We rated Swanswell Worcester as good because:

• The service kept people safe from avoidable harm by ensuring there were sufficient staff with the right training, supervision, knowledge and skills. Risk assessments were completed and care was planned around the client’s individual needs. Staff had good awareness of safeguarding issues, they followed the service’s lone working policy, incidents were reported, and lessons learnt were cascaded to staff.
• Staff used best practice and national guidance to complete comprehensive assessments, which enabled the development of personalised and holistic recovery plans detailing the appropriate treatment and care.
• Staff worked well together and with external partners to ensure clients received effective and consistent care and treatment, and monitored outcomes regularly.
• Clients told us staff treated them respectfully and with dignity, and they were involved in their own care. They felt they were listened to and both clients and carers were provided with relevant information and support to manage their recovery. The service invited feedback which was shared at a local and national level.
• The service responded to clients quickly and managed their caseload effectively to ensure they could provide care when the client required it. The service was meeting its targets and dealt with complaints effectively.
• The service supported clients to access work, education and mutual aid to enhance their recovery and was accessible to those people protected under the disability and discrimination legislations.
• There were good governance arrangements in place. Experienced managers and staff monitored the quality of the service using audits, client feedback, reviewing incidents and complaints, and key performance indicators. Low morale amongst some staff was being addressed by the service.
• The service encouraged innovation and had implemented quality improvements across the service to enhance the service they provided to their clients. The service had implemented good ideas suggested by clients.

However:

• However, we could not always ascertain whether clients had received their own copy of their recovery plan.
• Some interview rooms were not soundproofed to maintain confidentiality and privacy.

We do not currently rate independent stand alone substance misuse services.

• The service had enough staff to deliver assessment and treatment to the number of clients on their caseload and respond to their level of need. The service did not use bank or agency staff. Sickness absence and staff turnover was low. Staff and volunteers had the required checks to work with young people and vulnerable adults.

• The service was well maintained, visibly clean and had the required health and safety procedures in place to keep staff and clients safe.

• The service had procedures in place for incident reporting and disseminating lessons learnt at a local and national level.

• Staff carried out a holistic assessment with clients at the start of treatment, using appropriate assessment and monitoring tools. Risk assessments were completed and managed through risk management plans and recovery plans.

• Staff understood mental capacity and described they supported clients who needed help to make decisions.

• The service had mechanisms in place to raise and refer safeguarding concerns to the relevant agencies.

• The service saw, assessed and started treatment for clients in a timely manner. There were no waiting lists. The skills mix was appropriate to deliver the interventions identified at assessment.

• The service offered one to one psychosocial intervention, group work, including mutual aid programmes, blood borne virus testing and immunisation, basic health checks and substitute prescribing.

• It worked with other agencies to provide additional care and support such as mental health services and youth offending services.

• Clients who used the service were positive about staff and the support provided. Clients described staff as caring, supportive, respectful, and good listeners.

• The staff were passionate about their work with clients and worked together in a positive and supportive manner.

• A thorough role induction process was in place and staff had opportunities to develop their career and pursue special interests. Staff received regular supervision, annual appraisals, mandatory and role specific training.

• Staff knew how to raise concerns and were confident they could do so without recrimination.

• Clients using the service reflected the ethnic and cultural backgrounds in the local population and the service had access to interpretation services, when required.

• Internal governance structures were in place to manage quality and performance. The service reported to the local authority on a quarterly basis on performance against the contract deliverables including payment by results targets. Performance was improving against local and national key performance indicators.

• Audits were completed and actions set to improve standards.

• The service responded to complaints appropriately.

We found the following issues that the service provider could improve:

• The provider must ensure risk assessments and recovery plans are updated in line with case note records.
• The provider must ensure plans are in place for clients if they disengage with treatment.
• The provider must ensure that staff complete and record identified mandatory training.
• The provider should ensure the confidentiality of clients is maintained by using adequately soundproofed rooms.

• The provider should ensure boiler room signage is sufficient to reduce risk and old office equipment is stored appropriately.

• The provider should ensure a consistent approach in the use of screening tools.

• The provider should ensure case notes record evidence the psychosocial interventions delivered.

However, we also found the following areas of good practice:

• The service had enough staff to deliver assessment and treatment to the number of clients on their caseload and respond to their level of need. The service did not use bank or agency staff. Sickness absence and staff turnover was low. Staff and volunteers had the required checks to work with young people and vulnerable adults.

• The service was well maintained, visibly clean and had the required health and safety procedures in place to keep staff and clients safe.

• The service had procedures in place for incident reporting and disseminating lessons learnt at a local and national level.

• Staff carried out a holistic assessment with clients at the start of treatment, using appropriate assessment and monitoring tools. Risk assessments were completed and managed through risk management plans and recovery plans.

• Staff understood mental capacity and described they supported clients who needed help to make decisions.

• The service had mechanisms in place to raise and refer safeguarding concerns to the relevant agencies.

• The service saw, assessed and started treatment for clients in a timely manner. There were no waiting lists. The skills mix was appropriate to deliver the interventions identified at assessment.

• The service offered one to one psychosocial intervention, group work, including mutual aid programmes, blood borne virus testing and immunisation, basic health checks and substitute prescribing.

• It worked with other agencies to provide additional care and support such as mental health services and youth offending services.

• Clients who used the service were positive about staff and the support provided. Clients described staff as caring, supportive, respectful, and good listeners.

• The staff were passionate about their work with clients and worked together in a positive and supportive manner.

• A thorough role induction process was in place and staff had opportunities to develop their career and pursue special interests. Staff received regular supervision, annual appraisals, mandatory and role specific training.

• Staff knew how to raise concerns and were confident they could do so without recrimination.

• Clients using the service reflected the ethnic and cultural backgrounds in the local population and the service had access to interpretation services, when required.

• Internal governance structures were in place to manage quality and performance. The service reported to the local authority on a quarterly basis on performance against the contract deliverables including payment by results targets. Performance was improving against local and national key performance indicators.

• Audits were completed and actions set to improve standards.

• The service responded to complaints appropriately.