We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Risks were comprehensively assessed and the service had a strong focus on safeguarding adults and children from abuse. The comprehensive assessment they completed on first admission covered a wide range of health and social factors as well as drug use. The risk assessment and management plans completed from these were comprehensively documented. Access to the service was open which gave clients freedom around when they attended for assessment.

• The service used National Institute for Health and Care Excellence (NICE) guidance to focus their practice. Policies were created based on this guidance. We found good evidence of use of recognised tools and therapeutic techniques when working with clients. There was access to Naloxone and staff offered testing and vaccinations against blood borne viruses.

• There was good medical cover from a local GP surgery. Staff liaised with the clients GP on admission to the service to ensure prescribing was conducted in a safe way.

• Staff were experienced and qualified. They received mandatory and specialist training relevant to their role and they were supervised regularly by management. Auditing of care records fed into supervision sessions to ensure risk assessment and recovery plans were up to date.

• Incidents and complaints were dealt with effectively and the outcomes of these were fed back to staff and clients. The service fulfilled its duty of candour.

• Staff were caring and treated clients with dignity and respect. There was support available to families and carers.

• Staff were proactive in engaging clients in the service. Clients that did not attend were followed up to ensure that they were safe. Staff were flexible in where and when they saw clients. There was a range of information available to clients.

• The service was well led with good governance that allowed the management to have oversight of issues within the service. This ensured that they assessed their practice for effectiveness.

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

• There was a high staff turnover rate that impacted on caseloads of staff that remained working.

• Naloxone was not locked in the cupboard it was being stored in. The needle exchange room was not locked when not in use.

• There was not always evidence of a comprehensive physical health assessment. There was no record of calibration of the physical monitoring equipment.