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Community Impact Assessment (CIA)
Title of proposal:
Review of Drug and Alcohol Recovery Services in
Salford
Service Group/ Team:
Public Health
Date of assessment:
Completed 28.09.15
Lead CIA Officer:
Mark Knight
Officers in Assessment
Team:
Mark Knight
Review Date:
30
thJune 2016
The findings of your CIA MUST be included within the report for decision and
this document attached as evidence of your consideration of potential impact
on communities.
Summary of Community Impact Assessment
Brief summary of proposal or what you are impact assessing
A review of drug and alcohol service premises was conducted to ensure usage best
promotes recovery and utilises resources efficiently. This review was informed by the
recently commenced refurbishment of council owned premises on Orchard Street (M6) to
create a bespoke Recovery Community Resource Centre. This refurbishment has been
jointly funded by Salford City Council, Greater Manchester West Mental Health NHS
Foundation Trust (GMW) and the award of a Public Health England Capital Grant of over
£250,000. The new Recovery Community Resource Centre, located close to Salford
Precinct, will be an asset utilised by groups which comprise Salford’s growing recovery
community. The refurbishment is scheduled for completion in December 2015.
It is proposed that as the new centre opens the existing recovery centre located at nearby
Mona Street in Pendleton will close. In order to pool resources and create a clear focal point
for recovery activities it is also proposed to close the Haysbrook Centre in Little Hulton since
the review concluded that the service lacked the capacity to deliver a new recovery model
based on group work, family interventions and crucially the development of the capacity of
recovery community organisations.
Both of these centres are of inferior quality to the bespoke premises being constructed at
Orchard Street. They are also both rented from private owners. The new Orchard Street
Recovery Community Resource Centre will be mandated for Drug and Alcohol Service
provision alongside existing council buildings detailed in the ‘Integrated Drug and Alcohol
Treatment and Recovery System Service Specification’. The development will deliver a
modern fit for purpose space, enable better use of the council’s estate and keep money
within the public sector.
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How did you approach the CIA and what did you find?
During 2012, Salford Drug and Alcohol Action Team (DAAT) undertook a series of
stakeholder, public and service user consultations as part of the consultation phase of the
re-specification of the drug and alcohol treatment system. In April 2015, consultation with
service users and staff began in light of the award of the Public Health England Capital
Grant and confirmation of the feasibility to develop a new Recovery Community Resource
Centre.
The proposed closure of the Haysbrook Centre will affect approximately 162 service users.
Recovery Voices, a service user group, have consulted with Haysbrook Centre service users
and feedback was that the dilapidated condition of this centre does not lend itself to an open
and friendly environment that encourages recovery.
Assisted travel options and creative use of personal budgets will encourage these service
users to access the new recovery centre. Those requiring local appointments will be seen at
local venues. A targeted assertive outreach service in Little Hulton will also promote use of
the new recovery centre and provide support to individuals and groups who are harder to
engage. The service will continue to work with GPs in offering shared care provision at the
Gill Medical Centre and facilitate group work at the Walkden Gateway Centre.
What are the main areas requiring further attention?
The consultative processes detailed in this CIA have not identified any potentially
disproportionate negative impacts for individuals or groups with protected characteristics.
Service users and staff have been fully consulted about the proposals detailed. There is a
communication plan for service users and referrers. Updates have been regularly shared at
locality team meetings and staff have been directly involved in identifying Gateway Centres
and GP surgeries where individual and group work provision can be delivered if the
Haysbrook Centre is closed.
Summary of recommendations for improvement
Our recovery model aims to promote equality and inclusion whilst reversing the
disadvantage and stigma too often experienced by those with substance misuse issues.
Community development is central to our recovery model since what we are seeking to
achieve is improvements in both individual and collective well-being. We recognise that
people’s social networks, their commitments to them, and what people do with their daily
lives constitute outcome measures of real value. Improvement in these outcomes will be the
measure of success.
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1. The proposal
This section should outline details of the proposal. This could include (where
applicable)
• Description of the current service (policy, procedure, strategy, function)
• Explanation of the proposal
• Reason for the proposal
• Aim or purpose of the proposal
• Who should benefit from the proposal
• Who are the key stakeholders
• What outcomes are required from the proposal
• Details of other services on which the proposal could impact
• Social value considerations
In October 2014 GMW was awarded the contract to provide drug and alcohol recovery services
across Salford. As the Lead Provider for the new “Achieve Partnership”, GMW work with a
range of sub-contracted partners to deliver recovery-focussed services that adopt an asset
based community development (ABCD) approach which encourages individuals to positively
participate in their community and fosters a sense of purpose and self- belief.
A key aim of the new Achieve Partnership is to boost recovery capital and ensure access to the
resources required to protect against relapse. The level and quality of recovery capital plays a
pivotal role in generating successful treatment outcomes in that those with good social
integration and employment are more likely to successfully complete treatment and not relapse.
Achieve aim to ensure the new service model does not develop in isolation but instead
promotes community cohesion by working with local communities. To support this strategy
premises are open for use by partners and community groups that share the services aims and
values. In addition there is agreement to locate staff in a range of community venues to
improve relationships with partners and provide better access to services. Integrated joint
working and information sharing with partners in turn improves capacity to provide the targeted
recovery services needed to achieve long term recovery alongside a broad range of
interventions through from prevention to harm reduction and clinical interventions.
A review of current service premises has been conducted to ensure usage reflects this
approach to promoting recovery and utilises resources efficiently. Importantly, this review is
informed by the recently commenced refurbishment of council owned premises on Orchard
Street (M6) to create a bespoke Recovery Community Resource Centre. This refurbishment
has been jointly funded by Salford City Council, GMW and the award of a Public Health
England Capital Grant of over £250,000. The new Recovery Community Resource Centre,
located close to Salford Precinct, will be an asset utilised by groups which comprise Salford’s
growing recovery community. It will be a focal point for recovery activity in the City providing
practical, peer led and professionally facilitated groups, training and development opportunities,
and support to people in recovery, their carers and family members.
The refurbishment is scheduled for completion in December 2015. It is proposed that as the
new centre opens the existing recovery centre located at nearby Mona Street in Pendleton will
close. In order to pool resources and create a clear focal point for recovery activities it is also
proposed to close the Haysbrook Centre in Little Hulton. Whilst fit for the purpose of delivering
traditional treatment models based on 1-1 appointments, the review concluded that the service
base in Little Hulton lacked the capacity to deliver a new recovery model based on group work,
family interventions and crucially the development of the capacity of recovery community
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organisations.
Both of these centres are of inferior quality to the bespoke premises being constructed at
Orchard Street. They are also both rented from private owners. The new Orchard Street
Recovery Community Resource Centre will be mandated for Drug and Alcohol Service
provision alongside existing council buildings detailed in the ‘Integrated Drug and Alcohol
Treatment and Recovery System Service Specification’. The development will deliver a
modern fit for purpose space, enable better use of the council’s estate and keep money within
the public sector.
The building will offer a beacon of hope and practical support for people and families as they
seek to achieve and sustain abstinence. The new base will offer a dedicated centre for group
work, therapeutic and social interventions to support recovery journeys as well as the
opportunity for people in recovery to access a wide range of self help, mutual aid and skills
based opportunities.
The centre will be a resource for training, development and voluntary work, offering
constructive use of time, personal and employment related skills development including
accredited qualifications, and the development of social enterprise. Work at the centre will
recognise that recovery is more than the absence of addiction and requires the development of
opportunities for personal development, wellbeing and increased access to the labour market.
The centre will therefore offer access to office resources, support for developing micro
enterprises, workshop and training space, meeting space and professional advice.
The Achieve Partnership will enhance opportunities for people to access the new recovery
centre from all parts of Salford through assisted travel options and use of personalisation
budgets. For those who require clinical interventions the service will ensure these can be
accessed at venues across the city through the use of community venues, primary care
services, health improvement centres, mental health service premises, services at Salford
Royal and three dedicated substance misuse treatment centres inclusive of those for families
and young people.
The structure of the service delivery model includes a Single Point of Contact (SPOC) to
promote engagement and facilitate rapid access to treatment, recovery and wider support
services in Salford. A positive experience at the point of engagement with the service will
significantly contributes to an individual’s on-going recovery with Peer Mentors and volunteers
providing evidence of visible recovery at all treatment and recovery bases.
Recovery Voices, the partnership service user group, are supporting the development of
activities planned for the new centre and are helping to keep service users fully informed of the
intentions to develop recovery opportunities within the Little Hulton area and across Salford.
