cri impact report 2014-15

Positive Impact2014/15

CONTENTS: 01 WELCOME from our Chief Executive

03 ABOUT CRI

04 OUR values

05 OUR impact in 2014/ 2015

11 FOCUS ON Pathways to Recovery, Warrington Rethinking support for complex cases

15 FOCUS ON Hertfordshire Spectrum Growing successful opiate completions by 77%

MAKE A POSITIVE CONTRIBUTION TO COMMUNITIES

27 FOCUS ON Greenwich Support for Carers Supporting the mental health needs of informal carers

DRIVE INNOVATION AND SUPPORT RESEARCH

33

37

EDUCATION AND AWARENESS RAISING

45FOCUS ON Inspire at HMP Kirkham and HMP Lancaster Farms Addressing the challenge of drug and alcohol treatment in a custodial setting

FOCUS ON Birmingham Reach out Recovery Implementing substance misuse services in Europe’s largest local authority

FOCUS ON Halton Integrated Recovery Delivering a quality service for less

IMPROVE HEALTH AND WELLBEING


CRI | Impact Report 2014/15

CRI are now viewed in Birmingham as market leads with respect to the often underestimated task of contract mobilisation.

“

”Max VaughanSubstance Misuse Commissioning Manager, Birmingham DAAT

WELCOME

We have responded by developing new ways of intervening, empowering our staff to find creative solutions and focusing upon delivering tangible improvements for the individuals we work with. Together we strive to promote ‘sustainable recovery’ by helping service users achieve better health outcomes, meaningful employment, affordable accommodation and supportive family or personal relationships.

Throughout this period, we have continued to invest in our IT infrastructure, which promotes more efficient ways of working as well as providing far more effective management processes. These range from finance systems to online training programmes tailored to individual requirements that can be accessed by all of our staff.

We strive to embed a culture of continuous improvement in the organisation and ensure the skills of our staff remain relevant, despite an ever-changing treatment and operating landscape. The introduction of mobile devices has enabled us to move towards a new treatment model delivered in community locations. This has created easier, local access to treatment for service users and ensures recovery is placed at the very heart of the community. There are also significant opportunities to widen the scope of our activity in the future.

In this report, we celebrate the impact of our work on the lives of service users and we highlight their courage and determination to break free from addiction and the cycle of reoffending. As we move forward with our new name - change, grow, live - I reaffirm my commitment to all stakeholders to improve the effectiveness and quality of our services and deliver on our mission.

I hope you enjoy reading about our work and please do get in touch to find out more.

It has never been more important than it is now for charities to demonstrate that the public money they spend meets their charitable objectives and improves the lives of their beneficiaries.

The challenges faced by the third sector – the ongoing reduction in funding and the increasingly complex needs of our service users - remain the key drivers which shape the delivery of our services.

David BiddleChief Executive, CRI

01 CRI | Impact Report 2014/15

02CRI | Impact Report 2014/15

We celebrate the impact of our work on the lives of service users and we highlight their courage and determination to break free from addiction and the cycle of reoffending

“

”

ABOUT CRI

CRI is a social care and health charity working with individuals, families and communities across England and Wales that are affected by drugs, alcohol, crime, homelessness, domestic abuse and anti-social behaviour.

Our projects, delivered across local communities and in prisons, encourage and empower people to regain control of their lives and motivate them to tackle their problems.


04

OUR VALUES

Focusis on the service user as the way to achieve positive change for the individual and community at large

Empowerment

Passion Social Justice

Respect Vocation

allows service users and employees to reach their full potential and achieve their ambitions

is driven by innovation and determination – to bring about the safest, healthiest outcomes for individuals and communities

is a shared commitment as individuals and as an organisation

for each person we engage, without reservation or judgement

means our work is more than just a job


05

OUR IMPACT... THE FACTS

REACH

people across England and Wales on their journey to recovery

120,000

people across England and Wales on their journey to recovery

60,000

people with a mental health condition

8,500

Every day, CRI is working with over

In 2014/15 CRI worked with over

CRI staff made over

client contacts a year

2.5 millionWe are currently working with over

people per day

20,000CRI prescribed opiate substitute medication to

20,000provided psychosocial treatment for

+

All our services are aimed at recovery and rehabilitation rather than maintenance


06

OUTCOMES

IMPROVING SUCCESS

service users say their quality of life had improved by the time they finished treatment with us

7 out of 10

people beat their addiction with us last year

17,000More than

73%

91%

of offenders who entered drug treatment with CRI (October 2012-September 2014) were no longer offending after 12 weeks (compared to 67% between October 2010 and September 2012)

of offenders who completed CRI treatment with CRI (October 2012-September 2014) ceased offending (compared to 88% between October 2011 and September 2012)

improvement in successful 12 month completions for opiate clients free from dependency since the introduction, by a number of CRI services, of Foundations of Recovery

23%

There has been a


IMPROVE HEALTH AND WELLBEING

Over 17,000 people successfully completed treatment for their substance misuse problem last year.

Re-presentation rates were 35% lower than the national average, which meant fewer people had to come back to us for additional support.

20,000 people were prescribed opiate substitute medication every day, while at-risk groups like young people and rough sleepers received the targeted support they needed to turn their lives around.

