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Stocktaking and adaptation – it’s all part of the process

Stocktaking and adaptation – it’s all part of the process Cranstoun

Peter Glass, Executive Director of Operations

We recently, as we often do, took stock of Cranstoun’s whole-system integrated services. ‘Stocktaking’ is part of ongoing performance management and development, a continual process applied throughout the lifetime of any contract. Even with this mature and robust framework in place, general reporting cycles of KPIs or outcome and output data can fail to recognise some of the more macro aspects of delivering whole-system services, as well as the wider panacea of service evolution, often spanning up to five years. This is one of the reasons Cranstoun developed and continues to refine its Mobilisation, Implementation, Transformation, Exit (MITE) framework, a tool within our governance structure that considers wider operational aspects linked to service development.

While integrated services contain common core elements, each offers individualised, unique aspects that are significant both in the immediate locality and in relation to building an extensive collection of ‘what works best’. For example, in our countywide service across Worcestershire, which covers both rural and urban populations, the latest (Q4) NDTMS completions report shows significant improvement since the contract started on 1 April 2015:

  • Opiates improved from 4.8% to 8.5%
  • Non-opiates improved by 21%
  • Alcohol improved by 22%

Since implementation, PHE data analysis shows the following improvements in numbers accessing in-house Hep C treatment:

  • A substantial reduction in ‘did not attends’ (90+% to 20%)
  • An increase in treatment numbers (0 p/month to 3 p/month)
  • A reduction in test-to-treatment time (12 weeks+ to 8 weeks)

Since embedding the shared care service across Worcestershire, the service has seen an increase of 32% in prescribed clients accessing shared care.

In its 50th year, Cranstoun remains a leader in the sector; we have learnt a lot from our wide-ranging current and historical portfolios. While our approach will always be to learn and evolve, each service we manage assumes a local focus, seeking to co-produce, partner and complement local strategic and operational plans, systems and processes. Demography and geography are perhaps obvious factors within the planning and delivery for each service, but it’s when we start to consider other layers of overall operational and support requirements that we see a more representative picture of the sheer complexity of the task at hand.

People who use our services often present with a range of issues – homelessness, significant physical and mental health problems, contact with the criminal justice system, debt, to name a few. Indeed the whole sector has witnessed higher levels of presenting complexity over the last ten to 15 years. What particularly strikes me is how, despite deep and enduring financial constraints, there is sustained momentum to continually strive to improve and try new and innovative approaches.

Cranstoun’s Brighton and Hove service, Pavilions represents an excellent, real multi-agency partnership where Cranstoun is the lead organisation. Examples include:

  • Prescription collection – we have changed the culture from one where clients collected their prescription from pharmacies to collecting it from Pavilions. 70% of clients engaged better with one to one appointments than previously.
  • Mobile needle exchange – by providing needle exchange on the streets we have doubled engagement rates of the number of people rough sleeping and using the night shelter who have entered treatment as a result of a needle exchange interaction over the past nine months.
  • Peer-led group work – the totally peer-led ‘Speakeasy’ group is an excellent example of co-production, running five days per week with 65 regular attendees.

There are similar threads across all of Cranstoun’s services, with many excellent illustrations of how our provision evolves. By utilising co-production as a cornerstone of design and by ensuring relevancy and flexibility with built-in review periods, we create an environment that accommodates an adaptive and dynamic development process.

Annual Service User Survey 2018-19

We carried out our annual service user survey across Cranstoun Group services from December 2018 to February 2019. The survey was open to all service users in any type of treatment, from drop-in attendees to service users in long-term structured treatment.

We received 1348 responses across 15 services, including seven adult community substance misuse services, four young peoples’ community substance misuse services, one residential service, one supported housing service, one family and carers service and one family and carers team.

