CGL Spectrum

Updated 23 August 2019

Change Grow Live Spectrum is part of the of a national Change Grow Live provider who provides a non-for-profit drug and alcohol treatment service. Spectrum was awarded a seven-year contract by commissioners in September 2018 to deliver substance misuse interventions for people living in the Hertfordshire region. At the time of the inspection there were 1471 clients using the service.

Spectrum operates a hub and spoke model. There were four hubs at the time of inspection which were in Hatfield, Watford, Hertford and Stevenage. Satellite sites were strategically planned maximising the geographical region where the service was provided and accessible to clients. The service provided interventions and supported people of all ages. Adults were seen at the hubs and people under the age of 18 were seen at home, in schools and colleges if required. Opening times at all four hubs varied to ensure clients were able to access the service in the evening and weekend.

Each hub had specialist teams and recovery workers which where the Opiate Team, Alcohol Team, Complex needs Team and Engagement & Rapid Recovery. Co-located teams included, Family Safeguarding, Hospital Liaison, Integrated Criminal Justice and Family, Young People service.

Spectrum is registered with the Care Quality Commission to provide treatment of disease disorder or injury as a regulated activity. At the time of inspection, the service had a registered manager in post. A registered manager is the person appointed by the provider to manage the regulated activity on their behalf, where the provider is not going to be in day-to-day charge of the regulated activities themselves.

Updated 23 August 2019

• Spectrum had health and safety systems in place to manage the safety for clients and staff across all hubs. Fire risk assessments and the health and safety folders were up to date.

• All hubs had a range of appropriate rooms to meet client’s needs. The clinical rooms were clean, well-stocked and regularly reviewed by the clinical lead nurse. Staff had access to Naloxone (Naloxone is used to reverse the effects of opioids) and adrenaline which were stored in emergency grab bags at all hubs.

• The provider had robust policies, procedures & training related to medication and medicines management. These included: prescribing, detoxification and assessing people’s tolerance to medication. Staff adhered to infection control principles, including hand washing and the disposal and storage of clinical waste.

• Adverse events were planned for. The provider had a business continuity plan in place which was regularly reviewed by the hub managers.

• There was enough staff at all grades to meet the needs of the clients. All staff received mandatory training suitable for their role. Additional specialist training was provided for example, Recovery workers had access to qualifications and credit framework (QCF) diploma level three in a therapy related subject. The multidisciplinary team met regularly to discuss client progress and needs. Each day a morning meeting was held at all hubs, where the team discussed the clients they were scheduled to see that day.

• Clients received a comprehensive assessment in a timely manner which included a physical health assessment. Staff were able to identify signs of deteriorating in mental health. Risk management plans were discussed upon first assessment and regularly reviewed thereafter.

• The service bench marked their service performance against Public Health England treatment outcomes. We were provided with performance evidence where the provider was performing above the Public health England performance data for successful completions of treatment, opiate representation, incomplete Hepatitis B vaccinations and levels of incomplete Hepatitis C screening.

• Staff worked well with external agencies. Recovery workers and nurses were co located in hospitals, local authority family safe guarding team, GP surgeries, the job centre and police custody suites. This meant staff were able to share key information immediately.

• Staff in leadership roles had the skills, knowledge and experience to perform their roles and provide strong leadership to staff. Managers had a good understanding of the service they were responsible for and could explain clearly how the teams were working to provide high quality care.

• Staff we spoke with told us they felt respected, supported and valued by the provider. They reported that work related stress was minimal and manageable and that team morale was positive.

• There were robust governance systems in place to effectively manage the service. The manager had oversight of the service. Performance was monitored by completing regular audits and the outcomes were recorded on key performance indicator dashboards. This meant the manager could monitor performance over a period of time to ensure continuous improvement.

Updated 23 August 2019