Report for Decision.
Decision:
ORDERED that Executive approves the establishment of a
new central assessment site to support safe and effective care.
AGREED that Executive:
·
NOTE the revenue impact in the Medium-Term
Financial Plan (MTFP) from year two onwards and that these will be considered
for approval by Council as part of the budget setting process;
·
NOTE the capital implications on the
Levelling Up Partnership funding secured for Live Well East and;
·
NOTE the process and timescales to progress
the preferred option and ensure continuity of service during library
redevelopment.
Minutes:
The Executive Member for Public Health submitted a report for Executive’s consideration. The purpose of the report sought Executive approval for the reconfiguration of Recovery Solutions delivery sites, ensuring safe, accessible, and compliant service provision.
Nationally, Middlesbrough had one of the highest levels of need in relation to substance use, highlighted by the prevalence of both drug and alcohol-related deaths. This linked to the considerable levels of deprivation locally with Middlesbrough having high numbers of people engaged with our services.
The Council currently had ambitious government targets, including to further increase both numbers accessing treatment and those completing treatment successfully. To meet those challenging targets, Council services needed to be able to work collaboratively with key partners and be open and accessible to those who needed support.
Recovery Solutions currently operated from three sites:
· Live Well East (Berwick Hills) – this was currently the main assessment centre; served between 700-750 clients. Changes to the building usage and enforcement presence had compromised care and restricted the opportunity for the site to offer the necessary capacity required;
· Live Well West (Ayresome Green Lane) - served approximately 400 clients and had limited capacity;
· Live Well South (Hemlington) - served between 180-200 clients; offered adequate capacity and has improved the engagement rate.
The proposed relocation of the Neighbourhoods team into the LWE library introduced a significant police presence, which was unsuitable for substance use client group. The presence of Police and enforcement staff in close proximity to a substance misuse treatment service would place the service in breach of critical CQC regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This risk was escalated substantially if they were within a shared space, which would be the case with the space constraints introduced at LWE.
The new plans for LWE also introduced physical space reductions. This further impacted service delivery capacity, which resulted in the service not being able to accommodate the necessary range of roles and support key partner organisations to work into the setting. This severely restricted the ability to provide a full, person-centred treatment and recovery offer.
A new central site, Park House, on Park Road North, had been identified. This was located adjacent to Parkside Mental Health Resource Centre and both buildings were owned by Tees Esk and Wear Valley (TEWV) NHS Foundation Trust. Public Health and the substance misuse services worked in partnership with TEWV across South Tees as the services share many clients.
The TEWV Care Programme Board had approved in principle the plan for Public Health South Tees to utilise their building.
Collaborative substance use and mental health services were vital because they improved patient outcomes. This was achieved by providing integrated, co-ordinated care for complex co-occurring issues, moving away from siloed systems. The integrated approach in South Tees enhances treatment engagement and recovery, leading to reduced severity of symptoms, lower rates of hospitalisation and a decrease in people falling into the cracks between services.
Levelling Up Partnership funding of £1.15 million was secured for LWE as part of a wider £20.816 million capital investment programme for Middlesbrough. Due to the changes and resultant challenges, consideration was important to how the new plans could be delivered, based on which option is approved.
Members discussed what mitigations were in place combat potential antisocial behaviour in the area. It was clarified that the service would avail itself of any Street Warden Service as required. It was also commented that services such as that being recommended would help to reduce crime and antisocial behaviour.
It was also commented that work would continue to engage local businesses, and other relevant stakeholders, to ensure the service was a success.
Thanks were expressed to all involved in the initiative and approval was expressed at public health matters being included on Neighbourhood Action Partnerships.
The Mayor requested that an all Member briefing be delivered on this subject.
OPTIONS
Six options were considered and were described briefly in
paragraph 3.10 of the report and in more detail in Appendix 1. Option 2
provided the most local service possible within an affordable cost envelope
(£476,561 revenue and £189,744 + VAT capital) providing care closer to where
people lived.
ORDERED that Executive approves the establishment of a
new central assessment site to support safe and effective care.
