Archived: Primary Care Recovery Service (PCRS)

Updated 1 March 2019

Primary Care Recovery Service is a community based substance misuse service providing care and treatment from a main hub and eight participating GP practice hubs. The service provides a GP shared care scheme. This is an arrangement between two local healthcare professionals. This means clients substance misuse care is divided between Primary Care Recovery Service and the GP practice.

The service provides a medically monitored community alcohol detoxification programme, opiate substitution therapy, harm minimisation, group workshops and individual sessions. An aftercare service operates for those clients who are abstinent from alcohol and drugs.

The London Borough of Lewisham commissions the service.

The service treats clients over 18 years of age who drink less than 200 units of alcohol per week, and who consume alcohol daily or binge drink, and can engage in treatment at one of the eight GP practice hubs. For clients with an opiate addiction, the service treats those people who have stable employment and/or education, do not inject opiates, and are able to engage in treatment at one of the eight GP practice hubs. Clients that do not meet the service treatment criteria are referred to a different substance misuse service in the borough.

Clients receiving opiate substitution therapy or medically monitored community alcohol detoxification attend clinics at any of the eight GP practice hubs.

The service is registered with the Care Quality Commission to provide the following regulated activity:

• treatment of disease, disorder or injury

At the time of the inspection, the registered manager had left the service and the area manager stepped in to cover this role until the new manager started in March 2019.

The Care Quality Commission had not previously inspected this service.

Updated 1 March 2019

We rated Primary Care Recovery Service as good because:

• Staff managed clients’ risk safely and effectively. Staff safely carried out physical health checks on clients going through assisted withdrawal from alcohol. Clients’ care plans addressed the potential risks of early exit from the treatment programme.

• The service managed medicines well. Nursing staff followed best practice guidance when prescribing medicines for clients.

• Staff minimised the risk to clients and children from abuse and avoidable harm. Staff worked closely with the local safeguarding lead to seek guidance and support.

• Clients had care plans in place to support them going through alcohol detoxification. Clients’ had recovery plans and staff completed relapse prevention plans with clients. Staff involved clients in planning their care and the running of the service.

• Staff provided a range of care and treatment interventions suitable for clients’ recovery. Clients had access to psychological therapies to support their substance misuse treatment. These included cognitive behaviour therapy and mindfulness.

• Staff demonstrated a compassionate understanding of the impact clients’ care and treatment could have on their emotional and social wellbeing. Clients were positive about the care they received from staff.

• Staff actively engaged with commissioners, GPs, social care organisations and other secondary care services. This ensured staff could plan, develop and deliver the service to meet the needs of the clients.

• The service worked jointly with other services in the local borough’s pathway for drug and alcohol services. This ensured that staff could appropriately place clients along the drug and alcohol pathway to meet their needs.

• The service made sure staff were competent for their specialist roles working in substance misuse. Staff received an annual appraisal of their work performance and received regular managerial supervision to provide support and monitor the effectiveness of the service.

• The service was well-led at team level and by the senior leadership team. Staff had access to information they needed to provide safe care and high-quality treatment to clients. The team used key performance indicators to measure the performance of the service. Nursing staff had completed a short research report into the effectiveness of a medicine that clients used for alcohol cravings.

However,

• Staff did not keep up to date with their mandatory training. Low rates of mandatory training included harm reduction, managing difficult situations, risk assessment and care planning training.

• Staff did not always actively promote the needs of all clients, including those with a protected characteristic. Staff did not always include clients’ religion, ethnicity and sexual orientation into their care planning.

• The service did not have local systems to identify and manage risks within the service to ensure risks were mitigated.

Updated 1 March 2019