Newham Rise

The service provides specialist community treatment and support for adults and young people affected by substance misuse who live in Newham. This included community-based alcohol detoxification and an opiate substitute prescribing service. This was the first inspection of this service.

We rated it as good because:

• The service had enough staff, who knew the clients and received basic training to keep them safe from avoidable harm. Staff managed risks to clients well. They responded promptly to sudden deterioration in clients’ physical and mental health. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• The service provided safe care. The premises where clients were seen were safe and clean, well maintained and fit for purpose. The service had appropriate COVID-19 measures in place. The service managed client safety incidents well. Managers investigated incidents and shared lessons learned with the whole team.
• The service used systems and processes to safely prescribe, administer, record and store medicines. Staff regularly reviewed the effects of medications on each client's mental and physical health.
• 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. They ensured that clients had access to physical healthcare and supported clients to live healthier lives.
• 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 training, 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, including those with protected characteristics. They actively involved clients in decisions and care planning.
• 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 treated concerns and complaints seriously, investigated them and learned lessons from the results.
• Leaders had the skills, knowledge and experience to perform their roles, and were visible in the service and approachable for clients and staff.
• A restructuring of services was planned which would introduce a single point of entry to the service and bring down the higher number of cases some practitioners were managing.

However:

• At the time of inspection there was no clinical oversight of new referrals. The service had implemented a new system following our inspection.
• Managers could not give a timeframe as to when staff were due to complete their outstanding BLS training.
• The service was conducting local level audits, although they were behind with audits for assessments, case records and consent.
• Our findings from the other key questions demonstrated that governance processes could be made more robust in recording performance outcomes and improving some of the data systems.
• Staff did not have their own dedicated team meetings and internal governance team meetings were not minuted. This meant that the provider could not be assured that all information was shared with staff.
• The service’s risk register did not reflect all the current concerns about the delivery of the service, and we could not see where the risk register was reviewed. This meant that provider could not be assured that service risks were appropriately mitigated.