AGREED that Executive:
·
NOTE the revenue impact in the Medium-Term
Financial Plan (MTFP) from year two onwards and that these will be considered
for approval by Council as part of the budget setting process;
·
NOTE the capital implications on the
Levelling Up Partnership funding secured for Live Well East and;
·
NOTE the process and timescales to progress
the preferred option and ensure continuity of service during library
redevelopment.
REASONS
Recovery Solutions provides support for people with drug
or alcohol issues, including prescribing, psychosocial interventions,
counselling, and recovery support.
In February 2025 Recovery Solutions had its first CQC
inspection since bringing the Clinical Prescribing Service in house (previously
provided through Foundations GP Practice). CQC rated all three current sites as
“good” overall and the elements Safe, Effective, Responsive and Well-Led with
an “outstanding” rating for Caring.
The performance of the Service had continued to improve
since clinical provision was brought in-house and integrated with the wider
offer. The service delivered more than 8,000 individual interventions each
month to 2,000 adults in structured treatment, with an increasing number of new
presentations and increasing numbers of clients making substantial progress.
The rise in new presentations was linked to the development of the
locality-based delivery model, which had made treatment easier to access, offering
support closer to where people live.
The Service continued to develop and improve the offer to
support some of the most vulnerable people in Middlesbrough into recovery,
including:
·
A dedicated team to support people in
temporary accommodation and their own tenancies to prevent eviction, secure
housing, and move into more suitable homes. Working alongside neighbourhood
safety wardens, the anti-social behaviour officer, and the substance use
service, the team provided wraparound support that benefited clients and the
wider community.
·
Early screening had been introduced in
partnership with both Adult and Children’s Social Care to ensure individuals
identified at referral with substance-related needs were engaged at the
earliest opportunity.
·
The Outreach Team worked closely with
neighbourhood wardens and other partners to engage people in the community who
appeared to need support with substance misuse. The team proactively targeted
hotspots and individuals, delivering an average of 300 interventions per month.
In 2025 alone, 85 clients were assessed directly in community settings;
·
Young People’s Team provided tailored drug
and alcohol support across all Middlesbrough schools, alternative education,
and post-16 settings. This included one to one student support (143 young
people supported through drop-in), assemblies (over 5,000 students reached),
staff training (334 youth professionals trained), and parent resources;
·
The service had also been recognised for its
innovative work: awarded Team of the Year by Middlesbrough Council for new
pathways in lung health; and a Bronze Award for Public Health Nurse of the Year
at the national Nursing Times Awards for the work of the Night Clinic, which
engages vulnerable women with complex health needs.
As part of the Neighbourhoods model the former Library
part of the building is to be used as the Neighbourhood Hub for East
Middlesbrough. The Hub would be the platform from which a range of council
services would engage with communities in East Middlesbrough. It would also be
a space where residents could engage with the council to resolve complex
problems and from which they could be directed to appropriate services where
required. It would also allow the council to host partner organisations such as
the police and housing providers to enhance joint working a focus on the
improvement of the physical appearance of East Middlesbrough. It would also be
where partner organisations implementing locally derived joint problem-solving
plans to tackle issues such as crime and anti-social behaviour.
The relocation of the Neighbourhoods team into the
library at LWE would introduce a significant Community Safety and Police
presence, which was not appropriate for the Recovery Solutions client group and
raised concerns about maintaining a CQC compliant therapeutic environment. The
changes also reduced the available space that would require service users to be
seen in staff areas, which was not conducive to safe or effective care.
If LWE were to remain the main assessment site with the
largest footfall, there would be serious risk of service users disengaging and
deterring individuals from seeking treatment due to fear of stigma or
criminalisation. If service users were not aware of the police presence, they
could not make informed decisions about accessing care, undermining the
principle of person-centred care.
These factors collectively compromised the service’s
ability to operate in compliance with CQC requirements and NICE guidelines,
necessitating a review of alternative delivery models.
Providing services closer to where people lived by
localising LWE for nearby residents and providing a new, town centre offer that
served central, North Ormesby and other wards in the vicinity. This would
reduce travel and associated costs and ensure there is a recovery-focused site
that was not intimidating or distressing for service users.
Supporting documents: