CQC’s assessment of gambling treatment services: End of programme report

In February 2023, the Care Quality Commission (CQC) was asked by the Gambling Commission and GambleAware to inspect 14 organisations that provide gambling treatment services as part of the National Gambling Support Network (NGSN).

The aim was to assess if the services, which provide treatment and support for people experiencing gambling harms in England, Scotland and Wales, are delivering good quality, accessible and effective care, treatment and support.

This report presents CQC’s analysis of the quality of these gambling treatment services, including people’s experience, good practice and areas for improvement.

Our key findings

Overall, we found that the 14 gambling treatment services provided through the NGSN were delivering care that was safe, effective, caring, responsive and well-led. People experiencing gambling harms were able to access the services when they needed them, and received person-centred treatment and support that met their needs. Services supported people to stop gambling, reducing the impacts of addiction on themselves and their friends and family. They also supported affected others, such as family members.

Access to services

• People experiencing gambling harms were able to access gambling treatment services quickly, efficiently and for free.
• The services we inspected provided a variety of treatment and support options for both people experiencing gambling harms directly, and their friends and family.
• Services provided a mixture of in-person and online engagement activities, allowing people to choose a format best suited to their needs and where they lived.
• Treatment and support options were flexible and based on people’s needs. This helped people to engage at their own pace.
• Services provided aftercare through regular check-ins. People felt that they could return to the service at any time to receive support or be signposted to further support should they need it.
• People had joined-up care and access to the same support staff, which provided them with continuity of care.

Partnership working

• To improve outcomes for people, services worked systematically with other organisations, services and community groups.
• Good communication links between services in the NGSN led to quick referrals and assessment, which were based on people’s needs.
• Educating people in the wider community about how to recognise gambling harms and how to access services was a key focus for services. This included the use of ‘champion’ and/or ‘community connector’ roles which helped services to develop a wider understanding of gambling harms and to share information about how people could access treatment services.
• Services developed, designed and delivered specialist programmes, training and courses to community groups and other third sector organisations. This included working with the wider health care sector and general practitioners (GPs) to develop and share training.
• Services worked with universities to change the way they delivered treatments to reflect current guidance and best practice.

Person-centred help and support

• People were involved in co-creating their support and treatment plans. Plans were regularly reviewed to make sure they reflected the person’s goals.
• Services kept people safe and staff regularly reflected on safeguarding practices and/or incidents. Staff used learning from incidents to improve their services.
• Staff were well qualified and well trained to deliver treatment, help and support, and used monitoring tools effectively to make sure that the care delivered met people’s needs.
• Services were well-led, with leaders providing good support for staff. This included, for example, safe recruitment practices, effective induction processes, clear policies and procedures, manageable workloads, whistleblowing guidance and channels, wellbeing support and regular feedback opportunities.
• Staff with lived experience of gambling harms were described as crucial in encouraging people to actively engage with their treatment and recovery journey. Staff with lived experience were supported well by leaders and could access support from the services if needed.
• Services and staff created safe spaces that helped people to fully engage with their treatment, and supported their recovery journeys. Safe spaces were created through a shared understanding between staff and people who use services that focused on confidentiality, respect, non-judgemental attitudes and behaviours, and active listening.
• Equality, diversity and inclusion (EDI) was embedded throughout the culture of services. This ensured that the needs of people with protected characteristics were considered and understood.
• Governance structures in some services were not fully embedded due to the stage of development that the service was at. However, we did not find any evidence this was causing harm.
• Some services needed to improve how they carried out and reported on health and safety checks.

Value of the services and the impact on people

• People described the treatment, help and support they received from the services as life changing. People described entering the services at low points in their lives, and how their outlook on life and their gambling habits changed through working with the services.
• The majority of respondents to our survey of people with lived experience said they had positive experiences and would recommend the services to others.
• Despite the uncertainty surrounding commissioning changes, the services remained dedicated to helping and supporting people. This is testament to the passion and drive of staff wanting to make positive changes in both the lives of people impacted by gambling harms, and the work they do to improve awareness and promote their gambling harms treatment and support services.