Access to our needle exchanges helped to reduce the spread of life-threatening blood-borne viruses through the provision of equipment and advice that supported safer injecting practices.

17,000

35%

20,000


The more knowledge, support and tools we can give to our young people about drugs and alcohol, the safer they’ll be.

“

”


HannahPeer mentor

09

FACTS AND FIGURES

people left us free of dependency, and thousands more were supported on longer recovery journeys

We were there to support people at every stage of their recovery in both community and custodial settings. We prescribed opiate substitution medication (OST) to those who weren’t ready for full abstinence. Every day, 20,000 people were helped to steadily reduceand manage their opiate use. OST has been shown to be an effective support agent in detoxification as well as reducing blood-borne viruses and drug-related crime1. We also provided an additional psychosocial treatment to 20,000 people every day, helping over 17,000 people leave our services free of their dependency.

More than

17,000The provision of OST is thought to be associated with 25-33% of the fall in some types of acquisitive crime.2

“

”Advisory Council on the Misuse of Drugs

fewer re-presentations for alcohol

Our service users were less likely to re-present than the national average

46%fewer re-presentations for drugs

29%Supporting people to successfully complete treatment is one thing, but supporting them in a way that ensures their recovery is sustainable and means they won’t have to immediately come back for additional support is equally important. All our service users were less likely to re-present irrespective of the substance but CRI had 46% fewer re-presentations for alcohol and 29% fewer re-presentations for drugs compared to the national average. That means fewer people accessing services with limited resources and more people in sustainable, long-term recovery.

1 http://www.rcgp.org.uk/professional-development/~/media/Files/SMAH/RCGP-Guidance-for-the-use-of-substitute-prescribing-in-the-treatment-of-opioid-dependence-in-primary-care-2011.ashx2 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/371521/ACMD_RC_Time_limiting_OST_061114.pdf


Improve health and wellbeing

drug injecting service users in our needle exchanges

There were over 35,000 needle exchange contacts in our services where we gave advice and support around safe intravenous drug use, helping to prevent the spread of diseases like HIV/AIDS, Hepatitis B and Hepatitis C. We also distributed Naloxone, an effective treatment for acute opioid overdose, in many of our services, helping to provide the medication needed to prevent fatal overdoses. Drug-related deaths have recently increased in England, which is why we’ve chosen to roll out Naloxone provision across all our services and why we’re supporting the Naloxone Action Group’s campaign for wider provision of take-home Naloxone.

Our work saved lives and helped to prevent the transmission of life-threatening diseases.

Staff delivered interventions to over

35,000

service users tested for Hepatitis C

35,620

service users started vaccinations against Hepatitis B

6,319

were found to be HEP C positive and were referred to primary care

86% of which

In figures:


CRI have delivered a high standard of drug and alcohol treatment in Warrington community and its two prisons for several years. They have attained above average outcomes and outputs both locally and nationally on a regular basis. The staff at CRI are always welcoming , open to change and passionate about keeping the service user at the heart of their delivery; they are well respected by partners and key stakeholders within the Borough.

“

”Cathy FitzgeraldHead of Service - Substance Misuse, Warrington Borough Council


FOCUS ON: PATHWAYS TO RECOVERY WARRINGTON

We’ve implemented our innovative Foundations of Recovery model, and trained a new complex needs team with multidisciplinary skills to support our service users with more complex needs or dual diagnoses.

We’ve also adopted a more individualised, asset-based approach to identify additional support mechanisms for each service user.

Finally, we’ve driven cultural change by regularly reporting to staff on service performance information, encouraging staff to take responsibility for whole service performance as well as their individual case loads.

Since we began delivering the Warrington service in 2007, we have identified a number of long-term cases for whom our typical approaches have proved less effective. Our response to the challenge of their more complex needs has been multi-faceted.

Rethinking support for complex cases

Over the last five years I’ve been through the whole pathway with CRI – from service user to volunteer, to peer mentor - and now I work with them in a professional partnership. CRI are the best drugs service I’ve personally ever known, and I’ve been around services for about 30 years.

I first came to CRI having been through a residential detox. I was clean, but I didn’t have a clue how to live an abstinent lifestyle or what to do with my life really. I’d been dependent on drugs since I was seven because my mum was a sex worker who used to give me sleeping tablets to get me to go to sleep. From there it was a rollercoaster of care homes and prison. In total, I spent 18 years in prison – when I came out the last time I didn’t even know how to turn on a computer.

Whilst I was being supported at CRI Warrington I had two peer mentors who were massive for me, Linda and Rob. They were kind – I wasn’t used to that; and they were patient – I wasn’t used to that. At the end of the day, they would take me to a group or for coffee, or just spend time with me. But most importantly they were realistic role models for me. Rob and Linda were exactly like me, but just a bit further down the line.

It was whilst training to be a peer mentor that I learnt how to really listen to other people, and in the process, made some lifelong friends. From having no qualifications I’ve done my level 2 in Health and Social Care, about 15 accredited training courses, and I’m hopefully about to start my level 2 in Counselling. I’ve taken everything CRI offered with both hands and I’m proud to say I’m flourishing.

