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Annual Report 2014

Drug and Alcohol Service for London

Leena Kissensing

on 13 October 2015

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Transcript of Annual Report 2014

CEO's Report
We are fortunate to have sound financial footing to take our plans forward and a committed staff team to deliver. My thanks to our Chair and trustees for their support, time and commitment to DASL during this period and we look forward with renewed enthusiasm to the future continuing to provide services to those most in need.

Newham Services
The beginning of the year saw a partnership between DASL and ELFT to provide the Community Drug and Alcohol Service in Newham. The first few weeks of the new contract entailed a great deal of work for staff and managers to get a service up and running quickly and it is a testament to staff dedication and hard work that we achieved a safe, sound service within a matter of a few weeks. The following statistics represent DASL’s achievements for the Community Alcohol Detoxification Service, Drug and Alcohol Counselling, Structured Drug & Alcohol Day Programmes, Family & Carers Service and Women on the Street Service.
Wandsworth Alcohol Service (BAS)
Chair's Foreword

That’s not to say we don’t have a strong sense of disappointment. The expression, attributed to Oscar Wilde, that “no good deed goes unpunished” perhaps sums up the experience of the last year. After proving once again how responsive and effective DASL is at meeting community needs and commissioners’ targets, a new tendering procedure effectively prevented us continuing to deliver some of our major services. It is hugely disappointing that we are no longer able to deliver services to many of the clients we have previously. I would like to take this opportunity to wish our former clients and employees well for the future.

From February 2013 to July 2014 DASL partnered with East London Foundation Trust in Newham to form CDAT and to deliver an integrated community alcohol and drug services in the borough. Bringing voluntary and statutory services together is never straightforward but not only did we manage this within a very short timescale following the premature ending of the contract by the previous provider, we managed to salvage a badly designed and unsafe treatment service and together turn it around so that the year-end figures showed a remarkable improvement in uptake, engagement and outcomes. Michael O’Dwyer gives details in his report. It was therefore bitterly disappointing when the commissioners decided to disrupt the system yet again and commission a different service configuration with criteria which meant only large national providers could bid. For the first time in 30 years, there is now no local provider in the borough. Any report of 2013-14 must highlight this as a significant event in DASL’s history but fortunately we have now moved on to a new era.

DASL services in other boroughs continued to perform well and, as we broaden our focus within the public health arena, complement this new strategy with work on smoking cessation, gambling, marginalised groups and older people’s initiatives. Our cause and our beneficiaries remain important and we have ambition for the future.
DASL has been delivering the BAS Abstinence Based Alcohol Group Programme to Wandsworth residents over the past 2 years. The team of 5 staff and 3 volunteers delivers a 12-week structured mainly cognitive behavioral rolling group work programme to enable clients to work towards supporting abstinence recovery from dependent alcohol use.
Greenwich & Bexley Alcohol Service for over 55s (Silver Lining Project)
DASL has been able, with support from a Comic Relief grant, to provide a range of support to the over 55’s in the London boroughs of Greenwich and Bexley around problematic drinking. Some of the key targets for this service over the past year have included;
Auditor's Statement
David Mackintosh
Chair of Trustees
Sue Kenten
Chief Executive Officer
List of Funders
London Borough of Newham
London Borough of Tower Hamlets
London Borough of Wandsworth
Help a London Child
Coutts Charitable Trust
29th May 1961 Trust
Comic Relief
Big Lottery
Mayor's Fund
Trust for London
DASL Head Office
Capital House
134-138 Romford Road
London E15 4LD
Harrinder Dhillon
Clinical Director
Alesa Rahman
Young People's Project Co-ordinator
Shirley Simpson
Older People & Alcohol Project Worker
DASL Active
WOTS Service
A service for women who are sex working in Newham. The service provided a late night drop-in, with access to a range of advice and support sessions.
Family & Carer Service

0333 055 8585
Drug and Alcohol Service for London
Annual Report 2014
To the Directors of Drug and Alcohol Service for London
We have examined the summarised financial statements set out in these pages.

Respective Responsibilities of Directors and Auditors
You are responsible as Directors for the preparation of the summary financial statements. We have agreed to report to you our opinion on the summarised statements’ consistency with the full financial statements, on which we reported to you on 14th August 2014.

Basis of Opinion
We have carried out the procedures we consider necessary to ascertain whether the summarised financial statements are consistent with the full financial statements from which they have been prepared and on which we reported on 14th August 2014.

In our opinion the summarised financial statements are consistent with the full financial statements for the year ended 31st March 2014.

