We reviewed recovery services in June 2012 and again in May 2013. At the time of our first review we had a number of concerns, which were largely attributable to a re-design of the service in 2012. This had resulted in significant staff movement, relocation and re-branding of teams. Patients were not well informed about the changes to the service or how the changes would affect them. Many patients were dissatisfied with the service; they had experienced numerous changes which had affected the continuity of their care and they were anxious and distressed by this. The service was not fully staffed and this meant that some people did not receive the level of service they required.

When we returned in May 2013 we saw some improvements; however in some areas, teams were still under-staffed, due to both vacancies and high levels of sickness absence. Caseloads were too high, causing stress to staff and a disrupted service for some patients. Some patients were dissatisfied with infrequent contact with the service and lack of continuity and some still experienced difficulty contacting the service.

We returned to check whether further improvements had been made. Although we reviewed performance trust-wide we visited three recovery teams in North Wiltshire, Bath and North East Somerset (BaNES) and North Bristol. We spoke with 28 staff, either in person or over the telephone. We spoke with 16 people who used services and a carer by telephone. We attended a meeting facilitated by a local commissioner, attended by people who used services. We reviewed feedback from people who used services, captured by the trust. We also reviewed a sample of care records and trust performance data.

Most of the staff in the three teams we visited felt that staffing levels had improved and caseloads were now more manageable; however some staff, particularly in North Wiltshire told us that they were still concerned about their workload and the effect this had on them as workers and on the service they could provide.

We received mixed views about the service. Some people were happy with the frequency of their visits/contacts and felt the service was reliable. They spoke positivity about the staff. In some areas, most notably, North Wiltshire, some people were dissatisfied with infrequent or irregular contact with the service and the lack of continuity. Some people still experienced difficulty accessing the service and some people were very anxious about the prospect of being discharged and not being able to access support.