ADS in 2016/17IMPACT REPORT

October 2017

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ADS is a progressive 21st century addiction charity with a proactive, person-centred approach to building safer, stronger and healthier communities. We have spent over 40 years helping people recover from drug and alcohol addiction, diversifying into areas such as family support, employment and empowerment to ensure our service offer is reflective of wider health and wellbeing needs.

Our vision is:

This vision is supported by our values of integrity, compassion, consideration, dignity, empathy, pride and respect.

The purpose of this report is to evaluate the quantity and quality of work delivered by ADS in 2016/17 and the impact it had on the people and communities we serve. This report is indicative of our introspective approach to delivering high quality services which are evidence based, and supported by robust data.

This report is also a celebration of the hard-work undertaken by our dedicated staff and volunteers, without whom none of our achievements in 2016/17 would have been possible.

The DataAll data is for 2016/17 unless otherwise stated. All data has been taken from ADS’ internal reporting procedures and full data breakdowns may be available on request. Service data has been taken from the Nebula Case Management System and this report follows the service breakdown used. All analysis and data visualisation will present ADS’ service provision for 2016/17 broken down as:

• Bridge House• Blackpool• Bury• Oldham• East Staffordshire• North Staffordshire• West Staffordshire

Report StructureThe report is structured as follows:

• ADS in 2016/17……………………………..........................p. 2 – 4 • Service Provision……………………….............................p. 5 – 7 • Impact……………………………………….........................….p. 8 – 19• Conclusion…………………………………….........................p. 20

• Appendix 1: ADS by Numbers - summary visualisation of 2016/17 impact

For any questions regarding this report, please contact: jennifer.wall@adsolutions.org.uk

INTRODUCTION

To be recognised as a leading progressive charity, excelling in quality care, safety, support, research and innovation; dedicated to improving wider health and well-being for our diverse population and communities.

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ADS delivers services across the North West and Midlands and is supported by Head Offices in Manchester and Staffordshire. In 2016/17 our service provision included:

• ADS Bridge House• Blackpool Horizon• Bridging the Gap (BtG) Wigan• Bridging the Gap (integrated within Oldham and Bury services)• One Recovery Bury• One Recovery Oldham• One Recovery Staffordshire

ADS’ impact reaches beyond the doors of our services and we strive to make positive and long-lasting change within the communities we serve. The below graphic presents a snapshot of our service reach in 2016/17 by mapping the available postcodes of our clients:

ADS IN 2016/17

[NB: the above is for available postcodes only and does not cover everyone who accessed our services in 2016/17. The above has been created using 10,982 postcodes. Any location with less than 5 individuals has been left deliberately blank to preserve confidentiality.]

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StaffADS’ significant, positive impact on communities would not be possible without the hard work of our staff. Our workforce is collaborative and progressive at all levels, and our shared ethos of compassion and dedication is evident throughout the services we deliver.

As of 31th March 2017, ADS employed 168 staff and 33 casual employees, these personnel were situated within our services, as below:

Staff breakdown:

The Head Office personnel provide the full range of administrative functions, including finance, quality, facilities, HR and strategic development.

Our employees work across a variety of roles, the majority of which are concerned with direct service delivery and interaction with our clients. There are 56 recorded individual job titles in total, these can be grouped into the following overarching categories:

Job role breakdown:

Wigan38

1116161821242526

33

Bridge HouseIFSSWest StaffsNorth StaffsEast StaffsOldhamBuryHead OfficeBlackpool

Casual Staff

Total ADS staff

168

Administration - 21%

Practitioners - 65%

Management - 13%

Other - 1%

The majority (54%) of those categorised as ‘Practitioner’ are Recovery Practitioners and are situated throughout our full service provision. Other forms of ‘Practitioners’ include Detox Nurses, Prison Link Workers, Volunteer Coordinators, Criminal Justice Practitioners and Recovery Coordinators.

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VolunteersVolunteers are a central component of ADS’ service provision and a key contributor to our success. In 2016/17, there were 128 volunteers, on average, working across all of our services per month. By individual service, the average number of volunteers per month ranged from 1 in the Manchester Head Office up to 24 in Oldham. The overall quantity of volunteers also varied monthly, from the lowest in February with 113, up to a high of 149 in May.

In total, volunteers delivered 32,764 hours of work throughout the year. At an individual service level, the total number of volunteer hours delivered was:

Volunteer hours:

Blackpool

3935.54428.5

2223

4959.5

118

2460.5 2570

5383

7686

North Staffs.