Knox Cropper
Chartered Accountants & Registered Auditor
8/9 Well Court
London EC4M 9DN
September 2014

There were no recognised gains or losses other than those stated above
Year Ended 31 March 2014
As at March 2014
The summary accounts shown here have been extracted from the full unqualified audited annual financial statements of Drug and Alcohol Service for London for the year ended 31 March 2014 which were approved by the trustees on 14th August 2014 and subsequently submitted to the Charity Commission and the Registrar of Companies. The summary financial information on these pages may not contain sufficient information for a full understanding of the results and state of affairs at Drug and Alcohol Service for London. For further information, the full annual financial statements, the auditor’s report on those statements and the trustees’ report should be consulted, copies of which can be obtained from:

The Chief Executive
Drug and Alcohol Service for London
Capital House, 134 –138 Romford Road, London E15 4LD

Signed by David MacKintosh on behalf of the trustees.

Registered Charity Number: 299535 ; Limited Company Number: 2266538
Click to Donate to DASL
DASL would like to thank everyone who has donated, including the following funders, for their support.
Tel: 0333 055 8585
The last 12 months can perhaps best be described as “testing”. Having faced some significant hurdles it is a tribute to our staff, trustees, clients and supporters that we remain an effective and viable organisation. Our commitment to providing services that truly help some of the most vulnerable members of our communities is undimmed and in many ways we now enjoy a flexibility to innovate and respond which we have not had for some years.
However, unlike many other medium sized, community focussed services, we have been able to adapt. DASL retains a sound financial base and we have retained excellent staff. We continue to provide a number of high quality, well regarded and innovative projects. Our values are intact and we have the skills and capacity to help deliver real benefits in the challenging climate in which we all operate. For over 30 years DASL has been at the forefront of meeting fresh challenges by providing excellent services that benefit individuals and communities. We look to build on that foundation in the years ahead.
Fiona MacCarthy
Finance Director
" Smoking is the biggest single cause of premature death and preventable illness in the UK. 80,000 people die every year in the UK due to smoking related illness. "
" Stopping smoking is the single most effective step to lengthen and improve quality of life and has immediate and long-term benefits. "
However the addiction to nicotine as well as the psychological addiction and the fact that it can become the identity of the smoker are challenges that can be too powerful to overcome.
DASL is committed to exploring effective ways of supporting smokers when they have made the decision to stop smoking.
DASL Promotion of Stop Smoking Services amongst Drug and Alcohol users in Tower Hamlets.
Very Brief Advice
The VBA programme consists of 10 short videos covering the evidence for very brief advice (VBA), the three key elements of VBA and how to deliver it in everyday situations. The key elements are: ASK, ADVISE, and ASSIST. The training concludes with a short online assessment where the trainee is issued with a certificate.
DASL was commissioned by Public Health Tower Hamlets to provide VBA training to Substance Misuse Services (as a pilot project for six months) in the borough as evidence suggests that those who have substance misuse problems do not access smoking services and are identified as a high need group.
DASL contacted 11 substance misuse services in Tower Hamlets and delivered VBA training to 6 services; to 37 substance misuse workers, as well as deliver smoking awareness sessions to service users.

A leaflet was also devised with information about Tower Hamlets’ smoking cessation services (both specialist and generic). DASL envisages that this will be a useful tool and support front line staff on the “assist” and “advise” aspect of the training.

All services, including those that did not receive the training, have received the services leaflet.
Young People’s Stop Smoking Project
DASL’s successful school smoking cessation project, Bright Sparks (2009-2012) led to a request by Tower Hamlets Integrated Youth and Community Services and Public Health to deliver a shorter programme for the Autumn and Spring school term of 2013/14 in Tower Hamlets schools.

Young People do not traditionally access NHS run stop smoking services and having a service based at schools allows young people to seek help or be referred by teachers who are concerned about a student’s smoking.

Bright Sparks delivered preventative/early smoking cessation intervention that explored the underlying issues impacting on both present and future smoking behaviour and attitude.
Very Brief Advice (VBA) is the National Centre for Smoking Cessation and Training (NCSCT)’s e-learning programme for professionals who have contact with smokers.
The training explores a technique that can be used to explore smoking and encourage/initiate stop smoking with service users. Evidence suggests that smokers expect to be asked about smoking by healthcare professionals as it demonstrates concern for their health.
" 70 percent of the smoking population want to stop smoking. "
' Tower Hamlets has the highest level of smoking and smokeless tobacco use in London with over 45,000 adults (24.5 percent) compared to 21 percent in London. '
The programme delivered smoking awareness and presentations of Bright Sparks provision at assemblies and PHSE lesson, as well as health days and events that the school organised.
The most effective way of working with students in schools was to provide:

1. One-to-one drop-in clinic.

2. Students meeting with a young people’s smoking
cessation advisor on a weekly basis and discussing
smoking history, smoking pattern and motivations
to stop smoking.

