Background to this inspection
Updated
6 December 2018
Turning Point Suffolk Recovery Network provide substance misuse services across Suffolk. They offer a range of drug and alcohol services that help people recover from addiction and gain control of their lives. This is a national provider who have a contact point, a central engagement and screening service. This manages incoming referrals and completes a screening tool to assess the client’s needs. The client will be signposted for assessment with the appropriate team. The provider still accepts referrals into the service locally from a GP and other professionals. Treatment is free to clients.
Turning Point has been registered with the CQC since March 2015. As part of this comprehensive inspection, we inspected the following locations:
Bury St Edmunds:
Bury St Edmunds is a community team which offer specialist support to people with complex drug and alcohol problems in the surrounding area. Staff complete a comprehensive assessment with clients that helps form a plan of care. The service has a doctor, non-medical prescribing nurses, psychiatrist and psychologist to help support those in recovery. The service can provide stabilisation, detoxification, one to one support to help people to stop using illicit substances and treat alcohol misuse. Staff assess clients for substance dependency and apply for funding to refer them to a residential rehabilitation facility for treating addiction. The provider offers services to both adults and young people.
Ipswich:
Ipswich Turning Point offers support to those people living in the Ipswich area who need help with substance misuse and addiction. This is also a community service, which offered stabilisation, detoxification and maintenance for clients using illicit substances or alcohol. There is a multidisciplinary team of staff, such as a doctor, non-medical prescribing nurses, psychiatrist and psychologist. The community team also have young peoples recovery workers who see young people affected by substance use.
Lowestoft:
Turning Point Lowestoft is a community treatment centre, which offers help and support to those people wishing to recover from substance and alcohol abuse. The service has recovery meetings, one to one support and group work. These services are provided by a range of recovery workers, nurses, doctors, and a psychiatrist.
All three locations have a needle exchange where people wishing to use the service can drop in. Staff offer advice, information, make referrals and offer therapies. Turning Point has a Criminal Justice Team to support clients who have been given a treatment order from courts or have been released from custody.
At this inspection we found that this service had fully met and addressed actions from our previous inspection in May 2016:
The provider is registered by the CQC to provide the following regulated activities:
• Treatment of disease, disorder or injury.
Updated
6 December 2018
We rated the service as good because:
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Staff completed a comprehensive initial risk assessment for all clients at the start of treatment. Risk assessments were regularly reviewed and updated. The quality of risk assessment was consistently good.
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The service employed a range of staff to deliver treatment, including consultant psychiatrists, a speciality doctor, clinical psychologist, psychosocial lead, nurse manager, non-medical prescribers, recovery workers and senior recovery workers. Staff received specialist training for their role and were offered further opportunities.
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Staff responded well to sudden deterioration in client’s health. The effects of medication on client’s physical health was reviewed regularly. Clients were supported to live healthier lives and were sign posted to One Life Suffolk which offered support with weight loss, stopping smoking, health walks and provided health checks.
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The service followed good practice in managing and reviewing medicines including, following British National Formulary recommendations, and used recognised rating scales and other approaches to rate severity and to monitor outcomes. Staff provided a range of care and treatment for clients alongside prescribing services. Staff delivered a variety of interventions from alcohol and opiate detoxification, titration, maintenance and abstinence programmes. Clients were referred to clinics, delivered by the operational delivery networks, where vaccinations, health checks and medical reviews were also available to clients. The service offered blood born virus screening, safer injecting support, and a needle exchange. A secured medicine box system was in place for clients and was an area of good practise. Clients were offered Naloxone (an opioid antagonist that provides short-term reversal of an opiate overdose) and harm minimisation advice was given.
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Staff interacted well with clients, they were supportive, caring, and spoke to clients with respect. We observed on inspection how well staff supported clients during their visits. Feedback we received from clients and carers was very positive, staff went above and beyond to maintain contact and encourage engagement. Clients were supported to gain further qualifications and stay in employment.
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The service had a high-risk pathway in place with partner agencies. If a client was identified as being vulnerable or of high risk direct contact was made with the hub manager who had the ability to fast track the client. Staff worked in local hospitals supporting clients. The provider had a criminal justice team with a liaison role to help clients released from prison to engage in treatment. A young person and young adult pathway was in place offering engagement, recovery and change. The service had good working relationships with local agencies including GP’s, hospitals, prisons, the local authority safeguarding team, mental health teams, and social services. The provider was also part of the Ipswich locality homeless partnership.
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Family and carers were involved with client’s treatment and the service offered a family drop in session monthly. Carers were referred for further support to Suffolk family carers. The provider offered a wide range of leaflets in reception areas. There were posters and information throughout the premises, and events offered in the wider community.
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All locations had one to one interview rooms and all were adequately sound proofed. Clients privacy and confidentiality was respected when attending the service. However, there was a lack of private space in the drug testing area at the Ipswich site.
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The providers vision and values were displayed in all locations. Staff were fully aware of these and discussed them during appraisal and supervision. Staff had open communication with senior managers and the opportunity to email the chief executive officer. Staff were encouraged to have their say.
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Managers addressed poor performance promptly. Managers said they had sufficient authority to do their job, they had effective administrative support and human resources advice for clear guidance when required. Management of staff sickness and absence was effective and supportive to staff. Managers at location level held weekly meetings with teams to discuss and implement lessons learnt.
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Staff morale and job satisfaction was good. Staff worked well together. We observed very caring and cohesive teams. Staff and hub managers said they felt well supported by their senior managers who were visible in the service and approachable to all staff.
However:
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The Bury St Edmunds hub had no hand washing facility’s in the urine testing room. The Ipswich testing area was not fit for purpose. We found it was located at the bottom of a stairwell where we observed clients sitting on the stairs waiting for test results.
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Ninety two percent of clients across three sites were seen within the 21 day target set from referral to assessment. We found waiting times had improved. At Lowestoft the target of 21 days was being met. At Bury St Edmunds the assessment team was given extra support which meant appointments were offered within 21 days. At the Ipswich site, targets were still not being met, however an action plan was in place to offer more assessments per week and we saw this had a positive impact on reducing waiting times.