West Staffs.

WiganOldhamEast Staffs.

BuryBridge House

Head Office

We pride ourselves on the comprehensive offer we are able to extend to the people accessing our services, and the variety of roles undertaken by volunteers contributes significantly to this. Volunteers worked across 13 individual roles and the average number of volunteers per position was:

Volunteer positions:

Group Work Facilitator Administration

Outreach Hub Other BriefIntervention

Harm Min. Marketing Counselling Meetings Reiki

Peer Mentor Support Worker

23337913

55 36 30 16

2 1

[NB: some volunteers worked in multiple roles]

The diversity of our volunteers and the roles they undertake is demonstrative of our inclusive approach to service delivery. Our services are enriched by the lived-experience and knowledge our volunteers have, and in 2016/17, approximately 44% of volunteers were former clients.

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ADS records the number of people accessing our services in order to maintain a full understanding of the scale of need and our impact upon it. All clients who access a service are recorded on our Nebula Case Management System, which in 2016/17, recorded 12,314 individual clients.

Outside of Nebula, ADS also records the number of people accessing our services in a less structured manner, such as those receiving brief interventions in the community (e.g. substance misuse education and information), or those accessing our Needle Exchange services but not engaging any further into treatment. In total, 5,751 people accessed ADS via this unstructured route, and an additional 1,781 accessed the brief intervention material on our One Recovery websites.

In total, therefore, 19,846 people accessed some form of service from ADS in 2016/17. This is broken down by individual service below:

Service access:

SERVICE PROVISION

Total Number of Clients Recorded and Accessing Services

Total Service Access

People Accessing Services (but not recorded as a client)

12,314 7,532

19,846

2,3502,212

1,947

1,692

1,624

OldhamNorth Staffs

Blackpool

West Staffs

East Staffs

Brid

ge H

ouse

: 47

5,751

1,781Website Brief Interventions

Bury

Anonymous Brief Interventions / Needle

Exchanges2,442

Bury experienced the largest number of clients accessing its service, accounting for 20% of all ADS client access; there was relatively consistent access across all services with the exception of Bridge House. Bridge House is a residential rehabilitation service providing round-the-clock support for clients, due to the intensity of this, the capacity is much smaller than within ADS’ other services. The Staffordshire service is commissioned as a single ‘One Recovery Staffordshire’ service and the combined number of clients accessing it was 5,528 , however, due to the size of the contract and its geographical coverage, it is separated into three distinct areas for data reporting purposes.

Our service offer is extensive and we do not offer a ‘one-size fits all’ approach to what can be complex, difficult and highly personal needs. We do, however, monitor the type of services being accessed under five overarching categories, also known as modalities, and these were accessed as below:

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Recovery Support:

Psychosocial:

Pharmacological:

Needle Exchange:

Other: 423

7,021

8,023

4,493

3,348

Total Modalities Accessed

23,308

Modality breakdown:

The modality breakdown highlights the dominance of Psychosocial Interventions within our service offer, accounting for over a third (35%) of all recorded modalities. 30% of all recorded interactions with our services took the form of ‘Recovery Support Interventions’, 19% ‘Pharmacological’, 14% ‘Needle Exchange’ and 2% ‘Other’. The ‘Other’ category encompasses ‘Advice & Information’, ‘ALC – Brief Intervention’, ‘Outreach’ and ‘Structured Alcohol Intervention’. Due to the very small number within the ‘other’ category, it is likely that these form of services are delivered elsewhere, but for reporting purposes the majority of occurrences have been subsumed within the larger categories.

Clients accessing an ADS service are presented with a range of diverse engagement and treatment options, including intensive residential, structured treatment, group work and outreach. Our dedicated keyworkers also deliver 1:1 sessions with clients and, throughout this period, 85,379 sessions were recorded, of which 79% were attended. At an individual service level sessions were recorded as below:

Appointments recorded and attended in service:

Attended:

Appointments:

Service: OLDHAM

17,598

83%

EAST STAFFS

9,808

80%

BURY

11,035

81%

WEST STAFFS

10,575

84%

NORTH STAFFS

13,998

84%

BLACKPOOL

22,365

70%

In addition to 1:1 key worker sessions, ADS prides itself on the extensive range of high quality groups we have available to clients. Our groups are incredibly wide ranging and include motivation, assertiveness, mindfulness, holistic therapies, parenting programme, action planning, and C.R.A.F.T, to name just a few. In 2016/17, ADS delivered 7,635 groups.