3. Students set a quit date and were asked to
demonstrate that they could cut down the number
of cigarettes smoked.

4. Carbon monoxide readings were taken and
recorded and students could also be prescribed
Nicotine Replacement Therapy (NRT).
The programme delivered weekly drop-in sessions at six schools including Bow Boys, Oaklands School, Langdon Park, St Paul’s Trust, Morpeth School and Tommy Flowers Pupil Referral Unit.
The project also delivered a very successful sports diversionary programme, AIR Football, where trained football coaches worked with young people around fitness and sports skills, which are linked with health improvements made by quitting smoking. This group had a number of disaffected and disengaged young people who attended even when their school was closed for the day, as sessions continued as normal at the football pitch.
The Pupil Referral Units enforced a strict smoking ban on July 1st and requested Bright Sparks to provide support during this time. Bright Sparks provided support until the end of the summer term at all three PRU’s.
" A number of students were referred for extra support with their education and pastoral care which would not have been picked up if the student had not accessed support for their smoking. "
Alesa Rahman
YP Project Co-ordinator
" The programme supported 44 young people in their attempt to stop smoking, achieving 15 quits. The value of the one to one support again proved to be invaluable for the students and teachers, who observed a change in behaviour. "
" Smoking cessation has, in the past project and also in the current project, proved to be an effective way of young people addressing other difficulties in their lives and also making some correlation with their smoking. "
Michael O'Dwyer
Senior Services Manager
DASL was responsible for managing the duty service, offering brief advice sessions to all service users, a Triage and assessment of risk and referral for assessment.
Community Alcohol Detoxification Service
The nursing team at DASL undertook 240 ambulatory medicated alcohol detoxifications and were successful in detoxing 204 (85%). The nursing staff provided comprehensive daily medical support for the duration of the detox and then a review and referral on to further recovery support.

Counselling Service
The drug and alcohol counselling service worked with 111 individuals, offering a range of support and interventions, some people receiving short focussed work and others longer term interventions of up to 18 weeks.

Structured Drug and Alcohol Day Programmes
The drug and alcohol programmes offered group based support to 275 individuals. The programmes offered a range of interventions from psycho-educational, psycho-social and health and wellbeing provision. DASL also sustained the Eastern European support elements and provided the ever popular Women’s and Men’s Service.

Tier 3 Structured Interventions:
Tier 3 Outcomes
Service User Feedback
Overall Outcomes
WOTS saw 227 women for the year with 59% of women taking up BBV and substance use advice sessions. Some of the services provided were:

• Needle Exchange
• Access to Blood Bourne Virus Checks
• Health advice
• Housing support
• Support for Women experiencing Violence whilst on the Street
• Support and advice with anxiety and stress
• Referral on to mainstream support services

Over the year DASL received feedback from 233 service users. The service users were asked at care plan exit to rate the service they received. The following is their feedback:
The Family and Carer service ran group based, 1:1 Counselling and advice and information sessions for people affected by the substance use of others. The Family and Carers Counsellor worked with families, couples and individuals. This service enabled not just support to those affected by the substance misuse of those close to them but also a support mechanism for the substance misuser themselves.
Number of Clients Seen
There was also 27 carers groups run across the year, starting weekly at first then monthly following service user feedback and request.
' DASL helped me to change the way I think about drinking and helped me see a way forward '
' I was very comfortable with the Family and Carer Service and found the whole process very educational. I found it useful to be able to talk through some issues I was having in my relationship and how to deal with my partner's drinking and drug using. I been able to change some of the ways I dealt with things and my own behaviour. Talking has also helped me to get things off my chest and work on myself. '
' I like the groups, it's a good way to get ideas about how others cope, learn ways to deal with stress other than to get drunk, to get support and be able to offer support, was a real eye opener. '
' I was able to attend evening and weekends, this was a worry for me, as I needed support after having a detox and going back to work. '
' Counselling gave me the chance to talk about the reasons for my drug taking and see a future without drugs. '
The service supports people to change the way they think about and respond to different situations. We work on the basis that it is not the events which determine our feelings, but the meanings that we attach to these events. Clients learn to deal with their current emotional and practical challenges with support from their peers and the workers at the service.
“I learnt to change my thinking and think about situations that I am experiencing strong feelings about and look at different perspectives and reassure myself.”
“Discussing problems and strategies (to cope) with people who are coping with the same thing as you.”
Such a vital element that informs everything that BAS offers to clients. They have been especially instrumental in the development of the out-of-hours support available at
‘Social Sundayz’

at Garrett Lane, which has seen growing attendance.
Service User Involvement:
There is a variety of groups available including:
• Relapse Prevention
• Alcohol Awareness
• Relationship Groups
• Social and Life Skills
• Art, Drama & Yoga Nidra Therapy
• Goals Groups
• Recovery ‘in Focus’
• Aftercare and SMART Recovery
How well did we do?
• 76% of clients who commenced the programme
successfully completed

