We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Change, grow, live (CGL) provided safe and effective recovery-focused care and treatment. Clients were positive about the way staff involved them in planning their recovery and the support staff gave them.

• Staff thoroughly assessed risks to clients and identified their needs. Staff developed sound risk management plans and kept these under review to ensure that they met client needs effectively.

• Clients were able to access support and treatment quickly. Staff followed best practice and national guidance when prescribing medicines. Clients were able to access psychological support.

• At each site there was a multidisciplinary team comprising experienced and skilled staff. Most staff said their caseloads were manageable. At most sites the premises were suitable.

• Staff understood and implemented safeguarding procedures for adults and children. Staff liaised with commissioners and other local agencies to ensure they met clients’ individual needs and develop local services.

• CGL involved clients in reviewing and developing services at the local and national services. The service used feedback from clients to make improvements. Clients who had recovered from substance misuse were able to become volunteers at the service.

• Staff and clients understood the vision and values of CGL.

• Registered managers carried out audits of the quality of the service and ensured that teams took action promptly to improve services when required.

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

• CGL had not always sent CQC the required statutory notifications in relation to deaths and other incidents

• At Peterborough, staff were managing their caseloads but we were concerned that they were doing so through consistently working over their contracted hours.

• At Barking and Dagenham, interview rooms were not adequately soundproofed and private conversations could be overheard.

• At Barking and Dagenham, the room used by clients for urine tests was not appropriately designed to provide for clients’ privacy and dignity. The provider was aware of this and there were plans in place to make a more suitable room available.

• At the Bromley site, the cleaning of the toilets used by clients and by staff was inadequate.

• The system to identify when the Disclosure and Barring Service (DBS) criminal records check had been received by CGL was not robust at the time of the inspection. Consequently, it was not clear that rigorous measures were in place to ensure staff worked safely with clients whilst CGL was waiting to receive the DBS check. Senior managers advised us that by January 2017 a new human resource management system would be in place that will have an automatic alert system to flag up when a DBS check has not been received.