Client ProfileADS is committed to building stronger, safer and healthier communities, and a key element of this is maintaining a full understanding of who these communities are, via robust data collection and monitoring of the demographic profile of our clients. We strongly believe that a person’s experience of substance misuse, health and wellbeing inequality, and barriers to help, can be highly influenced by their gender, ethnicity, religion, parental status, sexuality, age, employment status and disability. Therefore, we monitor this information to ensure we are delivering services which are tailored and appropriate to the communities in which we are based.

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In 2016/17, the average client in treatment throughout ADS’ full service provision was:

Average client:

Male | 76%

White British| 90%

Aged 40

Parent| 51%

Opiate User| 52%

Not Employed (LTS / Disabled)| 37%

Self-referral| 57%

The age breakdown of clients in treatment reveals that the majority (66%) were aged between 30 and 49; those in their 30s represented 33% of all clients as did those in their 40s. There were slightly more people aged in their 50s (15%) than there were in their 20s (14%), and those aged 60+ accounted for only 5% of all clients in treatment.

The accuracy of demographic statistics is dependent on the response rate, for example only 64% of clients had their ‘veteran’ status recorded; of those that were recorded, 4% of clients in treatment stated they were veterans. Similarly, 56% of clients had their disability status recorded, of those only 18% stated they had a physical disability. This figure could potentially be an underrepresentation of disability when contrasted against the employment statistics which states that 37% of clients were recorded as ‘Long Term Sick/Disabled’.

Although ADS firmly believes that our clients should be viewed as more than the substance they are using, it is still vital to understand the level and type of need present. Consequently, when people access an ADS service, wherever possible, their primary substance is recorded. Where a substance is not recorded this tends to indicate that a client may have accessed an ADS service but not fully entered structured treatment, via a needle exchange, for example. In 2016/17, primary substance were recorded for 8,435 clients:

Recorded primary substances:

Alcohol Alcohol & Non-Opiate Non-Opiate Opiate

Opiate clients accounted for over half (52%) of all clients accessing services. At an individual service level, Opiate clients were the most common in the majority of services, accounting for between 46% and 60% of all clients in each service, apart from Bridge House. Bridge House was dominated by Alcohol clients, who accounted for 66% of their total.

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ADS’ introspective approach to service delivery fuels our commitment to delivering the highest quality services possible; we work to ensure we are achieving the best possible outcomes, and that our service offer is relevant and effective at meeting needs. Consequently, we have robust processes in place for measuring our outcomes and impact, both at an individual service and central organisational level. Measurement tools include:

Measurement tools:

IMPACT

Service Specific

BtG Outcomes

IFSS New Economy

Feedback Evaluation

Waiting Times

Completions

Interventions

Impact Measurement

Tools

DOMES(NDTMS)LOMS

PerformanceDashboard

Graphic Facilitation

Website Analytics

The remainder of this Report will now explore the outcomes achieved as recorded within the above measurement tools:

Website Analytics:ADS runs dedicated ‘One Recovery’ websites for Bury, Oldham and Staffordshire. These websites contain a drug and alcohol test which asks users to complete 10-11 questions regarding their drug or alcohol usage. Based on the responses provided, users are placed into 3 categories: low-risk, semi-risk and high-risk. At the end of the test users are given a score and an explanation of the associated implications. Users are then given access to brief intervention advice, signposted to further information sources, or given contact details of their nearest service. In 2016/17 these websites were accessed 1,781 times:

One Recovery website users:

As highlighted above, One Recovery Staffordshire received the highest number of visits, accounting for 77% of the total visits during this period. People accessing the sites were most likely to be high-risk alcohol users.

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LOMS:ADS monitors the progress of our clients and the effectiveness of our delivery through our Lifestyle Outcomes Monitoring System (LOMS). LOMS covers six domains: substance misuse problems, be healthy, build recovery capital, happier families, service satisfaction, and, safer, stronger communities.