Tony’s Story



CRI are the best drugs service I’ve personally ever known

“”

13

FACTS AND FIGURES

service users say their quality of life had improved by the time they finished treatment with us.

Regular exercise and a balanced diet can have a big impact on wellbeing. For people in recovery, enjoying a healthy lifestyle can be a great way of channelling energy and boosting self-esteem. All our services gave out information and advice on healthy living as a way to support service users’ personal wellbeing and maintain recovery. This included guidance on the Five Ways to Wellbeing. Services also ran a range of service user led activities, including healthy breakfast clubs, gardening clubs and alternative therapy sessions such as acupuncture.

Our service users were physically and mentally healthier than when they started treatment

7 out of 10

3 http://www.nta.nhs.uk/uploads/why-invest-2014-alcohol-and-drugs.pdf4 http://www.homeless.org.uk/sites/default/files/site-attachments/Mental_Health_Guide.pdf5 New Economics Foundation. (2008). Work it out: barriers to employment for homeless people.

spent on young people’s drug and alcohol interventions

We supported young people, so they no longer needed to turn to alcohol or drugs

£1 £5-83

Many young people who misuse drugs or alcohol do so because they’re dealing with incredibly difficult life problems and they haven’t had access to the guidance or support networks they need. Our services supported over 3,000 young people last year, helping them to work through those underlying problems, so they no longer felt the need to misuse substances. Getting young people the support they need now, rather than later, could help avert a lifetime of substance misuse and give them the confidence and skills they need to lead positive healthier lives.

Every brings a benefit of


service users who were at risk of being evicted when they came to us were no longer at risk when they left6.

The human cost of homelessness has been well documented. Homeless men can expect to live on average 30 years less than the general population and 72% of rough sleepers experience mental ill health, compared to 30% of the general population4. There are also the inevitable social costs associated with poverty and suffering such as antisocial behaviour and crime. The total annual cost to the state of a homeless individual is estimated to be £26,0005. Last year our street outreach services worked with 5,241 rough sleepers, helping them find short and long-term housing options and to access other specialist services, who can support them in alleviating the negative impact of homelessness.

Vulnerable rough sleepers were helped off the streets and into safety

9 out of 10

rough sleepers supported in finding short and long-term housing options and other specialist services

5,241

estimated annual cost to the state of a homeless individual

£26,0005

In figures:



15

FOCUS ON: HERTFORDSHIRE SPECTRUM

We’ve rolled out our successful Foundations of Recovery model across all 9 hubs. Our volunteers donate over 1,300 hours a week, with 33% of them gaining employment either with CRI or another organisation.

Those improvements have really been reflected in our results during the last two years, with successful completions up by between 51% and 77%, depending on the substance. All completions are above the Public Health England (PHE) national average.

Our Hatfield service was also awarded the Purple Star accreditation for delivery of high quality reasonably adjusted services to adults with learning disabilities. Going forward we’re looking to achieve Purple Star status across all our services in Hertfordshire.

Our approach to service delivery in Hertfordshire has been to provide a relentless focus on quality, building strong relationships with local hospitals, community groups and other charities to ensure we’re fully connected with the wider health and social care system.

Successful opiate completions grew by 77%


Purple Star accreditation:

I would like to congratulate Spectrum on the award of the Purple Star. They provide a highly valued service, helping local people with learning disabilities who are also experiencing drug and alcohol problems and this award recognises their high standards of healthcare and accessibility. This is a great achievement.

“

”Colette Wyatt-LoweCabinet Member for Adult Care and Health, Hertfordshire County Council

in the last two years, depending on the substance, and with all completions above the PHE national average

hours per week

51% - 77%

1,300

To date, the team have achieved the following:

Successful completions up

Volunteers donate



17

HANNAH’S STORY

Growing up I knew quite a few friends and family who used drugs or drank a lot, so taking a bit of ecstasy or MDMA at a big rave with all my mates wasn’t unusual. We weren’t taught about drugs at school at all, which is a terrible shame. I wish someone had sat down with us and said “this is what could happen if you’re not careful”.

I came to CRI’s Stockton Recovery Service and I have never met a more supportive, special, empathic bunch of people. My recovery worker challenged me on absolutely everything – my life, my behaviour, my attitude – she was a tough cookie! But I absolutely needed that because until then I’d swept it all under the carpet.

I’m now one year clean and a peer mentor for the Stockton service and I’ve enjoyed every minute. Half the people who come in the door are people I’ve grown up with, so there’s this incredible personal connection I feel doing this work. I actually went through recovery with a friend who I’ve known since I was 12 or 13 and he’s now a recovery champion. It is contagious seeing people who are in recovery – you think, I want some of that please!

For myself, I’m incredibly proud to say I’m starting college in September. I’ll be doing my level 2 and 3 health and social care qualification, which I’m really looking forward to. Afterwards I’m hoping to get a job in support services, because this is what I love doing now, supporting other people into recovery and showing them what they’re capable of.

I didn’t think I could be where I am now in a million years; I am a completely different person from the woman who walked through those doors a year ago. I think if I had a hope for the future it would be that we get much better at teaching young people in schools about drugs. It should be on the national curriculum as standard, like sex education. The more knowledge, support and tools we can give to our young people about drugs and alcohol, the safer they’ll be.

