- Community substance misuse service
Turning Point - City of London and Hackney Integrated Drug & Alcohol Service
Assessment report published 23 October 2026
Contents
Ratings - Community-based substance misuse services
Our view of the service
Turning Point – City of London and Hackney Integrated Drug and Alcohol Service is a community-based substance misuse treatment and recovery service providing comprehensive, free, and confidential support for adults affected by drug and alcohol use. The service is part of Turning Point, a national organisation delivering health and social care services across England. It offers a broad range of interventions, including initial advice, comprehensive assessments, harm reduction, prescribing for alcohol and opiate detoxification and stabilisation, and structured recovery support. Harm reduction provision includes needle exchange, naloxone supply, and access to blood-borne virus testing, alongside doctor and nurse-led clinics delivering physical health checks and medical treatment.
The service operates an open access model, enabling individuals to self-refer directly while also accepting referrals from a wide range of statutory and non-statutory partners, including GPs, local authority and social care services, mental health services, hospitals, criminal justice agencies, and housing and community organisations. While the service is primarily commissioned to support residents within City and Hackney, it accepts out-of-area referrals in exceptional circumstances to ensure individuals are not left without access to treatment, particularly where legal, safeguarding, or housing barriers existed.
A multidisciplinary workforce of approximately 110 paid staff delivered the service, supported by third sector partner organisations and NHS trusts. Additional capacity is provided by peer mentors, volunteers, and student social workers. The team included a range of clinical and non-clinical roles working collaboratively to meet the needs of a diverse population.
The service works closely with partner agencies to ensure coordinated, holistic care, including hospital liaison, criminal justice pathways, outreach provision for people experiencing homelessness, and integrated work with children’s social care. Clients are able to access a range of treatment options, including one-to-one key working and structured group programmes, supporting engagement and recovery at different stages of need.
We rated the service as Good. Staff assessed and managed risks effectively, delivered evidence-based care and supported people to achieve positive recovery outcomes. There were effective systems for medicines management, staffing, governance and learning, and people consistently described staff as compassionate, respectful and non-judgemental.
We found several areas of outstanding practice. The service had developed comprehensive safeguarding arrangements, including specialist competency sessions, a safeguarding dashboard, a dedicated perinatal multidisciplinary forum and weekly co-location with domestic abuse services. Its innovative harm-reduction approach enabled people to manage their own risks through confidential postal access to injecting equipment, home drug-testing strips, laboratory drug checking and extensive naloxone provision. The service achieved top-quartile national treatment outcomes across all four substance categories, hepatitis C micro-elimination and significant improvements in residential rehabilitation and inpatient detoxification pathways.
People were supported to plan beyond treatment through an established peer-mentoring pathway that developed confidence, skills and employment opportunities. Partnership working was integral to service delivery, with outreach across 32 community satellite locations, specialist chemsex interventions and coordinated support for people experiencing multiple vulnerabilities. The service also demonstrated a strong approach to learning and innovation through its Motivational Interviewing programme, specialist treatment pathways and flexible innovation funding that helped people overcome practical barriers to recovery and social inclusion.
Mental Capacity Act / Consent to Treatment Overview
In line with the principles of the Mental Capacity Act (2005), staff took all reasonable steps to support people to make their own decisions before considering any best-interest processes. 100% of staff had completed the Mental Capacity Act training.
Staff demonstrated a good understanding of the Mental Capacity Act. They were able to recognise when a person’s mental capacity to consent to treatment may be in question.
Staff understood how to access advice and support, as well as appropriate referral pathways to local community mental health teams where specialist input was required.
Where people were assessed as lacking capacity, staff ensured that decisions were made in their best interests. This included consideration of the person’s wishes, feelings, cultural background, and personal history.
The service had appropriate protocols and policies in place to support staff in managing situations where a person’s capacity was temporarily impaired, including as a result of illicit substance use.
People's experience of this service
We spoke with 10 clients and 2 carers during the assessment. Feedback was consistently positive. Clients and carers described staff as compassionate, respectful, approachable and non-judgemental. People told us they felt listened to, involved in decisions about their care and supported to make progress in their recovery. Clients reported positive outcomes including reduced substance use, sustained abstinence, improved wellbeing and increased independence.
People told us staff responded promptly to changes in risk and need and provided timely support during periods of crisis or difficulty. Clients valued the range of treatment and recovery options available and described the service as accessible and inclusive. Carers told us staff communicated effectively and provided advice and reassurance when needed.
Feedback data between February and August 2026 showed consistently positive experiences, with overall satisfaction remaining between 86% and 87%. Scores relating to communication and feeling safe were particularly positive. The majority of responses fell within the “agree” or “strongly agree” categories.
Overall, people described a service where staff treated them with dignity and respect and supported them to achieve positive outcomes.