We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Staff assessed risks of all clients accessing the service. There was oversight of this process to ensure that risks were up to date and accurately documented.

• Care plans were created with the clients input. Clients wishes were recorded and represented when treatment decision were made. Staff liaised with the clients GP’s to ensure treatment was commenced safely.

• There was an effective needle exchange service and a harm minimisation worker who was proactive in engaging clients who were difficult to engage. Naloxone was available for those at risk of opiate overdose.

• There was a strong emphasis throughout the team on safeguarding clients from abuse. Management kept oversight of safeguarding alerts made within the team. Safeguarding information was documented well and shared within the team effectively.

• Staff used recognised best practice such as motivational interviewing and cognitive behavioural therapy. Medicines were prescribed in accordance with National Institute for Health and Care Excellence (NICE) guidance.

• Staff were responsive to different needs of the clients. Clinics took place in pharmacies and outside of normal working hours in order to provide those unable to access the service within normal hours support.

• There was excellent multidisciplinary working within the team and with external bodies. Staff were proactive in working with external teams when clients posed an increase risk in the community.

• There was a strong sense of team work and morale amongst the staff was high. Staff felt supported and felt able to support each other. Staff received regular supervision, appraisal and training relevant to their role.

• There was excellent implementation of the Mental Capacity Act.

• Staff treated clients with respect. Clients were consistently positive about the service.

• Complaints and incidents were reported and investigated effectively. Changes were made as a result of investigations.

• The service had systems in place to ensure staff were well supported through supervision, training and appraisal.

We carried out this announced inspection as part of our schedule of planned inspections. We spoke with five members of staff and reviewed records related to the service provision, including care plans and audits. We spoke with four people who used the service. Due to the sensitive nature of the service we have not used direct quotes.

People were given sufficient information to enable them to consent to treatment programmes. Support contracts were in place which detailed the responsibilities of the service and of the person receiving treatment.

People's needs were assessed and a care plan implemented to meet their assessed needs. People were involved in this process and were able to determine who they wished their information to be shared with.

Care records were reviewed and updated when needed to ensure people's needs were met. The plans included managing risks associated with detoxification and any underlying mental or physical health issues a person may have.

People were supported by a multi-disciplinary team which included a doctor, nurse and social workers. People considered they were able to get appointments at a time which suited their needs.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.