Turning Point - City of London and Hackney Integrated Drug & Alcohol Service

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

This key question has been rated good. 

Staff provided flexible, person-centred support and adjusted care to meet people’s individual circumstances. People could access treatment through open access assessments, outreach, community appointments and weekend provision. The service had specialist pathways for people experiencing homelessness, women, neurodivergent people and people involved with criminal justice services. Staff also used interpreting services and information in different languages to reduce communication barriers.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care was delivered in a consistently person-centred manner, with clients actively involved in decisions about their care and supported through coordinated, holistic, and responsive approaches. Care records demonstrated people were involved in decisions about their care and treatment and were supported to identify goals that mattered to them.

We observed staff to be open, approachable and committed to delivering person-centred care. Daily meetings and multidisciplinary discussions focused on individual needs, risks and treatment progress, helping staff maintain oversight of people's care.

Clients and carers told us they worked in partnership with staff to develop treatment and relapse prevention plans. They reported being actively involved in decisions about their care and confirmed that confidentiality and consent processes were explained clearly.

The service demonstrated a strong commitment to supporting vulnerable groups. For example, staff had well-established experience supporting people experiencing homelessness and had developed approaches that improved engagement and reduced barriers to treatment for this population. Staff routinely undertook home visits for people who had mobility difficulties, accessibility needs or who had disengaged from treatment. Recovery workers, nurses, doctors and managers all contributed to this approach, helping the service maintain engagement with vulnerable individuals and ensuring people continued to receive care and support when attending the service was difficult.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service worked collaboratively with a wide range of health, social care and community organisations to ensure people received coordinated support. Staff maintained strong links with primary care services, mental health services, housing providers, social care and voluntary sector organisations.

There were established pathways to support continuity of care at key transition points. For example, staff maintained pathways for people leaving prison, people involved with criminal justice services and people being discharged from hospital. These arrangements helped reduce the risk of disengagement from treatment.

The service supported people to access a range of interventions including one-to-one key working, structured recovery groups, peer support opportunities, housing support and wider community services. This helped ensure recovery needs were addressed in a integrated and holistic way. Clients described positive outcomes from this support. For example, people told us the service had helped them access employment opportunities and improve their independence and wellbeing.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service provided clients and carers with information about treatment options, harm reduction, physical and mental health, safeguarding, advocacy services, mutual aid groups and support available for families and carers.

Staff adapted communication where required to support people's individual needs. This included considering communication preferences, literacy needs and additional support requirements to ensure people could understand information and participate in decisions about their care.

Information sharing arrangements supported coordinated care. With appropriate consent, staff shared relevant information with professionals involved in people's care and treatment. The service maintained robust information governance arrangements and all staff had completed information governance training.

The service also met its statutory reporting requirements through regular notifications and data submissions, supporting transparency and accountability.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had received 14 complaints during the last 12 months and managed these appropriately. Complaints were investigated and responded to in a timely manner and people were provided with information about escalation routes where necessary. 

Clients and carers told us staff were approachable and responsive when concerns were raised. People could provide feedback through direct discussions with staff, surveys, community meetings and formal complaints processes.

The service had established opportunities for service user involvement. Meeting minutes demonstrated ongoing efforts to involve people in service development and gather feedback about their experiences.

We saw evidence that feedback was used to drive improvements. For example, changes were made to the MyTP form following service user feedback to improve accessibility for neurodiverse individuals.

Whilst most people understood how to raise concerns, some clients and carers were less aware of formal feedback routes and some carers felt family support services could be more consistent. 
 

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service actively sought to reduce barriers to treatment and engagement. Staff considered the needs of people with mobility needs, communication needs and other additional requirements and adapted care accordingly.

A range of specialist pathways supported access for vulnerable and underserved populations, including people experiencing homelessness, women, neurodivergent individuals and people involved with criminal justice services.

The service provided flexible access arrangements. For example, people could access support through open access assessments, outreach services, community appointments and weekend provision. These arrangements supported engagement for people who may otherwise find it difficult to access traditional clinic appointments.

Staff planned discharge appropriately and supported continuity of care through referrals to community resources, mutual aid groups and specialist services where required.

The service took steps to reduce communication barriers and support equitable access to care. Interpreting services were available through Language Line during assessments and appointments whenever required, including during evening and weekend clinics. Information was also made accessible through posters and leaflets displayed in reception in seven different languages, reflecting the most commonly spoken languages within the local community. 
 

The evidence showed a good standard. The service monitored access, engagement and outcomes and worked to reduce inequalities.

Staff completed equality, diversity and inclusion training and demonstrated an understanding of how to adapt care to meet diverse needs. Clients told us they were treated fairly and without discrimination and described staff as inclusive and respectful.

The service used data to understand engagement and outcomes across different population groups. For example, the service reported increased engagement from clients from Global Majority communities and increased engagement amongst people identifying as bisexual, gay or lesbian.

The service had developed targeted approaches to improve access and outcomes for specific groups. For example, specialist pathways and partnerships supported women, people with co-occurring mental health needs, people experiencing homelessness and individuals leaving prison. The service also demonstrated improved continuity of care for individuals leaving prison, with a 36% increase since 2020. Enhanced pathways, including coordinated pick-ups and ongoing support, ensured individuals were effectively engaged at a critical transition point, reducing the risk of relapse and disengagement from treatment.

The service had recognised a reduction in engagement from women and had introduced additional initiatives including women-only groups and women-focused recovery activities to address this issue.

The service also responded to increasing levels of co-occurring mental health needs by adapting services and working with partner organisations to maintain access to appropriate support.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Care plans reflected both immediate recovery needs and longer-term aspirations. Clients told us staff helped them develop practical skills, build confidence and access to volunteering, training and employment opportunities. People described achieving important personal goals, including gaining employment, improving independence and rebuilding stability in their lives.

Staff encouraged people to access community resources, mutual aid groups and wider recovery networks to support long-term recovery and reduce reliance on services. The service maintained clear discharge and re-engagement pathways, helping people sustain recovery, remain connected to support and access assistance promptly if their circumstances changed. Future planning was regularly reviewed to ensure support remained coordinated and responsive as people moved between services, completed treatment or experienced significant life changes.