HannahPeer mentor



I didn’t think I could be where I am now in a million years; I am a completely different person from the woman who walked through those doors a year ago.

“

”


MAKE A POSITIVE CONTRIBUTION TO COMMUNITIES

They took part in local health awareness days

They raised thousands of pounds for both CRI and other charities

They donated over 420,000 voluntary hours to supporting their local communities

They supported the continued development of eight successful social enterprises

Many local residents were also able to access our facilities free of charge, helping to support vibrant local groups and embed substance misuse services at the heart of communities

8

Our service users, volunteers, peer mentors and staff have made a huge contribution to their communities

420,000

Our work contributed to preventing an estimated 4.9 million crimes7 last year


7 http://www.nta.nhs.uk/uploads/commentaryfinal[0].pdf

I can’t believe how much more confident I feel now, it’s a complete transformation.

“”


RobVolunteer

21

FACTS AND FIGURES

social enterprises

We have a proud tradition of supporting groups of entrepreneurial service users to create social enterprises at the heart of their communities. Social enterprises include a shoe recycling enterprise and a mobile barber shop. This brings the total number of social enterprises we’ve helped create to eight. These provide valuable training and work experience to people who have faced great challenges in their lives, often in very deprived communities, where there are limited employment opportunities.

Budding entrepreneurs created

8

service users in prison to take back control of their health, wellbeing and lives

We helped service users in prison break the link between substance misuse and reoffending

5,200Research shows that offenders reporting Class A drug use are more likely to reoffend than those who did not8, which is just one of the reasons why our work rehabilitating offenders in prison was so important. We supported over 6,000 service users in prison to take back control of their health and wellbeing by understanding and addressing their substance misuse. We also gave abstinent offenders the chance to become peer mentors, taking on a position of responsibility that has helped to build real trust and respect between prison staff and the wider offender community. When our peer mentors were approaching release, we found them placements at either CRI or another organisation, helping them to continue to build the skills and experience they need to find employment in the community.

We supported over


8 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/261620/re-offending-release-waves-1-3-spcr-findings.pdf9 https://www.gov.uk/government/publications/financial-cost-of-acquisitive-crime-caused-by-class-a-drug-users-in-the-uk10 From October 2012 to September 2014, based on self-assessment. 11 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/7596/2200485.pdf

Make a positive contribution to communities

of all acquisitive crime is committed by offenders who use heroin, cocaine and crack cocaine9

We helped our service users see there is a realistic alternative to crime by supporting them with their substance misuse problem, giving them access to education, training and employment opportunities and helping them to appreciate their skills and potential. As a result, we’ve seen a significant reduction in the number of people who were still committing offences when they exited treatment, helping to support safer communities and reduce human suffering for offenders and victims alike.

We reduced crime and costs in the communities where we were delivering services

Between

1/3 and 1/2

offenders who completed CRI treatment ceased offending10

1,069

per person for a drug offence conviction11

£16,000 It is estimated that it costs

In figures:


23

ROB’S STORY

Friday 25th June is a date I’ll never forget, because it’s the day my life hit rock bottom. I woke up in the morning with agonising stomach pains and was taken to intensive care where I was treated for acute necrotic pancreatitis, a rare illness that few people survive. Eight days later, after near lung failure, I woke up on a ventilator.

It goes without saying that I feel incredibly lucky to be alive today. It’s part of the reason that I’ve become a peer mentor with CRI, because I want to dedicate my life to helping others who are going through something similar. I don’t ever want anyone else to feel that loneliness, that despair and pain. I want them to know that there’s somewhere to go before it gets that far.

My key worker, volunteer coordinator and all the staff at CRI have been absolutely brilliant. I can’t believe how much more confident I feel now, it’s a complete transformation. My life is so full now - I volunteer for CRI, am currently in training and I run a guitar group. I’m also in a classic rock band and I’m proud to say I played my first gig, sober, in February this year. I was, I’ll admit, scared stiff but it was absolutely amazing – the crowd were behind me 100%, because they know my story.

Coming to CRI has genuinely been a life-changing experience for me. I have a photo of myself that was taken in the intensive care unit where I’m all covered in wires and tubes. I love that photo now because it shows just how far I’ve come.

RobVolunteer


My key worker, volunteer coordinator and all the staff at CRI have been absolutely brilliant. I can’t believe how much more confident I feel now, it’s a complete transformation.

“

”



s

25

FACTS AND FIGURES

We worked with local communities to reduce antisocial behaviour

In fact, local residents are more likely to see a drop in antisocial behaviour (and crime) because people will be getting the support they really need.

Our staff, volunteers and service users work incredibly hard to address instances of antisocial behaviour and ensure the people responsible are referred to appropriate services, including our own. All our services liaised with local residents and community groups on this issue, often holding residents question and answer sessions so that concerned parties could meet the service manager and their staff in person. Not only did this reassure the vast majority of those who attended, but many of them left with an understanding of the important role drug and alcohol services play in protecting the most vulnerable people in their communities.

One question we often get asked when we open in a new location is:

families every day

Living with a parent, sibling, child or other family member who is misusing substances can take its toll and, where children are involved, can present a risk if the right processes aren’t followed. Our specialist family services worked with families to get them the support they needed to look after their emotional and mental health. They also educated service users with children on how to safely store medications and worked collaboratively with social services both to identify children at risk, and to support children to return home where it was safe for them to do so.

Families and children got the support they needed to cope with a family member’s misuse

750Our family services worked with about

“will there be an increase in antisocial behaviour?”


s

hours to our service users

We’re fortunate to have incredibly dedicated volunteers and peer mentors who donated more than 420,000 hours to our service users. In return, we continued to invest in our peer mentor and volunteering service, helping our volunteers to engage in peer-to-peer support, develop confidence and skills and find a route into employment. We gave all our volunteers access to the same management support and extensive training, which helped many of our peer mentors and volunteers to achieve an OCN/QCY level 2/3. We also created more volunteer roles in our own services, including a growing number of specialist clinical volunteers such as social workers, psychologists, counsellors and student nurses.

We expanded our volunteer and peer mentor opportunities and invested in their development

Volunteers and peer mentors donated more than

420,000

Many concerned residents left with an understanding of the important role drug and alcohol services play in protecting the most vulnerable people in their communities.

“

”



27

FOCUS ON: GREENWICH SUPPORT FOR CARERS

As the existing provider of a successful local service for carers of people with substance misuse problems, we were keen to use our experience to design and implement the new service.

The team have established strong working relationships with community mental health teams and other non-statutory mental health teams, facilitating an effective two-way referral process. They will see anyone, irrespective of whether the person they’re caring for has a diagnosis, and they will deliver a tailored combination of structured and non-structured interventions.

To date, we’ve supported 79 carers who might otherwise have struggled to find the specialist support they needed, delivering 124 hours of structured one-to-one interventions with more than 314 hours of carer contact in total. Our close links with the existing carers support service and CRI’s mainstream drug and alcohol services ensure we provide seamless, integrated care to those with a dual diagnosis or complex needs.

As a result there’s no longer a gap in service provision and the informal carers of people with mental ill health get the advice and support they need to continue to safeguard their own wellbeing.

Following the introduction of The Care Act 2014, which made the rights of carers a statutory obligation for providers, we tendered for a new service specially designed to support carers and family members of people with mental ill health.

Supporting the mental health needs of informal carers


S4C continue to work proactively with partners and stakeholders in the Borough; the project has managed to support carers of adults with enduring mental health problems in a supportive and meaningful

“

”Sacha WheatleyMental Health Commissioning Manager Drug, Alcohol and Mental Health Commissioning Team Royal Borough of Greenwich

carers who might otherwise have struggled to find the specialist support they needed

hours of structured one-to-one interventions

79

124

Supported

Delivered

hours of carer contact in total

314Provided

In figures:




Innovation within the sector is critical to ensuring the service users of tomorrow get the best possible support.

We undertook research, forged partnerships and invested in initiatives that will help lay the foundations for exceptional service delivery in the future.

We invested more resource in further improving quality and accessibility in our services, securing accreditations from global best practice organisations, as well as putting in place infrastructures that can support our enhanced scale.

We gave our staff and volunteers access to nearly 800 new training courses, because the support we provide is only ever as good as our people.

800



The staff at CRI are always welcoming , open to change and passionate about keeping the service user at the heart of their delivery.

“

”Cathy FitzgeraldHead of Service - Substance Misuse, Warrington Borough Council

31

FACTS AND FIGURES

our most recent intervention has indicated a 66% reduction in relapse rates

For some time we’ve had anecdotal data from staff that service users who maintain contact with the service following completion are less likely to formally re-present. We tested that assumption by providing follow-up appointments to 1,000 service users up to six months after they’d successfully completed. Although this research is still in its infancy, our initial results show a reduction of up to two thirds in relapse rates. We are now rolling out follow-up appointments across all our services to further scrutinise these results and see if we can support more service users to remain abstinent.

Our groundbreaking research is helping to reduce relapse rates

66%

more likely to successfully leave treatment

Technological innovation meant that fewer service users had to come back to us for support

50% 60%

Support needs don’t stop outside working hours. Our new partnership with Breaking Free Online, an online substance misuse and mental health support package, provided all our service users, staff and volunteers with access to recovery support 24/7. Analysis indicates that people using Breaking Free Online are 50% more likely to successfully leave treatment and 60% less likely to re-present to treatment: a cost-effective way to get all our service users the additonal support they need.

People using Breaking Free Online are:

less likely to re-present to treatment


We’ve added to our suite of accreditations:

ISO 27001 is an internationally recognised best practice mark in information and data security. We already hold: ISO 9001, maintaining a robust quality management system; OHSAS 18001 occupational health and safety standards; and the Investors in People accreditation.

We also made a submission to the Stonewall Workplace Equality Index and ranked 267 out of 397. The highest first-time score for a voluntary organisation. Finally, our peer mentor training gained Approved Provider Status (APS) through the Mentoring and Befriending Foundation.

We continued to raise the bar on quality

Service users who maintain contact with the service following completion are less likely to formally re-present. Our initial results show a reduction of up to two thirds in relapse rates.