Clients are asked questions related to these domains and their responses are monitored and recorded throughout their treatment journey. In 2016/17 there were 23 individual questions across all domains, each with five possible answers linked to an outcome score, the answers/scores are spread across need from ‘1 - no issues’ up to ‘5 – major issues’. For example, within the alcohol domain, question 1 asks clients about their alcohol use and the available responses are:

1. I don’t drink alcohol – no issues2. I drink alcohol within safe limits – minor issues 3. I drink alcohol more than two days per week or occasional high alcohol use – problematic 4. I drink almost every day or binge drink – very problematic 5. I drink daily – major issues

Clients complete LOMS when they enter treatment, every 12 weeks thereafter and at treatment exit. Scores are monitored to ensure clients are moving in the right direction by experiencing a decrease in score.

LOMS domains are designed to get a full insight into the needs and progress of clients, they are not concentrated solely on substance misuse and this lack of topic restriction is endemic of our whole-person centred approach to delivery. The variety of questions cover physical and mental health and wellbeing, social life, family, housing, employment and training, violence and abuse, fire safety, and service satisfaction.

The type and quantity of LOMS we collect are reviewed regularly to ensure they are reflecting clients’ needs and treatment journey. Care is taken to ensure that LOMS reporting remains manageable for staff and clients, and that LOMS data is an active and important part of service delivery. Where a potential insight gap is identified additional LOMS are introduced; in April 2017, seven further outcomes began to be recorded that covered: domestic abuse, weight management, diet, smoking cessation, exercise, quality of life, and addiction to prescribed medication. These new LOMS were collected outside the scope of this Report, but have been detailed here in order to highlight the dynamic nature of our robust reporting procedures.

Analysis of LOMS that were recorded in 2016/17 for all ADS services reveals that, across all domains, there was a reduction in the overall average score for clients as they moved through treatment.

The below graphic visualises the significant LOMS score decrease that was achieved across a selection of key indicators:

LOMS outcomes for all clients:

2.31.9

2.52.8

1.7 1.7

4

2.9

3.74.2

3.53.2

Alcohol Use InjectingDrug Use Cultural Capital

Welfare Benefits

Fires

1

2

3

4

5

1.7

11.2

1.4

1.81.5

KEY: # #Average

Opening ScoreChange Average

Closing Score

# #

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National drivers for the commissioning of substance misuse services tend to fit within three main themes: crime, health and safeguarding. There is a cyclical nature to the dominance of these themes, dependent on the political will of the time. For example, the latest Drugs Strategy is heavily focused on crime, with the stated aim of tackling crime that is related to both the supply and purchase of drugs.

ADS is active in the political and strategic discourse surrounding substance misuse and we ensure our evidence base is relevant to the national policy focus. A key element of this evidence base is our LOMS, and the following can be aligned with the three main national delivery agendas:

LOMS related to key service delivery drivers:

CRIME SAFEGUARDINGHEALTH

Crime Adult safeguarding / vulnerability

Physical health

Anti-social behaviourChild safeguarding

Mental health

Sexual exploitation

Risk-taking behaviour

[NB: The other 15 LOMS also provide key data on clients’’ wider health and safeguarding needs (e.g. drug and alcohol use), but the above presents those with an explicit focus on these three overarching agendas.]

The following diagrams (overleaf) present the key LOMS reductions achieved for each of the above drivers, and the work that was undertaken by ADS to help clients achieve these reductions:

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Health LOMS:

1 1

2 2

3 3

4 4

5 5

I have no mental health needs, or my mental health needs are managed and I feel able to cope

I have no physical health problems other than infrequent general problems, or a physical condition which cannot be improved

I experience significant periods of mental health needs i.e. anxiety / depression

I have periodic episodes of different health problems or ongoing problems that are being medically managed but could be improved by lifestyle changes

I experience symptoms of severe mental illness but am receiving appropriate treatment

I sometimes (monthly) feel unwell/experience intermittent minor health problems and have no adequate treatment

I experience symptoms of severe mental illness. I need further assessment and treatment to manage this

I often (weekly) feel unwell/experience recurrent health problem which require medical attention or supervision

I feel suicidal and very vulnerable (Risk assessment / urgent referral needed)

I usually feel unwell and have significant health problems requiring medical attention. I do not comply with treatment/medication

Scores Scores

HEALTH LOMS

2.4 2.5

1.9 1.8

0.5 0.7

How ADS helped clients achieve these reductions:

TAILOREDTREATMENTACTIVITY Mindfulness

Mind Matters mental health programme

Tailored treatment plan

Medication management

Recovery walksYoga

Garden/Allotment projects

Pedometer challengePeer-led exercise

Healthy eating cookingFootball

Needs assessments

Dedicated 1:1 keyworking

Partnership work with mental health organisations

Relaxation to reduce anxiety

Bridging the Gap: empowerment

Acupuncture

GROUP WORK &

TRAINING

Mental Health Physical Health

ADS are dedicated to helping people live healthier, more active lives, and the wide range of recovery and diversionary activities we have in place are designed to improve physical and mental health. Each individual service offers a range of activities, treatment and training that is adaptable and often peer-led.

