Turning Point IMPACT

Updated 11 April 2019

The IMPACT Service is delivered by Turning Point and is a specialist community service providing support to people suffering from drug and alcohol problems across Wiltshire.

Funding for treatment is through the commissioning teams within Wiltshire and Swindon Councils who work very closely with the provider to ensure the service is supported and of high quality.

The Care Quality Commission (CQC) registered the service to provide the regulated activity of ‘Treatment of disease, disorder or injury’. There is a registered manager in place.

We have not previously inspected this service as they were newly commissioned in April 2018. The provider had previous experience of delivering substance misuse services within Wiltshire.

The service offers substitute prescribing for drugs and alcohol, access to detoxification and residential rehabilitation and signposting or referral to other agencies. They also offer harm reduction advice and support, a peer mentoring programme, testing and vaccination for blood borne viruses, brief interventions, outreach, group work, individual and one to one therapy, and community engagement. The service also offers treatment for clients with complex needs through the engagement and prevention team. Appointments for this service do not take place in the adult service hubs, but instead in GP surgeries, schools and other community settings. The service also offers online support and aftercare.

The service has good partnership working across the county with other agencies, including; probation, social services, GP surgeries, police and pharmacies.

Updated 11 April 2019

We rated Turning Point IMPACT as outstanding because:

• Staff supported clients to achieve their goals. A strong recovery ethos ran throughout service delivery and all staff shared a clear definition of recovery. Staff were hard working, caring and committed to delivering a good quality service. They spoke with overwhelming passion about their work and were proud to work for Turning Point.
• Staff used effective systems to proactively identify and manage client risk. Safety was a priority in all teams. The whole team was engaged in reviewing and improving safety and safeguarding systems. There were effective systems in place to ensure that safeguarding concerns were identified, managed and reviewed.
• Managers had oversight of the service through governance and assurance procedures, which were very robust, consistent and of a very high standard. The risk and assurance team had implemented effective systems across all teams. Governance and performance management arrangements were proactively reviewed and reflected best practice.
• The service offered clients a wide range of treatment options, including telephone and online support. There was specialist staff to meet the complex needs of client groups. The service actively worked to engage them in treatment, including vulnerable and complex clients.
• Staff supported clients to engage in their local community. Dedicated workers facilitated clients’ engagement with community services and worked to bridge the gap in support after treatment and promote independence and self-care in clients. They developed and maintained an electronic community resource map, with other 300 local resources.
• Staff conducted high quality, thorough and comprehensive assessments of clients’ needs. Staff completed detailed and meaningful risk assessments and risk management plans with clients following their initial assessment. Care plans contained risk information and were holistic and person centred.
• Managers supported staff wellbeing. A wellbeing lead had been appointed for the service who had implemented a number of support systems and schemes to enhance staff wellbeing. This included ‘check-out’ meetings on a Friday for staff to deal with any worries before the weekend, communal lunches and promotion of physical exercise.

However:

• Managers did not have systems in place to ensure that caseload numbers were manageable. Keyworkers individual caseloads were as high as 90 in some cases and managers did not have a way of assessing acuity of each caseload to ensure that they were manageable.
• Staff did not consistently document decisions or discussions relating to clients’ mental capacity.

Updated 11 April 2019