“

”

Drive innovation and support research



FOCUS ON: BIRMINGHAM REACH OUT RECOVERY

We introduced a community-based treatment model with fewer high-cost fixed locations and more ‘satellites’ based at existing community venues, such as pharmacies, community centres and GP surgeries. We also equipped all our staff with mobile technology (an initiative that’s currently being rolled out across all CRI services), allowing them to input data and manage paperwork remotely, so they’re able to travel to the client rather than the other way around. Where there were effective initiatives already in place, like widespread Naloxone provision, we quickly mobilised resources to ensure continuity.

In the two months since we started delivering services (from March 2015), we’ve seen strong initial outcomes, with 35 service users successfully completing and 107 service users engaging in Foundations of Recovery groups.

The team made almost 900 client contacts every day and in the first quarter delivered over 7,000 one-to-one key-working appointments with service users.

With 5,000 service users, circa 300 staff, multiple community languages and a considerably tightened budget, we needed to develop a radically different approach to service delivery in Birmingham; one that continued to drive quality while reducing overheads.

Implementing substance misuse services in Europe’s largest local authority

As one of the largest substance misuse systems in the country [Birmingham] was both a very large and complex contract mobilisation which, overall, CRI undertook with few problems – service user safety being of paramount importance. CRI are now viewed in Birmingham as market leads with respect to the often underestimated task of contract mobilisation.

“

”Max VaughanSubstance Misuse Commissioning Manager, Birmingham DAAT

client contacts every day

one-to-one key-working appointments with service users delivered in the first quarter

900

7,000

Almost

Over

In figures:



35

FACTS AND FIGURES

in the number of opiate users successfully completing treatment

We launched Foundations of Recovery, a recovery toolkit which allows service users to choose from a wide range of treatments and services, creating a bespoke programme of care that genuinely reflects their needs and aspirations. In addition to providing service users with this care, services that use Foundations of Recovery see an average increase of 42% in the number of opiate users successfully completing treatment and 25% for non-opiate users. We’re now looking to roll FoR out nationally to ensure all our service users can benefit from this innovative model. We’re also piloting a modified version, Foundations of Rehabilitation for our criminal justice services.

More people are successfully completing through our new recovery models

23%Our positive outcomes don’t happen by chance, they’re the result of our service users’ hard work and commitment and the skills and experience of our staff and volunteers.

by implementing a new partnership with:We’ve taken steps to support our staff’s wellbeing

The work our staff, peer mentors and volunteers do isn’t always easy and can sometimes demand a level of emotional resilience. We implemented a new partnership that provides all our staff, volunteers and peer mentors with free access to Headspace, a mindfulness and meditation website and app. The aim is to introduce the concept of mindfulness to staff with a longer term view of increasing knowledge around mindfulness for client interventions. Research has shown Headspace has a positive effect on focus, self-control and stress management. This complements our wellbeing zone, which has a wide range of resources that support a healthy body and mind.

Services that use Foundations of Recovery (FoR) see an average increase of:


Headspaceproviding free access for all our staff, volunteers and peer mentors

learning days across the organisation have taken place in the last year

Our positive outcomes don’t happen by chance, they’re the result of our service users’ hard work and commitment and the skills and experience of our staff and volunteers. To keep delivering good outcomes, we invested in a new online learning and performance platform from Cornerstone OnDemand, which we’ve named Skill Station. It brings together organisation-wide processes and allows staff and volunteers to access training on any device. Increased reporting functionality, allows managers to drill down into staff performance and create bespoke training programmes to match an individual’s job role and needs, which are linked to individual and organisational objectives. Our new system also provided access to 200 additional training titles, bringing our total training offering to nearly 800 courses, which are effectively targeted at our full range of professions and packaged together to create complete programmes of learning.

More training opportunities meant more knowledgeable staff

to keep delivering good outcomes

8,074

additional training titles

200


Our new system provided access to

which are effectively targeted at our full range of professions

800 coursesOur total training offering is nearly

36

In figures:


37

FOCUS ON: HALTON INTEGRATED RECOVERY

Public Health England (PHE) reported that around 25% of children live in poverty in the Halton area and, with the national agenda highlighting child sexual exploitation, we’ve invested significantly in our children and families’ services, recruiting two dedicated Hidden Harm/Think Family Recovery Coordinators. Their targeted remit enables them to focus on the wider family’s needs and spot the early warning signs of emotional or physical harm in children, coordinating a multi-agency approach that ensures each member of the family is being effectively supported. They’ve had a number of excellent outcomes to date, where children affected by their parents’ substance misuse have exhibited better behaviour at school and generally appeared much more settled following this integrated intervention. We’ve also been able to supplement our budget with capital grant funding, which has funded, among other things, a dedicated support team for carers to establish the Halton Brew Café and an ETE scheme, which provides training and employment opportunities to our service users, peer mentors and volunteers. Working in partnership with our commissioners and service users, we have established a second satellite location in Runcorn to provide enhanced accessibility to services and we recently found out we’ll be hosting the UK Recovery Walk 2016, which is the first time a town has been awarded the honour.