• 87% of clients stayed in treatment for more than 6

• 42% of clients completing the programme
embarked upon some form of recovery aftercare
such as BAS ‘Living Sober Group’ or 12-Step
Fellowship Groups

Who did we work with last year?
• 146 referrals received (40% coming from the primary
care alcohol detox Fresh Start Clinics)
• 92 clients commenced treatment on the abstinent
alcohol group work programme
• 40% of clients were women
• 35% of clients were non-White British
• 11% of clients described themselves as LGBT
• 45% of clients described themselves as having a mental
health diagnosis (including depression)
• 8% of clients said they had a disability
• 30% of clients said they were survivors of domestic
The service refers on to counselling and other aftercare services such as training and employment support as well as providing ongoing relapse prevention groups in the evenings following treatment.
Service User
Service User
Service User
Service User
Service User
Service User
Service User
• To support older people to reduce their drinking levels – the Silver Lining Project
Worker facilitates a weekly social support group in a community setting. On a regular
basis approximately 11-12 service users have attended with the aim of reducing their
alcohol consumption.

• To support older people to achieve improved physical and psychological health. The
Project Worker and volunteers have conducted weekly home visit support sessions to
8 service users. In addition 7 service users have received weekly support sessions at
agreed community venues to tackle their social isolation issues.

• Workers from other agencies better understand the issues of problematic drinking in
older people and how to respond to these. The project worker has delivered training
sessions to 50 practitioners in health and social care settings (including Signpost,
Greenwich CCG and the Drugscope Round Table event).

• To increase the capacity of older peer volunteer mentors to work with older people
experiencing, or at risk of experiencing, alcohol problems. DASL has trained 10 peer
mentors with 4 being retained into the 3rd year of the funding from Comic Relief.
The Silver Lining Service has supported some 26 service users to reduce their alcohol consumption over the year with individual and/or group support in the community. This has comprised;
• 16 men
• 10 women
• 25 service users aged 60-74
• 1 service user aged 75+
It was especially pleasing to see that Drugscope and the Recovery Partnership profiled older peoples’ substance misuse at a joint event on 27th February 2014 at London’s Guildhall. Silver Lining presented its work as an example of a good practice pilot project in London.
DASL Active
AIR Football, although in its final year of a three year programme, was a major success over the past year, engaging with 234 new clients and supporting over 130 existing clients.

These individuals are some of the hardest to reach clients across Newham and Tower Hamlets of which 95% were inactive, 22% had offending issues and 60% had on-going substance misuse problems.
The programme is a combination of sports based activities
(football, cardio fitness, cross fit, boxercise, circuits, aerobic sessions, resistance training, bleep testing, SAQ, Fartlek, stretching and core strength sessions )
and education programme
(group work, guest speakers, mentoring, one to one wrap around support and employment support)
aimed at increasing the numbers of excluded and hard to reach Londoners active and reducing substance misuse amongst this group.

A secondary aim of the programme was to support individuals to access local employment, training and education opportunities.
Over the past year, even under the loss of significant funding, the programme surpassed all of its expectations in terms of client outcomes, delivery and community networking. The programme and its clients achieved the following:
• 200 structured sports sessions
• 400 hours of structured sport
• 100 free gym passes worth £4000 given to the
most dedicated clients
• 95% of clients felt fitter
• 91% of clients felt their health improved
• 68% felt their substance misuse had reduced
• 85% felt their alcohol consumption had reduced
• Average attendance at sessions was 16 clients
• Average retention was 13 weeks
• Community programme involved over 30 local partners
Client’s achievements were again significant and included:

• 13 employment outcomes
• 41 volunteering outcomes
• 61 training outcomes
The DASL Active Programme
“I came out of jail in 2007 with a drug habit, I was homeless, penniless and in a poor state physically and mentally. I had no prospect of finding work and had little contact with my children. I feared the future, the present and had no confidence. Since I joined DASL Active I have my health back, I have made new friends with the players and staff and have had great support through my recovery."
Service User
Colm Whitty & Bertie James
Air Football Co-ordinator & Football Coach
Full transcript