the medicines fridge locked, as they did not know where the key to lock it was. They had not reviewed the security around the storage of medication but accepted that the key was missing.

• Risk assessment and risk management plans showed that staff awareness about how to mitigate risks and document them was variable. This meant that staff might not provide appropriate harm reduction advice or manage the risks in a safe manner.

• Staff did not always record electronically if their clients had given consent to share information. This had the potential to lead to a breach of confidentiality.