Data for specific health related LOMS reveals that recorded health issues reduced dramatically between the opening/closing scores and this is most evident in the number of people recording a score of ‘1 – no issues’. By treatment exit, 31% of mental health scores were ‘1’, as were 42% of physical health scores.

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Crime LOMS:

1 1

2 2

3 3

4 4

5 5

I have never offended / I am not currently offending and I have no criminal justice proceedings pending

I am not engaging in anti-social behaviour

I am not currently offending but I am on a community sentence (no proceedings pending)

I am at risk of engaging in anti-social behaviour

I occasionally (less than weekly) participate in criminal activity or I have criminal justice proceedings pending

I commit anti-social behaviour but am not on an ASBO

I am regularly offending (weekly)

I am on an ASBO but not subject to a Crime Reduction ASBO (CRASBO) or similar

I am a prolific offender and or a Prolific and Priority Offender (PPO) or in breach of a community sentence

I am on an ASBO and subject to a CRASBO or similar

2.4 2.3

1.7 1.5

0.7 0.8

TAILOREDTREATMENT

COMPLEX DEPENDENCY

SERVICES

Tailored treatment plan

Life events and choicesMotivation to changeAction planning and making decisionsPositive changesStraight ahead

Needs assessments

Reduce inappropriate use of emergency services

Offender focused

Partnership approach

Multi-agency collaborative action planning

Chaos index monitoring & evaluation Dedicated 1:1 keyworking

GROUP WORK &

TRAINING

Scores ScoresCRIME LOMS

Crime Anti-Social Behaviour

How ADS helped clients achieve these reductions:

People accessing an ADS service can present with a wide variety of highly complex needs, including behaviour and activity that is anti-social and/or criminal. Our holistic approach to service delivery seeks to tackle these behaviours and equip clients with the resources they need to achieve positive change. The above graphic is not exhaustive, but highlights some of the crime/ASB reduction interventions used throughout our services in 2016/17.

As with the health LOMS, data for specific crime related LOMS reveals that recorded issues reduced dramatically between the opening/closing scores and was most evident in the change in the number of people recording a score of ‘1 – no issue’. By treatment exit, 53% of crime scores were ‘1’, as were 41% of ASB scores.

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1 1

2 2

3 3

4 4

5 5

I have never been or am not being subjected to or subjecting others to exploitation or abuse

I have no childcare issues and no need to be involved with family services

I have been a victim/perpetrator of abuse/exploitation but not within the last 2 years

I have no involvement with family services, but have some childcare concerns

I have never been subjected to/I am not subjecting others to exploitation or abuse, but I have some concerns

I have voluntary involvement with family services and there are some child care issues

I have recently (within 6 months) been a victim/perpetrator of abuse/exploitation

My child/children are subject to Child in Need Plan

I am being subjected to/I am subjecting others to exploitation or abuse

My child/children are subject to Child Protection Register and/or Care Order

3 3.1

1.7

2.3

1.30.8

How ADS helped clients achieve these reductions:

TAILOREDTREATMENTCAMPAIGNS

Understanding ourselves and othersFamily/concerned other support group

Tailored treatment plan

Holistic approach

Partnership work

Family focus

Complex dependency

Engaging hard-to-reach

White Ribbon:National domestic

abuse

‘Sitting right with you’: GMPCC domestic abuse

Needs assessments

Dedicated 1:1 keyworkingAll Age Early Help Coordinator

Communication skillsWomen’s support groupParent programme

GROUP WORK &

TRAINING

Scores Scores

SAFEGUARDING LOMS

Adult Safeguarding Child Safeguarding

Safeguarding LOMS:

ADS is committed to ensuring clients, their families and others are protected from harm, and has robust safeguarding policies and procedures to ensure this. We also work extensively with clients to equip them with the skills and confidence to protect themselves and others. Our safeguarding related activity in 2016/17 incorporated both service level interventions, tailored activities, and the participation in national campaigns. The success of our safeguarding focused activity is most evident in the number of clients leaving our services and scoring ‘1 – no issue’. For adult safeguarding 61% of scores at treatment exit were ‘1’, for child safeguarding it was 74%.