They are also helping to ensure that service users can access information from local
pharmacies where they access prescribed medications.
Ongoing consultation has involved service users, individuals in recovery, families and carers.
Service users have been informed via posters at treatment centres and at an individual level
case workers have discussed planned developments with service users when attending
appointments.
Mangers and staff regularly meet with the Recovery Voices group to ensure information is
cascaded throughout the recovery community. Voice Box Inc, a local research and production
company led by people in recovery, have also been commissioned to consult with service
users across Salford about the new service model and develop strategies for involving local
people in the design and future activities of the new centre.
The proposed closure of the Haysbrook Centre will affect approximately 162 service users. As
stated above, assisted travel options and creative use of personal budgets will encourage
these service users to access the new recovery centre. Those requiring local appointments will
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be seen at local venues. A targeted assertive outreach service in Little Hulton will also promote
use of the new recovery centre and provide support to individuals and groups who are harder
to engage. The service will continue to work with GPs in offering shared care provision at the
Gill Medical Centre and facilitate group work at the Walkden Gateway Centre. Achieve will work
with GMW’s Communication Team to ensure all partners and referring agencies are informed
of the proposals and informed in advance of any venue changes.
The Haysbrook Centre currently provides a needle exchange service. Achieve will ensure that
this provision is not unduly disrupted. Provision of needle exchange and waste disposal (e.g.
used injecting equipment) will continue to be delivered from local pharmacies that will be
supported appropriately to address an increased volume of clients. Targeted outreach workers
will work to ensure the needs of hard to reach drug users are met.
Twelve staff currently based at the Haysbrook Centre will be relocated to the new resource
centre. Though based at the new centre they will continue to work from a range of service
bases and community venues inclusive of local gateway centres, as is the case for the vast
majority of Achieve staff.
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2. Evidence and research
What equality information (qualitative and quantitative), research or other intelligence
have you used to develop this proposal?
This can include; equality monitoring information, census data, customer satisfaction
surveys and feedback, inspection reports, desktop research (local, regional and
national), professional journals, feedback from individuals and groups. Details of
information considered when assessing the impact should be published (whilst
ensuring individual confidentiality).
Information source
What has this told you?
Salford Drug and Alcohol
Health Needs Assessment
(2014) – Public Health, Salford
City Council.
This Needs Assessment directly informed the procurement
of a new recovery-orientated treatment system in Salford. It
provides detail on local and national strategies. Promoting
recovery and reducing the harm caused by substance
misuse through effective partnership working and integrated
service
delivery
are
the
overarching
principles
recommended for service delivery.
Recovery Orientated Drug
Treatment (2011) and
Medications in Recovery (2012)
Recovery Orientated Drug Treatment (ROTD) states that
the level and quality of recovery capital plays a pivotal role
in generating successful outcomes since those with good
social integration and employment are more likely to leave
treatment without relapse. Accordingly, a key aim of
recovery orientated drug treatment is to boost recovery
capital and ensure access to the resources required to
protect against relapse.
An expert group chaired by Professor Jon Strang was set
up in 2012 through the National Treatment Agency in
response to the challenges set out in the National Drug
Strategy. It concluded that Opioid Substitution Treatment
(OST) helps prevent people dropping out of treatment,
suppresses illicit use of heroin, reduces crime, reduces the
risk of blood borne virus transmission, and reduces the risk
of death. The expert group also identified key elements of a
successful treatment system that should be embedded into
any current and future delivery of specialist services
including a shared vision of recovery, availability of
psychosocial interventions and strong links to recovery
orientated community organisations.
New Economics Foundation
(2010)
The new service model adopts the 5 ways to health and
well-being approach which will deliver a range of accredited
and evaluated group programmes to individuals, families
and carers.
Rec-Cap Tools, Best et al
(2013)
All interventions are agreed with service users following an
assessment of motivation and recovery capital alongside a
comprehensive assessment of severity of substance misuse
and personal, social and health complexity.
Service User Records
Treatment and Postcode
Analysis (August 2015)
In August 2015 there were 162 individuals accessing the
Haysbrook Centre for treatment. Of these:
•
102 were male with 74 accessing services for a
primary drug problem and 28 accessing services for
a primary alcohol problem.
