5 March 2019
During a routine inspection
The service was last inspected in 2016, at which time we did not rate independent substance misuse services.
Following this inspection:
We rated Detox Support Project as Outstanding because:
• The service was well staffed with a range of well trained, supported and experienced staff. Staff put into practice the service’s vision and values. Staff had contact with managers at all levels of the organisation, including the most senior, who were said to be supportive and visible.
• All staff members we spoke with were enthusiastic and highly motivated to provide support that is kind, promotes people's dignity and recognises the totality of people's needs. This made clients feel that they mattered.
• The service was clean and comfortable, with effective systems ensuring any issues were rectified quickly. Staff worked hard to create a warm, safe environment.
• Clients were truly respected and valued as individuals and were empowered as partners in their care, practically and emotionally.
• There was a proactive approach to understanding the needs and preferences of different groups of people, and to ensuring the service met these needs, promoting accessibility and equality. The individual needs of each client were considered very carefully by staff, ensuring their individual preferences and needs were always reflected in how care was delivered.
• Clients were always treated with dignity by all those involved in their care, treatment and support. Consideration of people’s privacy and dignity was consistently embedded in everything that staff do.
• Staff managed risk well using effective systems and protocols, including clients at risk of exiting the service without completing treatment. All clients had holistic, personalised support plans, and were encouraged to take an active role in their own treatment and risk management.
• Staff managed opiate detoxification safely. Staff assessed clients for suitability for detoxification in collaboration with their local substance misuse detoxification prescribing service prior to admission and clients received a full prescribing assessment on the day of admission. Detoxification prescribing regimes implemented by the local substance misuse detoxification service supported the DSP. These were in line with “Drug misuse and dependence: UK guidelines on clinical management (2017)” and relevant National Institute of Health and Care Excellence (NICE) guidelines. Staff effectively monitored withdrawal symptoms and were knowledgeable about what actions to take if a client’s health deteriorated during detoxification.
• Clients spoke very highly about their experiences of the service, their relationships with staff and the impact the service had on their lives. Relationships between clients and staff were strong, caring, respectful and supportive. These relationships were highly valued by staff and promoted by leaders.
• Incidents, complaints and safeguarding concerns were monitored to identify where improvements could be made. Clients were involved in reviews of how complaints were managed to ensure their view was taken into account.
• The culture within the service was that of openness, transparency and learning. Staff and clients were confident to raise issues.