VIews
Read views and comment at:
www.drinkanddrugsnews.com
LegaL LIne CLInICaL eye
BE THE BEST! Learning curve
Take one simple step to
make sure your CQC
inspection is as good as it
can be, says Nicole Ridgwell
IT IS VERY ENCOURAGING TO HEAR OF INSIGHT PLATFORM’S POSITIVE
CQC EXPERIENCE and impressive outcome (page 16). As would be expected,
clients rarely come to those in my profession with their good news stories! What
really shines out in the article is how staff are so enthusiastic about the service.
This will no doubt have translated into a frontline commitment to make the
service the best that it can be.
While all providers will undoubtedly begin their services with this same goal,
the daily grind can weaken resolve and standards may imperceptibly slip. It is
therefore vital that providers give their service regular health checks, to ensure
that every aspect of the service is reaching the expected high standards.
This need to check each and every part of a service arguably has a specific
importance for substance misuse services. As in the Insight Platform article, CQC
does not currently rate providers in the substance misuse sector.
Where they do rate, CQC reports confirm whether a service is ‘outstanding’,
‘good’, ‘requires improvement’ or ‘inadequate’ as an overall rating, and as
individual ratings under the headings of safe, effective, caring, responsive and
well-led. In services they do not rate, CQC will summarise their assessment of a
substance misuse service with the stark conclusion that the service in question
is or is not safe/ effective/ caring/ responsive/ well-led.
This presents a challenge for services because it deprives them of the
nuanced approach of the four ratings. Being told that your service is ‘not safe’ is
a blunt and concerning outcome for any provider. Providers have expressed
concern that a conclusion of ‘not safe’ leads potential service users to simply
stop reading and choose another service; whereas a service with ‘requires
improvement’ may encourage a potential service user to read on, find out what
exactly requires improvement and weigh up the information themselves.
Those in the substance misuse sector, therefore, cannot afford to lose points
on inspections in any category. We have previously discussed the importance of
providers challenging draft reports where they believe any of the contents to
be factually inaccurate. To do otherwise is to let damaging and incorrect
information into the public domain, with all the reputational and commercial
implications that entails.
It is of course far preferable to be proactive and ensure that the service that
CQC visits is the best that it can be. A health check is the best way to test this.
Using an external consultant or via internal audits, we recommend regular mock
inspections. To ensure that your health check aligns with the reality of
inspection, use the CQC Provider handbook for specialist substance misuse
services, July 2015; the appendices of which provide the key lines of enquiry, the
characteristics and the principles upon which the assessments are grounded.
With this one simple step, providers will know that they have done
everything within their power to obtain an excellent CQC report – leading to
more providers having the same positive CQC experience as Insight Platform.
Nicole Ridgwell is solicitor at Ridouts LLP, www.ridout-law.com
www.drinkanddrugsnews.com
Discovering that we can’t
impose our own timetable
on clients is a vital lesson,
says Ishbel Straker
THE FEELINGS I HAVE ABOUT THE FIRST
CLIENT WHO BROKE MY ‘NURSING HEART’
WILL NEVER LEAVE ME. I was given this lady
‘She blamed
me for her
lack of
success, her
inability to
sustain her
sobriety and
for all the
wrongs she
had ever
suffered...’
as the first on my student caseload and I
believed –with an authority that can only
come from naivety – that I was going to be
the catalyst of change in her life.
I was going to instigate the promise of
hope for the future and be the indication of
how the best was yet to come in her life. I met
her for our first of six sessions, pen and paper
shaking in hand, mentally prepared to
keywork the addiction right out of her. I was
ready to listen and set those achievable goals
that would enable her to move just that little
bit further forward, and we would look back
at the end of the six weeks with
astonishment at how far she had come.
None of you reading this will be surprised
to hear the story didn't end in this way, and
after the third session I received a phone call
from this client who was not only intoxicated
but highly abu sive. She blamed me for her
lack of success, her inability to sustain her
sobriety and for all the wrongs she had ever
suffered.
I remember the devastation I felt, the
absolute disappointment that my foolproof plan had not worked and the
confusion that this sweet lady I sat with each week, to whom life had been so
cruel, could become so personal. I sat with my mentor who talked to me about
their experience and we reflected on these emotions and how he used them to
improve his practice for his clients. At the time I did not believe him – I was
overwhelmed and uncertain that I would ever have belief in my skills as a
practitioner but also a blind trust that all are capable of change.
Of course he was right and each similar occurrence gave me a deeper
understanding and enabled me to be a more skilled nurse. It taught me to truly
reflect on my practice and consider the effect my clients had on me, but most
importantly it taught me that there is nothing that I could ever do, or say, for
anyone who is not ready to change, and that clients must do it for themselves
and nobody else. Especially not me.
Ishbel Straker is clinical director for a substance misuse organisation, a
registered mental health nurse, independent nurse prescriber (INP), and a board
member of IntANSA.
September 2017 | drinkanddrugsnews | 17