Turning Point Herefordshire Drug and Alcohol Recovery Service

Updated 12 September 2023

The Herefordshire Recovery Service is delivered by Turning Point in partnership with Healthwatch Herefordshire.

The integrated substance misuse service provides free and confidential support for adults and young people around their use of alcohol and other drugs. They also offer support to families and carers affected by the alcohol or drug use of someone else.

The are registered to provide:

• Treatment of disease, disorder or injury
• Caring for adults over 65 years
• Caring for adults under 65 years

The service is delivered from a main hub in Hereford with five satellite services attached to the main hub that are delivered locally in areas around Herefordshire. Four of these satellite services are delivered five days a week with one being delivered one day a week at Ledbury. These were commissioned due to the rural, spread-out nature of the community that the organisation delivers services to.

They were first registered in April 2021 and this is their first inspection.

What people who use the service say

The people we spoke with, who use this service, in the course of our inspection were all positive about the service that they had received. They were complimentary of the staff they had worked with. They stated that there had not been any delays to referrals or appointments and felt that the service they had received had helped them.

Updated 12 September 2023

Our rating of this location stayed the same. We rated it as good because:

• All areas we inspected were clean, fit for purpose and well presented. Environmental risk assessments were in place and safety checks had been undertaken on all equipment. The service had enough staff to cover case loads and recruitment was underway to fill vacancies. Staff turnover and staff sickness levels were both low and case load numbers did not exceed organisational targets. Staff had received training and were qualified and experienced for the roles they undertook. Risk assessments were in place for all clients and there were regular reviews of care.
• Staff provided care in line with national guidance. The service had introduced new processes and equipment to support clients and reduce the need to source services from external agencies. Process and services had been introduced to reduce stigma and encourage people to use the service. Confidentiality was maintained and electronic records were safe.
• Staff treated service users with dignity and respect. Staff involved clients in planning and delivery of their own care and we were told that clients felt that the service was supporting them and delivering a quality service.
• Referral to treatment times did not exceed organisational targets. Case load numbers were manageable and did not exceed organisational key performance indicators. The building had sufficient rooms to undertake appointments and these were well presents and fit for purpose. We reviewed complements and complaints and found that they were reviewed and managed correctly.
• Senior leaders were visible within the service. Staff told us that they felt that they could raise issues and suggest improvements and felt that they would be listened to. Governance structures were in place that ensured the smooth running of the service. Managers reviewed data from audits and investigations to formulate improvements where required.

Updated 12 September 2023

• The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Caseload numbers were monitored to ensure that staff did not carry more than 40 clients on the caseload. Staffing numbers had been estimated to ensure that this was possible. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• Staff developed holistic, 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 service had purchased equipment and trained staff so that they could undertake tests on site that would normally be undertaken by third party providers, for example a fibroscan machine that allows staff to monitor the health of clients livers. This meant that the service was able to react more quickly to the long term health conditions of its client group. Staff engaged in clinical audit to evaluate the quality of care they provided.
• 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 training was at 96% compliance which was above organisational set key performance indicators. Data provided by the organisation showed that supervision and appraisal took place in line with organisational policy. This was also monitored as a key performance indicator and the service was above set targets. 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. We observed staff working with clients and saw that interactions were supportive and understanding. The service also had provision in place to consider a clients social, ethnic and religious requirements. They actively involved clients in decisions and care planning.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. Though the service is based primarily in Hereford its client group come from often rural and isolated locations. As a result of this the service had set up a number of hubs to reduce travelling time and increase access for all its client groups. These were run out of buildings provided by third parties but closely monitored by Turning Point to ensure that they were safe and appropriate. This included comprehensive environmental risk assessments being maintained for all areas. The service had also introduced an outreach vehicle “Lance” to provide responsive outreach across the county, including delivering needle exchange, BBV testing and confidential advice in rural locations.
• The service was well led, and the governance processes ensured that its procedures ran smoothly.