Archived: Addaction Rotunda

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The service locations were clean and tidy. All furniture was in excellent condition. There was an up to date fire risk assessment, dated 1 July 2016. Fire wardens were identified, with three members of staff designated fire wardens, with signage indicating the three staff and their positions. A counselling room was decorated to reflect young interests, giving a relaxing atmosphere. Rooms that were available to interview clients were quiet and private. Clinical support was facilitated through adult services, where any prescribing was generated and managed in line with a locally agreed client's prescribing protocol. All clients were assessed within a comprehensive risk assessment framework on joining the service. There had been no serious incidents requiring investigation in the 12-months prior to the inspection.

• Addaction Rotunda had clear and comprehensive referral criteria, and a comprehensive assessment of physical and mental health needs was carried out. We reviewed five sets of care records and care plans that related to clients at Addaction Rotunda. They were comprehensive, personalised, holistic and recovery orientated. The service reacted to problems with physical needs by referral to the GP, and mental health needs by referral to children and adolescent mental health services or the early intervention and psychosis team. We saw evidence of the use of client-centred ‘substance misuse maps’, completed by clients, to show their journey and the point they had reached at the time of review. Staff had completed specialised training, including cognitive behavioural analysis and motivational interviewing techniques.

• We interviewed two clients of the service at the time of the inspection. They stated they felt safe in the service. The clients told us that staff were always polite and respectful, caring in their approach. We saw consent and confidentiality agreements signed by both clients and staff in care records. The service allowed treatment to be client led, with full involvement in care plans: this was seen during the inspection. Recovery plans were individualised and stressed the strengths of the client, recognising a wide range of needs and aspirations, and directing appropriate support. The service allowed clients to feedback using forms, such as a client satisfaction form, a form that had been devised by clients at the service.

• On average, clients referred to the service averaged three days from referral to admission to the service. The service tried to remain ‘barrier-free’, accepting referrals of clients from vulnerable groups such a sex workers, pregnant women, lesbian, gay, black and ethnic minorities, bisexual and transgender people. The service had a diversity working group with a remit to remove barriers to clients entering the service. Discharge plans were included for clients of the service, and discharge reasons were audited and monitored by Public Health England. Complaint forms were easy to understand and complete, with a monthly complaints and compliments log maintained by the service. Leaflets were available in easy read format, as well as a graphic novel approach outlining the treatments available.

• The values for the service were ‘compassionate, determined, and professional’. The staff at the service stated they used these values to improve effectiveness and productivity. The service had a statement of purpose that stressed the journey required to move forward, rather than the concept of recovery.