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•
60 were female – with 37 accessing services for a
primary drug problem and 23 accessing services for
a primary alcohol problem.
Postcode data for those receiving treatment at the
Haysbrook Centre evidences that:
•
45% live in the areas of Walkden and Little Hulton.
•
55% live in the areas of Pendlebury, Clifton and
Swinton.
It is proposed that clients living close to the current service
are offered appointments at the Walkden Gateway and local
shared care GP surgeries in the event that the Haysbrook
Centre closes.
Clients from the areas of Pendlebury, Clifton and Swinton
will similarly be offered appointments at local GP surgeries
and at the Swinton Gateway in the event that the Haysbrook
Centre closes.
Service users will also be encouraged to make use of the
facilities at the new Recovery Centre through assisted travel
options and creative use of personalised budgets. Achieve
has an established system for administering personalised
budgets.
It is worth noting that service users from Little Hulton, and
throughout Salford, already travel to the King Street site in
Eccles when a medical appointment is required with the
Consultant Psychiatrist or Nursing Team. This system has
been in operation for the past 12 months and there have
been no objections from service users from any area of
Salford in relation to accessing these appointments.
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3. Engagement / Consultation
When considering your proposal, you should be engaging with individuals and groups covering the following protected characteristics
(You can use evidence from existing consultations if this evidence is relevant to your proposal):
•
Age
•
Disability
•
Gender
•
Gender reassignment
•
Marriage and Civil Partnership
•
Pregnancy and maternity
•
Race
•
Religion and belief
•
Sexual orientation
We also advise you to consult people on a low income, carers, ex-offenders, refugees and people seeking asylum, gypsies
and travellers, where appropriate.
You should detail below your engagement activities (Please note; you must ensure individual confidentiality)
Date(s) of
engagement
Who was involved?
Main issues identified
January to March
2012
Salford Drug and Alcohol Action
Team (DAAT) undertook a series of
stakeholder, public and service user
consultations
as
part
of
the
consultation phase of the
re-specification of the drug and alcohol
treatment system. The CIA for the
new
Recovery
Strategy
was
updated in January 2013 following
the decision to adopt a Lead
Provider Model for service delivery.
Provider Briefing Event
This took place on 19th January 2012 and was attended by 68 people from a
range of agencies. The main points raised by participants were:
•
The need to develop peer recovery focused support including recovery
champions and peer based assertive outreach.
•
The development of a visible and accessible recovery community.
•
Greater integration and co-ordination across the system with a single
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This model became operational in
October 2014 with GMW as the
Lead Provider for the Achieve
Partnership.
•
Community development and links between the services and the
community.
•
Development of employment related activity, linking into the local
business economy.
•
Fast entry and re-entry to prevent people disengaging and dropping out.
•
Focus on families including the most vulnerable young people, adult
carers, parents in recovery and identifying families and parents who are
not in treatment.
•
Need to develop accessible opening times, evening and weekends,
drop-in sessions.
•
Need for women specific services, especially women leaving prison.
•
Recovery to be integrated into the model, as a guiding principle not as a
service at the end of the model.
•
Need to have more detail within pathways and methods of achieving
outcomes.
Service User Consultations
These were held at services in Eccles, Pendleton and Little Hulton during
February and March 2012. The main points raised were:
•
Lack of after-care support once finished treatment and the need for
support to continue when people are in recovery.
•
The need for recovery mentoring and more ex users working in services
•
The need for help with methadone reductions.
•
The need for services in the evenings and at weekend and in local areas.
•
The need for provision for women i.e. residential rehabilitation and mental
health provision.
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talks in local community, schools, and churches.
•
The need to combat stigma.
•
The need for relapse prevention and residential support for people who
relapse.
•
Support for families i.e. childcare, weekend provision.
•
Support tailored to the person.
•
Not enough groups i.e. need to be longer, more confidence / self esteem
related, more peer led.
•
The need for more publicity about personal budgets.
•
Importance of support from key-worker, having continuity of care, phone
calls to remind of appointments and follow up calls.
Public Consultations
During March 2012, DAAT Officers attended public events in Ordsall and
Langworthy, Broughton, Pendleton, and Eccles. The range of issues addressed
included:
•
Alcohol being recognised as a key issue with particular points made about
home drinking, social acceptability, and accessibility.