Additional LOMS associated with safeguarding are risk-taking behaviour and sexual exploitation, these have not been visualised above, but a reduction in average score was achieved. The average opening score for risk-taking behaviour was 2.6 and this fell by 0.9 to 1.7 for the average closing score; for sexual exploitation, the average scores reduced by 1 from 2.8 to 1.8.

The introduction of the new ‘domestic abuse’ specific LOMS from April 2017 will strengthen our ability to monitor and impact upon the safeguarding concerns of our clients.

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Graphic Facilitation:ADS believes strongly in the need for different forms of soft and hard data collection in order to gain a full understanding of our impact and the value of our work. In 2016/17, we commissioned an independent graphic facilitator to work with clients and staff within our Bridging the Gap (BtG) and Intensive Family Support Service (IFSS) to co-produce a series of images that reviewed and quantified the impact of these services. This non-traditional form of reflection allowed people to assert their voice, and is as valuable to ADS as traditional statistical data collection. Feedback that contributed to the creation of these images included:

• BtG: safe, structured and nurturing ethos | flexible and highly adaptable to need | learner-led approach | rigorous professionalism | capitalises on diversity and resourcefulness

• IFSS: intensive early help | creates positive way forward | leaves behind debilitating baggage | creates positive outlook | unlocks choice | rainbow of possibilities and options

Graphic Facilitation images:

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Performance Dashboard / DOMESADS uses robust performance management tools in order to comply with NDTMS reporting requirements, however, we do not view data as a static administrative function, instead we ensure that data is active and used to inform service delivery, staff development, and the propagation of organisation-wide best practice. The following performance measurements are central to both NDTMS compliance and our internal performance management processes:

Discharges: In 2016/17, ADS discharged 8,699 clients as below:

Discharges (all categories):

Drug freeTREATMENT COMPLETED:

TRANSFERRED:

INCOMPLETE:

OTHER:

Alcohol free

Occasional use

Not in custody

In custody

Dropped out

Treatment withdrawn

Retained in custody

Treatment declined

Client died

Inappropriate referral

Education only

Never attended triage

1,166

1,247

600

376

20

37

163

129

92

446

1,281

1,491

1,651

3,013

1,867

2,000

1,819

Not in custodyTRANSFERRED

Blackpool (1,136 | 76%)

1,491

The raw numbers presented above provide an overview of how clients left ADS, but they do not tell the full story. For example, the quantity of people ‘discharged not in custody’ is incredibly high, representing 17% of all discharges during this period. However, ADS stopped delivering services in Blackpool in April 2017, and began the process of transferring clients to the new provider in February in order to avoid disrupting treatment and ensuring clients were not adversely affected. Therefore, the majority of those ‘discharged not in custody’ were treated in the Blackpool service:

Blackpool transfers:

The ‘other’ discharge category is collated in order to understand how many people are accessing our services but not fully engaging and entering treatment. This is a useful measurement tool as it allows us to further understand our impact and the scale of our service reach, however, these people cannot be ‘discharged’ as they technically never entered treatment. For ease of analysis, therefore, the chart overleaf presents the overarching breakdown of client discharges:

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Discharges (overarching categories):

Treatment Completed or Transferred

Treatment Incomplete

71%

29%

71% of ADS clients in 2016/17 left treatment either drug free, alcohol free, an occasional user or they transferred to another service/custody. Across our full provision, every service achieved a treatment complete/transfer rate of above 50%, the average rate per service was 69%. Of the 29% of ADS clients who did not complete treatment, the majority (83%) of these ‘dropped out’ of service. ADS closely monitors and works to reduce ‘drop out’ rates to ensure clients are receiving the help that they need. Our services are designed to ensure consistent engagement, and remedial practices are put in place if a service is experiencing drop-out rates that exceed internal and/or national targets. Re-presentations:ADS works to ensure that our ‘successful discharges’ are long-lasting and clients are equipped to leave services confident that their recovery is enduring and sustainable. Consequently, we monitor the number of people re-presenting to treatment within six months of successful completion. Throughout our service provision, 90% of clients who successfully discharged did not re-present to treatment, the rate varied by individual service as below:

Successful completions not re-presenting within six months:

