The Care Quality Commission
  • Community
  • Community substance misuse service

Change Grow Live - Barnet

Overall: Requires improvement read more about inspection ratings

Dennis Scott Unit, Edgware Community Hospital, Edgware, HA8 0AD 0300 303 2866

Provided and run by:
Change, Grow, Live

All Inspections

09 December 2021

During a routine inspection

This was our first comprehensive inspection of this service. We had previously carried out a focused inspection looking at the safe domain. As a result of this inspection, we rated it as requires improvement because:

  • Not all clinical staff had completed basic life support training.
  • The number of clients on the caseload of some recovery coordinators was too high, preventing staff from giving each client the time they needed.
  • The service had 75 (18%) clients with medical reviews that were overdue.
  • The service was not conducting regular local level audits of the quality of clients’ records, recovery planning, and risk assessments which in-turn could impact of the quality of clients’ care and treatment.
  • Our findings from the other key questions demonstrated that governance processes did not always operate effectively.
  • The service’s risk register did not reflect all the current concerns about the delivery of the service.

However:

  • All premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose. The service had made improvements since our previous focused inspection and appropriate COVID-19 measures to keep people safe were now in place. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Staff developed 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.
  • 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. They actively involved clients in decisions and care planning.
  • The service was easy to access. Staff planned and managed discharge well.

14 - 21 January 2021

During an inspection looking at part of the service

We have not previously inspected or rated this service. This was a focused inspection looking at parts of our key question of safe. We rated the service as Requires Improvement for being safe.

We found:

  • Clients did not have a specific risk assessment concerning COVID-19. Clients' physical health risks were not assessed by staff when deciding if a client should attend the service. Of 15 client care and treatment records, none contained a specific risk assessment.
  • Staff did not discuss with clients before their appointments if they had symptoms of COVID-19. This meant clients may be travelling and attending the service with possible COVID-19. This did not follow national guidance
  • Additional measures introduced into the service to minimise the risk of COVID-19 transmission were not carried out consistently. The frequency of cleaning, tape on floors to remind staff of social distancing, and cleaning of a room where clients were seen were not always carried out as planned.
  • Staff wore masks when meeting with clients but did not otherwise wear masks consistently when working in the service. This did not follow national guidance.
  • The providers guidance on infection control and COVID-19 did not describe all of the practical actions staff should take to minimise transmission of COVID-19. The guidance had not been updated to reflect changing national guidance.

However:

  • The environment had been adapted to reduce the risk of transmission of COVID-19. This included risk assessment of room sizes, taped floors and signs to promote social distancing.
  • New procedures included cleaning of frequent touch points, such as light switches and door handles, and speaking to most clients on the telephone. Clients attending the service were expected to wear masks and use hand sanitiser located at the entrance to the service.
  • Clients' appointments were staggered throughout the day to limit the number of clients in the service at one time.

Following the inspection, the provider took immediate action to review and update policies concerning infection control and COVID-19.