•
The need of a social life for people who abstain from drugs and alcohol.
•
Women’s needs were recognised, in particular the need for childcare.
•
Support for the separation of prescribing from co-ordination, brief
interventions and outreach.
•
Workforce issues were raised with the need to ensure the right people are
doing the right jobs and to avoid the loss of talent, skill and existing
expertise during the re-organisation process.
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April 2015 (ongoing) Recovery Voices Service User
Group
Voice Box Inc.
In April 2015, service users from the Recovery Voices group met with service
management to establish a service user steering group to shape service
development. This steering group has since met once every two months (the last
meeting was in September 2015). The group has directly informed the
commissioning of the new Recovery Centre and has been consulted on interior
design, external signage and the range of recovery activities that will be delivered
from the new centre.
Voice Box Inc is a peer led community research organisation that have received
funding from the Achieve Community Asset Fund to consult with service users
across Salford in the planning and development process of the new Recovery
Resource Centre. In May 2015 they began by facilitated an all day event utilising
a ‘world conversation café approach’ for sharing ideas. They have worked closely
with Recovery Voices and have particularly focused on individual and community
outcomes. Learning from the project will be used to influence ongoing
developments within and across services and local communities.
Recovery Voices have also consulted with Haysbrook Centre service users and
feedback was that the dilapidated condition of this centre does not lend itself to
an open and friendly environment that encourages recovery. The group plan to
support service users who currently use the Haysbrook Centre to access the new
Recovery Resource Centre. There are plans for volunteers and peer mentors to
facilitate transport, the minibus owned by THOMAS (an Achieve partner) will
contribute to this alongside personal budgets and assistance with travel costs.
July 2015 (ongoing)
Staff Consultation
All GMW staff have been fully consulted about the proposals detailed in this CIA.
A communication plan for service users and referrers has been discussed by
staff. In line with service user suggestions it has been agreed that existing
contact numbers will continue to be used to support ease of contact during the
transition. Updates have been regularly shared at locality team meeting and staff
have been directly involved in identifying Gateway Centres and GP surgeries
where individual and group work provision can be delivered if the Haysbrook
Centre is closed.
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4. Assessing the impact
From your evidence gathering, you will have identified potential disproportionate negative impacts. Please provide details and
your actions to overcome these below. We would also like to know if there will be any positive impacts that your proposals will
make to improve equalities:
•
Potential impact: If the proposal could result in some groups (including customers and/or staff) being disadvantaged or
treated unfairly
•
Mitigations and actions: Where there is a potential for disadvantage or unfair treatment, what are your plans to
eliminate, reduce, mitigate or justify it? Could making these changes have a negative effect on any other group(s)?
Explain why and what you will do about this. You should include details of who will be responsible for the actions and
target dates for completion:
•
Promoting Equality: Could the proposal result in an opportunity to promote equality or inclusion? Explain how.
Please note: this table will form the basis of your action plan.
Protected
characteristic or
other group
Potential impact
Mitigations and
actions
Responsible
officer
Target date Promoting equality
Age
The consultative processes detailed in this CIA have not identified any potentially disproportionate negative impacts for
individuals or groups with protected characteristics. Our recovery model aims to promote equality and inclusion whilst
reversing the disadvantage and stigma too often experienced by those with substance misuse issues. Community
development is central to our recovery model because recovery prevalence is shaped as much by community recovery
capital as personal recovery capital. This means that a successful treatment journey will increasingly focus less on
addictive behaviour and more on the internal and external resources needed to initiate and sustain recovery.
Disability
Gender
Gender
reassignment
Marriage and Civil
Partnership
Pregnancy and
maternity
Race
Religion and belief
Sexual orientation
Other groups
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5.
Assessing the impact on community cohesion
Community cohesion is what must happen in all communities to enable different groups of people to get on well together. A
key contributor to community cohesion is integration which is what must happen to enable new residents and existing residents
to adjust to one another.
An integrated and cohesive community is based on three foundations:
•
People from different backgrounds having similar life opportunities.
•
People knowing their rights and responsibilities.
•
People trusting one another and trusting local institutions to act fairly.
And three ways of living together:
•
A shared future vision and sense of belonging.
•
A focus on what new and existing communities have in common, alongside a recognition of the value of diversity.
•