ADS TOTAL 90%

98%

100%

87%

98%

87%

93%

79%

Blackpool

Bridge House

West Staffs

East Staffs

North Staffs

Bury

Oldham

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Waiting Times:Engaging with a substance misuse treatment service can be a daunting prospect for people, it is the beginning of a potentially life-changing road to recovery and it is therefore essential that engagement is professional, streamlined and perfunctory, particularly during the early stages. It is vital that the time between initial triage and first modality is as short as possible to ensure people do not lose motivation or confidence in the service before it has even fully begun. In 2016/17, across our full service provision (excluding Bridge House which has a different criteria for referral/timeframes), 85% of our clients waited between 0-3 days between triage and first modality start date. At an individual service level, the 0-3 day rate varied between 64% (Oldham) and 96% (North Staffordshire).

Service Specific In addition to centralised performance management reporting, ADS’ diverse services have robust impact monitoring procedures that are specific to their individual delivery, these include: IFSS Financial Tracking, Service Evaluations and BtG outcomes:

IFSS Financial Tracking:ADS delivers the Intensive Family Support Service (IFSS) in Staffordshire. This service works with families experiencing parenting difficulties and substance misuse issues; it is an intensive intervention with a whole family approach, designed to prevent children being placed in local authority care. IFSS utilises cost benefit analysis developed by New Economy in order to calculate how much the local authority saves via the IFSS as opposed to the average cost of a child becoming ‘Looked After’. In Staffordshire the cost benefit analysis is based on the following figures:

IFSS cost benefit analysis (annual figures):

£57,036£5,000

ADS IFSSCost per family:

Looked After ChildrenCost per child:

In 2016/17, the cost of delivering IFSS instead of children within the same families being taken into local authority care, resulted in a saving of £1.6 million.

Service Evaluation Data:ADS strongly believes that clients are vital contributors to assessing how well we are achieving our aim of delivering the highest quality services. Consequently, we keep an open and consistent dialogue with clients in order to gain feedback and understand areas of best practice, challenge and potential change. Part of this dialogue takes the form of service evaluations, which are completed for both individual programmes of treatment and entire services.

Evaluations are tailored to each service/programme, but generally include a series of statements that clients are asked to state whether or not they agree with, based on a response scale of 1 (‘strongly disagree’) to 5 (‘strongly agree’). The evaluation also asks a series of open questions in order to ellicit more detailed feedback. For example, the following feedback was received regarding the Oldham One Recovery service:

“I love meeting new non-users and sharing similar experiences – I feel less alone and isolated.”

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“All your workers are reliable and easy to talk to. I don’t think I’d be alive and doing the things I want to if it wasn’t for the people here. I can’t [thank] them enough.”

“All I can say is I’ve had great support, and all the help I’ve wanted. A big thank you, all.”

Service evaluation data for Oldham is incredibly positive, and the responses to the scaled questions reveal that the majority of clients either agreed or strongly agreed that they were happy with multiple aspects of the service on offer:

Oldham service evaluations:

AGREE STRONGLY AGREE TOTAL

“I have a good relationship with my keyworker”:

“I am treated with dignity and respect by my keyworker”:

“I am treated with respect and care by members of staff”:

“I would recommend the service to family and friends”:

“The work I do with the service is helping me to overcome my problems”:

“I am clear about the work I do in 1:1 and group sessions, and how it will influence change”:

19%

24%

45%

12%

29%

26%

72%

73%

55%

85%

69%

65%

91%

97%

96%

94%

94%

100%

Service and programme evaluation data is collected and analysed on a rolling basis to ensure we are kept up to date with the quality of our work from our clients’ perspectives. Where negative feedback is provided or concerns are raised, these are investigated and, if necessary, remedial action is put in place.

Bridging the Gap Outcomes:ADS delivers Bridging the Gap (BtG) courses in Bury, Oldham and Wigan; this innovative programme is designed to help people who have substance misuse related problems gain the skills needed to become work ready.

