Cranstoun Worcestershire

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Staff assessed the physical and mental health of all clients on admission, ensuring relevant information was collected to inform the development of individualised care plans. Care plans were developed for each client and reviewed regularly through multidisciplinary discussions, with updates made as required to reflect changes in client needs, risks, or treatment goals. Staff provided a range of treatment and care based on national guidance and recognised best practice, ensuring interventions were evidence-based, safe, and responsive to the diverse needs of clients. The staff team included, or had access to, the full range of specialists required to meet client needs, ensuring appropriate professional input was available to support complex physical and mental health requirements. Staff from multiple disciplines worked collaboratively, combining their expertise and coordinating effectively to ensure that care and treatment decisions were comprehensive, consistent, and promoted safe, positive, and person-centred outcomes for clients. However, staff knowledge and application of the Mental Capacity Act were inconsistent, with some practices observed as insufficient, particularly where evidence of formal mental capacity assessments being undertaken for clients was absent.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Of the 8 care records reviewed, all were comprehensive, personalised, holistic, and recovery-orientated, with clear evidence that care plans and records were regularly reviewed to reflect clients’ changing needs and progress.

A client reported being offered treatment and service choices relevant to their individual needs, while another stated that the service supported them to make informed decisions regarding the care and treatment they received.

Several clients said they felt listened to by staff and were actively involved in decisions about their care and treatment.

The initial assessment process for new clients incorporated a review of known physical health conditions or concerns, enabling identification of specific support needs, which were then included in individual risk assessments and recovery plans.

Clients identified as requiring prescribing or detoxification interventions were seen by Cranstoun clinicians or their shared care GP, with general health screening conducted to ensure ongoing monitoring of physical health during treatment. These procedures were carried out in line with relevant treatment and detoxification guidelines, ensuring the service consistently maintained best practice and applied evidence-based approaches in relation to the care given.

Nurses within the harm reduction team provided detailed wound assessments to client’s GP surgeries, to escalate concerns regarding infection or complex injuries, often arising from frequent injecting or accidents while intoxicated.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the client group, consistent with best-practice guidance, including NICE guidance and national guidance on clinical management of drug misuse and dependence.

For example, formal assessment tools were used to evaluate clients’ substance dependency, physical health, and mental wellbeing, and treatment goals were agreed collaboratively at the initial assessment.

Recovery workers, specialist project staff, clinicians, prescribers, and managers demonstrated strong knowledge and expertise in their roles.

The service supported adults and young people under 18 who experienced difficulties with drugs or alcohol. It provided opioid substitution treatment, medically assisted alcohol detox, one-to-one keyworker sessions, and group therapy, including a women’s group. Community outreach, harm-reduction work, and a needle exchange programme were also offered. Clients accessed detoxification, including ambulatory detox, alongside pharmacological interventions delivered by clinical staff. The team supported housing needs and helped clients access education, training, and employment opportunities. Families and carers received guidance designed to strengthen their wellbeing and resilience.

Young people accessed the Here4YOUth service, that was provided by Cranstoun. This service provided age-appropriate advice, support, and guidance across the county. Staff within this team could meet with children and young people at their school, their college or their home.

Staff ensured clients received support for their physical health through their GP or local services. They maintained strong communication and working relationships with GPs, met clients in surgeries, and helped arrange appointments when needed.

The service remained up to date and worked in accordance with legislation and best-practice guidance. Work practices were reviewed through Clinical Team Forums and Meetings, governance peer groups and multidisciplinary meetings. These forums allowed staff to discuss best practice, consider new initiatives, and identify areas for development.

We found evidence that the service worked collaboratively with external agencies to share information and develop action plans aimed at improving service delivery and reducing harm to clients. External partners included the police, local authority, NHS Trust, probation service, and mental health services, ensuring multi-agency engagement in addressing client needs and promoting coordinated approaches to risk management and support.

Regular multidisciplinary meetings were held, demonstrating strong joined up working across roles and teams within the service, ensuring effective communication, problem-solving, and collaboration to support clients’ care, treatment, and safety.

The service held Incident Review Group meetings, where all serious incidents were reviewed and learning was identified and shared.

Cranstoun Worcestershire participated in the Worcestershire Drug-Related Deaths Group, which brought together local agencies to review drug-related deaths, identify trends, assess risk factors, and provide recommendations to reduce future fatalities.

The service attended and presented at organisation wide Drug and Alcohol Related Death Forums, reviewing case studies of drug- and alcohol-related deaths or near-fatal overdoses, with learning shared across the staff team to improve practice.

Managers explained that the service collaborated with the local NHS Hospital Trust to review hospital data on overdose admissions and related incidents, developing targeted approaches aimed at reducing future drug- and alcohol-related harm.

The service held regular prescriber and clinical team meetings, attended by all clinicians, providing opportunities to discuss clinical issues, share learning, reflect on positive practice, and address challenges collectively.

Cranstoun Worcestershire participated in the Local Authority’s Professional Information Network, providing, sharing, and responding to intelligence regarding illicit drug use, supporting local professionals to respond to emerging substances promptly. For example, alerts were issued through these networks following the emergence of potent synthetic opioids, enabling timely communication, coordinated multi-agency responses, and proactive actions to reduce harm and protect clients.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Clients reported that nutrition, healthy living, healthy sleeping habits, and overall wellbeing were discussed during sessions, helping them make positive lifestyle changes and improve their recovery outcomes.

One client highlighted the benefits of participating in the ‘Couch to 5k’ scheme, which was supported by the service and encouraged physical activity and engagement.

Staff introduced a walk-and-talk group, allowing clients to discuss issues while walking. This created a more relaxed environment and encouraged open conversation.

The service provided a healthy eating booklet on their website, tailored to support individuals recovering from drug or alcohol misuse and promoting nutrition and overall wellbeing.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Clients reported that the support they received, along with the staff’s approach, the range of services offered, and the welcoming environment, helped them make positive progress in their recovery.

We were told that the proportion of people successfully completing the treatment had been increasing since the start of 2024. We saw that between 1 July 2024 and 30 June 2025, the total number of clients in treatment was 3229, of those 659 successfully completed treatment, which equates to 20.4% completion rate, below the national average.

The service employed a Hepatitis C Virus Co-ordinator who, in addition to coordinating staff training on blood-borne viruses, promoted and facilitated increased Hepatitis C testing. Since taking up the role, they had improved patient outcomes by increasing the number of clients tested, the frequency of testing, and referrals for treatment.

The evidence showed some shortfalls. Although the service consistently informed clients about their rights regarding consent, as well as respecting client’s rights, staff understanding and practical application of the Mental Capacity Act was inconsistent.

Care records were reviewed for evidence of risk assessment and management, alcohol and drug assessment, consent and capacity, physical health, and prescribing. The records demonstrated that generally these areas were consistently assessed, reflecting the staff’s clear commitment to their work.

However, the application of the Mental Capacity Act (MCA) appeared inconsistent. While some staff demonstrated a strong understanding of the functional test of capacity, others struggled to explain or apply it. Evidence of mental capacity assessments having been conducted was often missing. Several staff reported they had not received specific MCA training. One nurse noted that formal, decision-specific capacity assessments were not routinely recorded, although references to assessed capacity were sometimes included in case notes.

Records did show that consent to treatment and information sharing was discussed with clients.