We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• The provider ensured that the environment was clean and safe with good infection control practices and good management of health and safety responsibilities. There was safe staffing levels and staff had completed mandatory training and understood how to safeguard adults and children at risk of harm. The systems used by the service to safeguard clients and their children were robust, and staff routinely demonstrated best practice in ensuring their welfare.

• The service worked effectively with partners, and had forged good working arrangements with local GPs and local authority teams, including for instance employing staff who worked across the system to support clients with their social needs as well as their health needs. The service used best practice and carried out regular audits and acted quickly to make improvements where necessary.

• Staff were caring, and demonstrated a compassionate understanding of clients and the impact of their drug and alcohol use on their lives. Clients were treated with dignity and respect and included in decisions affecting their care. Client feedback about the support they received was universally positive.

• The service offered a supportive and welcoming environment with a structured timetable offering a range of groups and one to one sessions. The service demonstrated a commitment to engaging positively with clients to encourage them into treatment, offer them choice in how they met their goals, and pro-actively re-engage them in the event that they dropped out.

• The service had robust governance systems that managed risk to staff and clients and ensured that staff were well trained and supervised to do their jobs. Staff were well supported by local and senior managers.

We found the following areas the provider needed to improve:

• While overall the systems to manage and mitigate risks were good, not all clients had documented risk management plans held in their files.

We rated Slough Treatment Advice and Recovery Service as Good because:

• Since the last inspection the service made improvements in creating a documented risk assessment for each client for all identified client risks.

• Staff safely identified and managed the risks associated with detoxification or withdrawal. Comprehensive risk assessments were undertaken at the start of treatment. Staff identified, reported and responded to adverse incidents. The provider had appropriate arrangements in place to respond to clinical emergencies.

• Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by and were delivered in line with guidance from the National Institute for Health and Care Excellence. Clients’ physical health was monitored throughout their treatment. Clients gave their consent to treatment and had been given enough information about treatment options and risks.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff had the knowledge and ability to monitor and recognise the signs of deterioration in clients’ physical and mental health during treatment and how to seek or provide help.

• Staff treated clients with kindness, compassion, dignity and respect. Feedback from clients confirmed that staff treated them well and offered them personalised care. Clients were involved in their care planning and encouraged to give feedback about the service. Staff were able to offer support to families of clients.

• A new operations manager had been appointed in November 2018 with an extensive background working with the client group and the provider organisation and demonstrated a commitment to improving the service.

However:

• Some staff raised issues of low morale, caused by staff leaving and the impact that had had on their workload.