During our visit we were able to speak with nine people who used this service. People told us they were treated with respect and dignity. We saw that staff interaction with people was appropriate and professional.

We looked at the care plans of four people and saw that the provider had used information from associated professionals such as social workers and that people and their representatives had been asked their opinion.

People told us they felt safe using the service. Staff training records confirmed that staff had all completed training in safeguarding discussions with them confirmed they knew how to escalate any concern.

Staff had completed a robust induction programme and selection process. This ensured that the centre was effectively staffed by appropriately trained people.

The provider operated a comprehensive monitoring system that ensured regular reviews and audits of all service areas.

People who use the service understood the care and treatment choices available to them. We spoke to five people who used the service. They all told us that they had received excellent information about their future options.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us that staff worked closely with them to help them address their alcohol and drug use.

People told us they felt safe and support by competent staff. They said they were confident in raising concerns if they had them.

People who use the service told us that they participated in decisions about their care and treatment. They said that their needs had been fully assessed when they were new to the service. People who use the service valued the quality of care and support and said that it had made a significant difference in their lives.

People told us that staff treated them respectfully and were sensitive to their needs. People also told us that they were able to express their views formally and informally about the quality of the service. They said they were listened to and taken seriously.

Overall South Westminster Drug and Alcohol Services 32a Wardour Street was compliant.

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The provider had made improvements since the previous inspection in September 2016. At our previous inspection, we found that the provider did not have appropriate fire safety arrangements in place, that medicines management wasn’t as robust as it should have been and that staff hadn’t received immediate life support training. At this inspection, we found that the provider had taken the appropriate action to improve the service.

• Staff had addressed outstanding actions from fire safety risk assessments and were aware of what action to take in an emergency. Medical equipment had been calibrated and the environment was clean and tidy. Handwashing facilities were available across all sites.

• Medicines were stored in a secure, organised and tidy fashion at the appropriate temperature. The provider had updated its medicine policy to ensure an appropriate policy was in place for the storage of medicines. Medicines were prescribed in accordance with national guidance.

• Staff were skilled, experienced and knowledgeable about substance misuse and had a good understanding of clients’ needs. The majority of staff had now completed immediate life support training.

• Clients were positive about staff and felt involved in the planning of their treatment.

• The provider had a good outreach and peer mentor programme for clients. A range of employment and education opportunities were available to clients.

• Staff held effective multi-disciplinary meetings and worked well in partnership with external local agencies.

• The provider monitored the length of time it took to assess clients. The majority of clients were assessed within five days of being referred. Client assessments were detailed and comprehensive.

• Staff described senior managers as visible and approachable. The provider had an effective governance framework. Complaints and incidents were investigated in a timely manner with learning and feedback given to staff

However, we also found the following issues that the service provider needs to improve:

• Staff had not undertaken all the mandatory training required by the provider

• Risk assessment were not always consistent, some were informative and comprehensive whilst some did not reflect the client’s current level of risk.

• Not all staff received supervision on a regular basis.

• Staff did not always have the time to undertake the training and development programme that was available due to increases in referral rates and higher caseloads without increased staffing levels.