CGL Waltham Forest Adults Substance Misuse Service

The service provides specialist community treatment and support for adults affected by substance misuse who live in Waltham Forest.

Our rating of this location was good because:

• The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff managed risk well and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to 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.
• The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
• Most clients that we spoke to were happy with the level of service they were receiving and felt well supported by staff.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
• The service was well led, and the governance processes mostly ensured that its procedures ran smoothly.

However:

• Not all clinical staff had completed basic life support training.
• The service’s risk register did not reflect all of the leadership team’s current concerns about the delivery of the service.
• At the time of inspection there was no clinical oversight of new referrals. The service had implemented a new system following our inspection.
• There were significant vacancies in the alcohol and non-opiate team. At the inspection three out of four vacancies were covered by agency staff. This meant that there was a risk that clients could receive inconsistent care and treatment.
• Client’s consent to treatment was not always recorded.