Although employment focused, BtG is about more than getting people into a job, and the course has received feedback from clients that emphasises the rich impact it has had on their confidence, wellbeing and relationships. This wide ranging impact is reflected in the outcomes data, which incorporates onward journey information and student feedback:

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Bridging the Gap outcomes:

Student Outcomes

100%

50%

90%

66%

40%

Students felt more motivated:

Students completed extra training:

Students went on to education:

Students went on to mentor:

Students went on to placement:

I have gained more social skills, found that everybody was very helpful and learned more about boundaries and child protection

BtG made me grow ... I have undertaken training in safeguarding, recovery coaching and group facilitation. BtG put me on another level and I am ready for future work now

BtG has given me the opportunity to get better health and learn about boundaries and building confidence ... I am moving on to become a mentor

I am now much more confident, motivated and feel more self-respect after finishing the course

I have learnt life skills, community and personal growth. Whether or not you have an issue with substances, this course will help develop your humanity

The measurement tools presented within this section of the report are demonstrative of our highly reflective approach to service delivery. The data we collect is not passive – it feeds directly into how we function at all levels of the organisation in order to ensure consistent best practice and the greatest possible outcomes for our clients.

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CONCLUSIONIn 2016/17, ADS helped 19,846 people via our services, websites and brief interventions. Our 168 staff and 128 volunteers delivered 7,635 groups and 85,379 keyworker sessions. Through our data collection and reporting we have been able to evidence that 71% of the people in structured treatment were discharged after completing treatment or being transferred, and 90% of those discharged did not re-present to treatment within six months. Across our outcomes indicators, we can demonstrate how people benefit significantly from our services by reducing dependence on substances, improving mental and physical health, reducing offending and improving family relationships. We have demonstrated that our BtG graduates felt more motivated to volunteer and engage in education and training, and our clients felt clear about how their work with us would influence change.

ADS has set a clear course for the future of our charity, comprising of developing new services, projects and programmes that add real value to the public and demonstrate social outcomes. We have committed to a significant staff training programme, developing the skills and expertise needed to meet new and emerging complexities and respond better to the needs and strengths of our services users. We have committed to exploring new markets and diversifying our income. We have embedded investment models into our practice and are able to report savings to public budgets from our services. For example, we have been able to report cost savings to one local authority of £1.5 million by working with families to avoid children entering local authority care. Our commitment to innovation and excellence will continue.

None of this would have been possible without the hard work and dedication of our entire workforce. Our workforce, including all of our staff, volunteers, front-line practitioners and back-office support, have worked in a collaborative and progressive manner to ensure that the highest quality service is having the deepest impact throughout the communities we serve. Our staff are passionate about the work that they do and committed to facilitating positive, long-lasting change.

We believe that our work in 2016/17 has fully supported our overarching vision:

Throughout 2016/17 we have invested heavily in new thinking and research to ensure our workforce are fully equipped to achieve our vision. We understand that people’s needs are complex and frequently traverse between the capacities and boundaries of individual organisations. As a result we have become a leader of effective alliance arrangements to progress the design of integrated service offers, bringing together a number of associate disciplines and sectors to secure a whole-care approach.

Addiction remains one of the most damaging social problems facing the UK today and we pride ourselves on our ability to serve as a connector of knowledge, treatment, influence and behaviour change for people and communities.

Throughout 2016/17 we have provided ambitious and intuitive health-creating practice, which has been grounded in the priorities and asset development of communities – inspiring people to create new recovery capital and ultimately become better agents of their improved health, wellbeing and social mobility.

Our ongoing proactive response to helping people address their substance misuse, health, and wellbeing needs is done so alongside an acute awareness that the level of need within communities is increasing in severity, and the future stability of the substance misuse, and wider third sector, is far from certain. Consequently, we move forward dedicated to the continued monitoring and reporting of our impact, and we will consistently seek new ways to understand both what we are doing well, and how we can do more.

ADS is an ambitious organisation, dedicated to helping those most in need; we are proud of the impact we have had in 2016/17 and will build upon this moving forward, expanding the scale and breadth of our service offer to ensure that fewer lives are ruined by poor health, wellbeing and disadvantage.

To be recognised as a leading progressive charity, excelling in quality care, safety, support, research and innovation; dedicated to improving wider health and well-being for our diverse population and communities.

PEOPLE:

Appendix One: ADS by numbers

19,846

12,314

85,37916,024

6,241

7,635 8,699

5,751

1,781

interacted with ADS

Structured Treatment

One Recovery websites

Needle Exchange / BI

Keyworker AppointmentsAssessments

Care Plan Reviews

GroupsClients

of discharges completed treatment or transferred

did not re-present within 6 months

of BtG graduates felt more motivated

would recommend the service to friends / family

felt clear about 1:1 work and how it will influence change

ACCESSED: ATTENDED:

Permanent staff:

Casual staff:Volunteers:

DISCHARGED: ACHIEVED:

71%

94%

90%

100%

100%

168 33128