Our culture means that staff are flexible and committed, ensuring they deliver the best possible care for service users. This has meant that in 2014 we were at the top of both the opiate and non-opiate comparator local authority groupings for successful completions without re-presentation.

Halton is an excellent example of a service that has adapted really well to a tough financial climate whilst still meeting local needs.

Delivering a quality service for less


CRI Halton have delivered a high-quality service, with a positive staff culture and service users at the heart. The staff culture is further reinforced by a strong management team that has steered the team through a period of service redesign, whilst the fiscal pressures on public services continue to impact.

“

”

John WilliamsCommissioning Manager, Halton Borough Council

In figures:



Halton reached the top of its opiate comparator local authority grouping for successful completion of treatment and this was 3% higher than the PHE average.

Halton’s non-opiate comparator local authority grouping for successful completion of treatment was 57.18% i.e. 18% higher that the PHE average.

The successful alcohol completion rate was 54% which is 14% higher than the PHE national average.

The alcohol/non-opiate successful completion rate was 45%, which is in the top quartile range for comparator local authorities, 8% higher than PHE national average.

EDUCATION AND AWARENESS RAISING

The more we can raise awareness of the issues we support, the less misinformation, fear and stigma our service users will face.

We supported mutual aid groups, which do an incredible job of showcasing the skills and passion of the recovery community.

We delivered thousands of hours of free training to education and healthcare professionals on preventing and identifying substance misuse problems, including taking a lead on raising awareness around New Psychoactive Substances.

Every day we were educated and inspired by the service users who guided our service delivery, fed back on our work and supported decision-making at a national level.


CRI was there for me. Now I have a responsibility to be there for others. It’s something I take extremely seriously.

“

”


PaulVolunteer and peer mentor

41

FACTS AND FIGURES

Our service users continue to face stigma every day, which can have a negative impact on their wellbeing and the opportunities that are available to them.

Mutual aid and peer support groups can have a big impact on changing those negative perceptions and demonstrating the talents, energy and contribution our service users can make in their communities. We supported mutual aid groups like Red Rose Recovery, Cascade and ESRA, and actively encouraged our service users to set up their own mutual aid groups, fostering dynamic local recovery communities that are driven by service users, for service users.

Mutual aid groups are changing perceptions of substance misuse

12 http://www.hscic.gov.uk/catalogue/PUB14579/smok-drin-drug-youn-peopl-eng-2013-sum.pdf


Our teams were invited into schools, colleges and universities across the country to educate young people on the risks of new psychoactive substances (NPS), as well as more well-known drugs like cannabis, ecstasy, cocaine and alcohol. They interacted with young people in a number of different ways, holding myth-busting workshops and discussion groups for individual classes as well as participating in school-wide events with activities, stalls and games. Their workshops on new psychoactive substances were particularly important at a time when rapid NPS production has made it difficult to provide the most up-to-date information to the public. The workshops meant our teams could get out on the ground fast to dispel common misconceptions, such as that legal highs are safer than traditional drugs.

Schools and colleges partnered with us to educate young people on the risks of substance misuse

Recent figures show that

16%of secondary school pupils aged 11 to 15 had taken drugs at some point12

Our Mutual aid and peer support groups can have a big impact on changing those negative perceptions and demonstrating the talents, energy and contribution our service users can make in their communities.

Education and awareness raising

healthcare professionals on how to identify and treat different NPS

1,000

We took a leading role in education and public awareness, training over:

In figures:


43

PAUL’S STORY

I’m going to be celebrating my two-year ‘sober anniversary’ in October and I can’t wait. The motivation for me coming to CRI was my mum. Growing up my dad wasn’t around so we always had a very close relationship, but after she died a few years back I became seriously depressed.

One day, I looked at a photo of her, which I kept next to my bed, and thought ‘you wouldn’t want to see your little boy like this, you’d want me to be happy.’ It gave me the push I needed to go and get help. Since then I’ve gone from strength to strength. For about a year, I volunteered with CRI and afterwards did the peer mentor training, which has really helped me get back on the ladder careerwise. I have to say, volunteering for CRI has never seemed like work to me, it just feels like this is what I should be doing. When I was struggling they were there for me. Now I have a responsibility to be there for others. It’s something I take extremely seriously.

I chair a peer-led mutual aid group, which is going amazingly well. Recently we had the chief executive of a national supermarket chain attending the group to understand how they can support employees who might be struggling with substance misuse. Because of that meeting their board is actually discussing changing their policy, which is a mindblowing result! Achieving something like that is definitely better than any high.

I’m also on the Recovery Walk steering group and I’ll shortly be starting a job as a support worker for a supported housing service, which provides safe accommodation to vulnerable people. I’ve always known I would end up working in this field, I think working with people just comes naturally to me.

What’s the secret to recovery? Well I was actually saying the other day, I’ve always been stubborn and ironically that’s what’s kept me going in my recovery. The more I experience of recovery, the more stubborn I get, and the harder I work! I guess the secret is knowing that you already have everything you need to recover, accessing support just gives you a helping hand along the way.

PaulVolunteer and peer mentor


I chair a peer-led mutual aid group, which is going amazingly well. Recently we had the chief executive of a national supermarket chain attending the group to understand how they can support employees who might be struggling with substance misuse.