Here are a few of the key results:

The highest scoring question was on staff friendliness (9.6/10).
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The most commonly given score was 10 out of 10.
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Service users find our most helpful treatments/activities to be key work sessions, group sessions and prescribing.
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The most common positive outcomes experienced by our service users are abstinence, less use, and prescription.
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The top three words used to describe Cranstoun services were safe, happy and supported.
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97.7% of service users said they would recommend their service.


In response to the survey, we also received some fantastic feedback from our service users:

All I wish to say is please keep going, as there are so many others needing help out there. I’ve still got a long way to go as well – it’s a life saver. Good luck to all the staff and the organisation. We need you.

– East Sussex FACT

Just a big thank you!! West Hill has given me back safety and security, plus my independence. I’m looking forward to working on my problems positively and overcoming them, and becoming a clean and well-balanced working member of society!

– West Hill & Ritherdon Road

Thank you so much. You’re all very professional, understanding, knowledgeable and emphathetic. An amazing service.

– Pavilions FACT

I feel very grateful to have had this opportunity for change. Thank you for being in my life.

– Inspire Sutton

Thank you for saving my life and for the love that I feel coming here, which is very important when you’re lonely.

– Swanswell West Berkshire

Click here to read the full service user survey report.

Cranstoun’s residential detoxification service, City Roads – an announcement

It is with deep regret that, after 40 years of operation, Cranstoun is announcing the proposed closure of City Roads, our London based detoxification unit.

This decision has been reached after a prolonged review period, where Cranstoun has continually sought solutions to the longstanding problem of ongoing disinvestment for this type of provision. For over ten years, Cranstoun’s trustees have agreed to support the unique and valuable City Roads service and have funded any deficits arising. Unfortunately, the financial position has deteriorated such that the service is no longer considered sustainable.

City Roads has served residents of London and the Home Counties for many years, both as a crisis intervention unit, and more recently as a high care detoxification facility for alcohol and drug users with enduring and complex needs. Indeed, the decision to close comes at a time when there remains a high level of need for this type of provision. Despite this, diminishing resources have consistently reduced referrals below the level required to support the ongoing operation.

In making this announcement, we wish to acknowledge the dedication and commitment of our current and previous staff groups and volunteers, who have worked tirelessly for the betterment of people’s lives, in what is truly inspiring ‘front end provision’. Additionally, we wish to recognise the efforts and courage of all people who have used the service as a platform for stabilisation, and recovery.

The proposed closure date is projected to be the 10th of May, with admissions being accepted until the 15th of April.

For any further information or clarification, please contact:

Peter Glass, Executive Director – Operations pglass@cranstoun.org.uk
Niamh Donnelly, Director of Operations ndonnelly@cranstoun.org.uk

Pavilions rated ‘Good’ in latest CQC report

We’re delighted to announce Pavilions, our substance misuse service in Brighton, has received an overall ‘Good’ CQC rating.

The CQC inspection team carried out a thorough assessment of several aspects of the service, including looking at the quality of the physical environment, speaking to service users and staff, looking at records, policies and procedures, and observing a group therapy session.

Our people are at the heart of what we do, so we are particularly pleased about the following feedback:

Staff demonstrated a kind, compassionate approach during their interactions with clients. They treated clients with dignity and respect. Staff consistently spoke with and about clients in a sensitive, caring and professional manner. We saw staff interacting positively with clients, appearing to be responsive and respectful. Staff demonstrated a genuine interest in client wellbeing and understood the needs of each client. 

Clients we spoke with praised staff for their care, professionalism and non-judgemental attitude. All clients that we spoke with were complimentary about the staff and overwhelmingly positive about the service. Clients were involved in making decisions about their care.

Hélène Begg, City Manager for Pavilions, said, “I’m delighted that our staff were complimented in our CQC report and that our innovative solutions to working with rough sleepers and increasing employment opportunities for clients have all been noted in the report. We will continue to work on developing our practice following the inspection and will work towards an ‘Outstanding’ rating for their next visit.”

Read the full report here.

