Cranstoun Royal Borough of Windsor and Maidenhead

Updated 19 August 2019

Resilience is a drug and alcohol recovery service for adults covering the Royal Borough of Windsor and Maidenhead provided by Cranstoun. It is a community-based service offering a range of interventions and provides a community alcohol detoxification programme. It also provides a needle and syringe programme, which is a place for people who are injecting drugs to obtain free sterile injecting equipment and advice.

The Royal Borough of Windsor and Maidenhead Public Health Team commissioned the service which is provided in partnership with a local GP practice. We did not inspect the GP practice as part of this inspection. The current contract started on 1 April 2017 for three years, however commissioners have extended this for an additional year until April 2021.

Resilience is registered to provide the following regulated activities:

• treatment of disease, disorder or injury

• diagnostic and screening procedures

There is a registered manager in post.

CQC previously inspected Resilience in February 2018. Following this inspection CQC issued the provider with three requirement notices due to breaches of regulation. These were in relation to safe care and treatment, good governance and receiving and acting on complaints. During this inspection in June 2019 we were satisfied that the provider had appropriately addressed the areas identified for improvement at the previous inspection.

Updated 19 August 2019

We rated Resilience as good because:

• The service provided safe care. The environment was safe and clean. Staff assessed and managed risk well.
• Staff carried out comprehensive assessments for all clients prior to them starting treatment. This included assessing previous medical history including mental health, carrying out physical health checks, and assessing levels of dependence. Staff also requested medical summaries from clients’ GPs.
• GPs assessed all clients face to face prior to prescribing and documented their prescribing rationale on the electronic system which all staff could access. Medicines prescribed were those recommended by the National Institute of Health and Care Excellence. Details of prescribing regimes were sent to clients’ GPs.
• Staff monitored clients’ physical health on an ongoing basis to assess for signs of deterioration.
• Staff provided a range of treatments suitable to meet the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• Staff developed holistic care plans for clients with a clear focus on recovery.
• Managers ensured that staff received training, supervision and appraisal.
• Staff treated clients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of clients. They actively involved clients in their care planning.
• Staff were responsive to the needs of clients and had set up a satellite clinic in another part of the borough to make it easier for clients to access the service.
• The service was well led and the governance processes ensured that procedures ran smoothly.
• Staff were committed to working collaboratively and found innovative ways to work with other local health professionals and local police. Staff had developed training to help educate other professionals about substance misuse. They also trained police in how to use Naloxone and provided them with kits to use.
• An outreach worker worked with the service to help engage the local homeless population in treatment. They provided satellite surgeries three days a week and supported homeless clients to apply for housing and obtain identification documents.

Updated 19 August 2019