Turning Point - Smithfield Detoxification Unit

Updated 16 March 2020

Turning Point is a national health and social care provider with over 250 specialist and integrated services across England and Wales, focusing on improving lives and communities across substance misuse, learning disability, mental health and employment. Turning Point Smithfield is a 22-bed inpatient unit that provides treatment to men and women over 18 years of age who have a drug or alcohol dependency. The service provides a detoxification service. The majority of clients are referred to Smithfield by the community drug and alcohol teams, with their places being funded through their Local Authority. However, clients can also refer themselves to the service and self-fund. The service takes referrals from all over the country however, the majority of clients on the day of our inspection were from the local area. The service is situated close to the city centre of Manchester and it is easily reached on foot, by car and public transport. There was a registered manager at the time of our inspection.

The service is registered to provide the following regulated activities:

• Accommodation for persons who require treatment for substance misuse

Turning Point Smithfield has been registered with CQC since 8 February 2011. There have been three previous inspections carried out at Smithfield; the most recent was conducted on 23 August 2016. We did not rate inspections at that time. The service was found to be meeting all the required standards inspected.

Updated 16 March 2020

We rated Smithfield as good because:

• The service provided safe care. The clinical premises where clients were seen were safe and clean. The service had enough staff. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
• The service was tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care.
• The service was flexible, provided informed choice and ensured continuity of care post discharge with the group that ran on a Sunday for past clients
• The service had created strong links with the local community. This offered clients choice not only around which abstinence meetings they wanted to attend but also hobbies and interests they could take up to aid their own sobriety in the future.
• The service was easy to access and clients never waited for a bed. Staff planned and managed discharge well. The service had alternative care pathways and referral systems for people whose needs it could not meet.
• The service was well led, and the governance processes ensured that its procedures ran smoothly.

However,

• We found that the monitoring and recording of withdrawal symptoms and when required medication was given were not always complete. Although nurses were keeping patients safe by assessing their symptoms and dispensing when required medication accordingly, this was not always being documented. This meant there was a risk to patients that physical health was not monitored effectively throughout withdrawal.
• Controlled drugs that were delivered from the pharmacy prior to the patient being admitted were checked on arrival but then they were not checked again until the day the patient was admitted. This meant that staff may not be aware if medication had gone missing.
• We found one example of a patient who had brought their own inhaler to the service but the self-medication chart was not completed.

Updated 9 November 2016

Inspected but not rated