Turning Point Leicester City Substance Misuse

Updated 16 January 2019

Turning Point is a national organisation with 350 healthcare, residential and substance misuse services in England and Wales.

Turning Point Leicestershire and Leicester established in 2016 and registered with CQC in July 2016. The service provides community based substance misuse interventions including detoxification to over 3,000 young people and adults across Leicester City, Leicestershire and Rutland. The service also holds the contract for Leicester prison drug and alcohol services.

The service operates through four hubs: Leicester City at Eldon Street; Coalville; Loughborough; and Granby Street the young people’s hub. There are six teams within the hubs, City North East with Market Harborough; City South West with Rutland; Coalville & Hinckley; Loughborough and Melton; Young People and young adults team; and the criminal justice team. The prisons team was not part of this inspection. In addition to the clinical hubs there is a data performance and administration team, an engagement team, a partnership team, and a senior management team all based at Eldon street.

The service is registered to provide treatment of disease, disorder or injury. The registered manager is Inderjit Thoor. Turning Point Leicestershire and Leicester has been inspected once before in June 2017, they were not rated on that occasion and we issued two requirement notices: -

• The provider must ensure that clinical waste is managed in accordance with guidelines.
• The provider must ensure that the stair lift at Granby Street is properly maintained.

In addition, we also told the provider they should address the following issues: -

• The provider should ensure all ligature audits are complete and risk management plans are in place.
• The provider should ensure that clients privacy and confidentiality are maintained while using the needle exchange in Loughborough.
• The provider should ensure that staff update and document all risk assessments.
• The provider should ensure that all building repairs and maintenance at Granby Street is carried out in a timely manner.
• The provider should ensure they have the required staff to develop a community detoxification service and enhance their physical healthcare activities in line with best practice.

At the time of inspection in November 2018 the provider had addressed all the above issues.

Updated 16 January 2019

We rated Turning Point Leicestershire and Leicester as outstanding because:

• The provider had invested in a strong senior leadership team, who held a shared, clear vision of what the service should look like. The senior leadership team held a collective responsibility for maintaining the high standards of care described in their vision. The provider had invested in developing a robust infrastructure of support teams such as the engagement, partnership, administration, and analytical teams to support the delivery of high quality clinical services. The senior management team had developed and supported team leaders and staff to embed a culture of shared values based on inclusion, partnership working, learning and innovation.
• Governance was exemplary. The provider had a range of governance and assurance processes that provided structure and maintained high standards of quality for the service and clients. The provider had key performance indicators to gauge the performance of the teams. Between July 2017 and June 2018, 935 clients successfully complete treatment. This placed the services performance above average for comparator local authorities in all substance categories, and in the upper quartile of comparator authorities in city opiate users and county alcohol users.
• Managers had developed a structured treatment pathway model that followed National Institute for Health and Care Excellence guidelines. The model included five clear treatment pathways: the opiate, and drugs pathway, the dependent alcohol pathway, non-opiate drugs pathway, non-dependent alcohol pathway, and the risk, vulnerability, and complex safeguarding pathway. All pathways included relevant evidence based interventions including psychosocial interventions delivered by recovery workers. Doctors and nurses delivered evidence based clinical interventions including substitute prescribing, community detox and referral to inpatient detox, blood borne virus interventions and a needle exchange service.
• The provider recognised that continuing development of staff skills, competence and knowledge was integral to ensuring high quality care. Managers proactively supported all staff to acquire new skills and share best practice. The provider recognised staff success with its ‘Inspiring Leicestershire’ recognition and reward scheme, this scheme recognised and celebrated the work of all Turning Point staff.
• The service had exemplary partnership working arrangements, including a highly regarded and unique partnership with the local constabulary.
• The service had a good track record for safety. All the hubs were clean and tidy and cleaning records were up to date. Staff had completed environmental risk assessments including the risks posed by ligatures.
• Clients received holistic packages of care with a choice of treatments guided by needs assessments. Staff personalised the clients’ treatment interventions within the pathway model and based around what the clients wanted to achieve. Staff interacted with clients in a respectful and caring manner. Staff showed compassion, dignity and respect, and provided responsive, practical and emotional support as appropriate. Staff supported clients to understand and manage their care and treatment in a personalised way that suited the client’s needs. Staff directed clients to other services when appropriate and, if needed, supported them to access those services.

However:

• The physical environment at the Coalville and Loughborough hubs was not as welcoming as that at Eldon Street. The decoration at the hubs was tired and dated, and the waiting rooms and clinic rooms were not as well organised as those at Eldon Street. There was no one, or obvious person, on-site with specific responsibility for the clinic rooms.
• At Coalville the ground floor interview room was not fully soundproofed. When it was quiet in the waiting area some conversation could be overheard. Managers were aware of this and had taken steps to address this but were not allowed to make structural changes to the rented premises.

Updated 16 January 2019