“

”



Alex was 23 years of age and it was his third time in prison. He realised he had a problem with alcohol.

Following his self-referral from Lancaster Farm’s induction process, he had the opportunity to be assessed and then agree his recovery goals. He took part in CRI’s Foundations of Rehabilitation programme, which included a mapping tool which helped Alex identify where he would be in five years if he continued to drink, and then where he could be if he stopped drinking. He started to understand that his anger and a lack of consequential thinking were triggers for his drinking. His one-to-one structured sessions helped him identify the feelings behind this anger.

Alex engaged with the programme incredibly well, saying that it was the first time he really understood the reasons behind his anger. During the later stages of the programme there was a noticeable change in Alex’s thinking and he has now been granted parole, mainly due to his change in attitude and behaviour. He says he now deals with emotions differently and he’s much more conscious of how to manage his behaviour. He’s also surrounded himself with positive peers who all help and support each other.

Alex’s Story

FOCUS ON:

We use a variety of techniques including assessment, detox and recovery-orientated treatment that challenges individuals and encourages them to reflect on some of the reasons behind their substance misuse and offending. Our treatments include a range of clinical and psycho-social interventions to support service users on their recovery journey. We offer one-to-one and group working, counselling, mutual aid and peer mentoring. Service users can also work towards educational qualifications that are recognised in the community and will eventually hopefully help them to secure employment once they are released.

Our Foundations of Recovery and Pillars of Recovery programmes help service users to create opportunities and make positive and enduring lifestyle changes. With these new skills, individuals can return to their communities with a renewed sense of purpose and an ongoing commitment to recovery.

As an organisation with considerable experience working in prisons with offenders, we had a substantial existing knowledge base when we were commissioned to deliver services in HMP Kirkham and Lancaster Farms.

Addressing the challenge of drug and alcohol treatment in a custodial setting


INSPIRE AT HMP KIRKHAM AND HMP LANCASTER FARMS

During 2014/15, 632 clients successfully completed an intervention and demand for our services increased by over 50% in the final 6 months of 2014/15

interventions carried out in 2014/15

individuals took part in our treatment programmes

4,957

1,144

We exceeded our target of 80% for successful completions per clinical caseload

88%

In figures:



47

FACTS AND FIGURES

The best people to raise awareness of the challenges facing service users, are service users.

Ours spoke at hundreds of events, some run by CRI and others by our partners. They inspired, impressed and challenged in equal measure, giving communities a unique insight into the lived experience of substance misuse and the challenges they’ve had to overcome to get to where they are today.

Courageous service users shared their recovery stories at community events across England and Wales

service users and peer mentors supported us to deliver non-structured services every day

Service users and peer mentors lent us their expertise and supported higher quality services

6,000

Education works both ways. Our service users play a significant role informing our work and help us develop our services in a number of different ways, through our dedicated regional Service User Councils and sitting on the boards of national groups, such as the Research Group and the Clinical Governance Group. In addition, last year hundreds of peer mentors supported us to deliver non-structured services every day, using their expertise and passion for recovery to continue to drive excellence in our delivery and educate us on how we can best support every individual on their recovery journey.


You’ll hear from a few of our courageous service users in these pages – you can read even more of their stories on our website: www.cri.org.uk

delegates from across the sector enjoyed presentations on a range of topics

The University of Manchester and CRI held their annual conference, Driving Innovation and Delivering Excellence. Over 320 delegates from across the sector enjoyed presentations on a range of topics, from lessons learnt on alcohol misuse in Scotland to the growing challenge posed by New Psychoactive Substances. The day was a valuable opportunity for clinicians to discuss key trends in substance misuse and to share best practice, helping to drive improvements in frontline care.

Our Clinical Conference supported knowledge-sharing and provoked debate

320

of attendees rated the Driving Innovation and Delivering Excellence conference and workshops as excellent or good

95%

In figures:


Over


To ensure we protect the identity of the people we help, we have used models and the names of our service users have been changed.

Crime Reduction Initiatives (CRI) is a registered charity in England and Wales (1079327) and in Scotland (SC039861) Company Registration Number 3861209 (England and Wales) Registered office: 3rd floor, Tower Point, 44 North Road, Brighton, East Sussex BN1 1YR

Our Regional Offices:

Regional Office - South3rd Floor, Tower Point44 North Road, Brighton BN1 1YR

T 01273 677 019

F 01273 693 183

E [email protected]

Regional Office - London140-142 King’s Cross RoadKing’s Cross, London WC1X 9DS

T 020 7833 7975

F 020 7278 4513

E [email protected]

Regional Office - North2nd Floor, Duncan House14 Duncan Street, Leeds LS1 6DQ

T 0113 380 4640

F 0113 246 8568

E [email protected] or [email protected]

Regional Office - Wales57-59 St Mary StreetCardiff CF10 1FE

T 02920 349 800

F 02920 226 183

E [email protected]

If you would like to see what we are doingplease follow us on social media:

@cri_tweets

LinkedIn https://www.linkedin.com/company/crime-reduction-initiatives

For a full list of our services, please visit:

W www.cri.org.uk

cri impact report 2014-15

Documents