CQC rates Swanswell services ‘Good’ in all areas

We’re delighted to announce our Swanswell Worcestershire service has received an overall ‘Good’ CQC rating at two of its locations following recent inspections: Kidderminster and Worcester.

Service users told the CQC that staff treated them respectfully and with dignity, and they were involved in their own care. They felt they were listened to and both service users and the people who care for them were provided with relevant information and support to manage their recovery.

Jason Warriner, Cranstoun’s Director of Care, Quality and Governance, said, “We are pleased that the CQC report highlights our commitment to providing high quality and safe services. The ratings we received across all areas show how we respond to the individual needs of our clients and help them to make positive changes to their lives.”

Read the full Swanswell Worcester report.
Read the full Swanswell Kidderminster report.

50 years of Cranstoun

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2019 is a special year for us – we’re proud to have been empowering people to live healthy, safe and happy lives for 50 years.

In 1969, it was our founders responding to local needs that established Cranstoun House, a residential community for people in recovery. We’ve adapted and evolved over the past five decades, and we have our incredible service users, staff and volunteers – past and present – to thank for our journey so far.

We’ll be celebrating our achievements and the people who make us who we are over the course of this year, and there’ll be lots of opportunities for you to join us. Watch this space for updates!

Swanswell to work with Thames Valley Police on drugs diversion pilot scheme in West Berkshire

Thames Valley Police has launched a drugs diversion pilot scheme in West Berkshire. The scheme, which aims to reduce the harm caused by the use of drugs and drug-related offences, allows offenders in possession of small quantities of illegal drugs an opportunity to be offered a tailored diversion route through Swanswell West Berkshire drug recovery service, to address their use of drugs instead of facing prosecution.

Swanswell, part of the Cranstoun group, has worked in partnership with Thames Valley Police to develop the drug diversion scheme and specialist support programme.

Download our press release here

CQC rates Cranstoun City Roads ‘Good’ in all areas

We’re delighted to announce our residential detox service City Roads has received an overall ‘Good’ CQC rating.

Following an unannounced inspection, during which the CQC assessed the physical environment, spoke to service users and staff, looked at records, policies and procedures, and observed a service user group meeting and the admission of a client, City Roads has been rated ‘Good’ across all areas.

Our people are at the heart of what we do, so we are particularly pleased that the CQC highlighted the care, compassion and skills of our staff, and found service users to be extremely positive about the care and treatment they received at City Roads.

Jason Warriner, Cranstoun’s Director of Care, Quality and Governance, said, “We are pleased that the CQC report highlights our commitment to providing high quality and safe services. The ratings we received across all areas show how we respond to the individual needs of our clients and help them to make positive changes to their lives.”

Read the full report here.

Caroline Lucas MP visits Brighton Pavilions

 

Caroline Lucas MP visited our Brighton service, Pavilions, on Friday 7 September. We showed her around the new premises for the substance misuse service and shared our service developments with her, in particular, the work we are doing to target high risk injecting populations.

We were also joined by Oliver Standing, the newly appointed director of Collective Voice.

East Sussex FACT receives a grant of £34,000

 

Cranstoun’s East Sussex Families & Carers Team (ESFACT) has received a grant of £34,000 from the Police & Crime Commissioner’s Safe Space Sussex Funding Network.

Team Leader, Emma Jones joined the Police & Crime Commissioner, Katy Bourne on 22 August to accept the grant award and explain how the funding will help victims to cope and recover from crime and abuse in Sussex.

Commenting on the funding award, Emma Jones said: “We are delighted to have been awarded this grant from the Safe Space Funding Network, which will allow us to continue to deliver our service to families in East Sussex who are affected by someone who has a dual diagnosis of mental illness and substance misuse.”

Commending East Sussex Families & Carers Team on its successful bid Mrs Bourne said: “The East Sussex Families & Carers Team is a great example of an innovative local project that aims to help victims and protect our most vulnerable. I look forward to visiting the team at their office in Eastbourne and following the progress of their project over the next year.”