Disseminating best practice
The probation inspectorate has just (29 September 2021) published the latest in its effective practice guides; this one relates to working with people on probation who use alcohol and/or drugs and is based on the recent joint thematic inspection of community-based drug treatment and recovery work with people on probation. These HMIP guides consist mainly of examples of effective practice (which the inspectorate defines as where its inspection standards are delivered well) drawn from the fieldwork that underpins inspection reports. The effective practice examples are organised across four sections: leadership, assessments, case supervision and reducing harm to individuals. In addition to the effective practice examples, each section of the guide includes a summary of the “key take-aways ” which I reproduce below.
The key take-aways on leadership and working in partnership to deliver key services are:
- Leadership is based on strong and clear communication loops, with two-way communication feeding into planning, delivery and monitoring activities.
- Stakeholders are essential partners and dedicated work must be put into nurturing effective partnerships and relationships.
- Recovery services and the role of lived experience in developing good services are key.
- Users’ insights should inform responsive services.
- Diverse services and approaches must be developed to meet the range of needs in local communities.
- Clear, shared objectives are central to delivering good partnership results.
- Good profile information relating to demographics and needs is needed to secure the right services and influence partners.
- Partners and sentencers need good-quality information.
- Partners must share information, and protocols need to be in place to support this.
Advice to court
The key take-aways on advice to court are:
- Gather information from all relevant sources, including other services.
- Don’t forget to ask about recovery and treatment work completed from periods in custody.
- Always consider previous youth interventions for people under 26 years of age.
- Obtain a specialist drugs assessment that considers the person’s previous experience of treatment, recovery and support services.
- Consider risks to others and immediate risks to wellbeing and safety.
- Consider people’s specific needs or protected characteristics such as gender, maturity and diversity. Think about how these intersect with drug misuse and choices.
- Check out the defendant’s motivation, readiness to change, views and lived experience.
- Ensure that all DRRs have written consent.
- Frame proposals to court with evidence, individual views and a structured plan with specific information about how treatment and recovery services will help to deliver the proposed sentence.
Effective work in this area focused on the following components of a person-centred approach:
- hope, engagement and choice
- trauma-informed practice
- diversity-informed practice
- connection- with the practitioner. Plus, the practitioner facilitates the
individual’s access to other agencies and
then provides ongoing encouragement.
- reducing risks.
Vulnerabilities, complexity of need and social isolation are often amplified for people with drug problems. Effective practice depends on acknowledging these vulnerabilities, and the trauma that often underlies them, while balancing risks to the public. A blended approach is key to positive practice. Inspectors highlight the following strengths from effective harm reduction work:
- Foundational to good practice is creating the conditions to avoid stigma, or better challenge stigma, through a culture of social justice. This requires bold choices: heroin treatment can be highly politicised, and the work in Swansea Bay, Lambeth and Middlesbrough has involved brave decisions. A well-developed evidence base is key.
- Services need to be built on respect for each individual, taking account of their rights and choices. Alternative choices must be on offer to make this meaningful. This provides the basis for the relational work that is needed to help people navigate their way through their drug problems.
- Central to reducing harm from drugs is the principles of safety; it is essential that drug-related deaths are prevented, by providing naloxone, clean injecting equipment and advice to increase safety and reduce risks of harm from infections and physical and mental damage. A trauma-informed approach is key to supporting people’s emotional safety.
- Allied to this is the provision of practical solutions, such as needle exchanges and sharps boxes in local services, in accessible locations, with advice freely available in community languages and easy-read formats. Advice on preventing overdose should be given in court, in custody and on induction in the community, and repeated whenever needed.
- Diverse services and options are crucial too, for harm reduction work to meet the community’s needs. Inclusive services need to work in collaboration with people who use drugs and organisations that support and advocate for and with them. Co-production of services ensures that the offer is meaningful and appropriate for people and integrating individuals’ lived experience is vital in getting this right.
Overall, inspectors identified that their standards are delivered effectively in relation to community-based treatment and recovery work when the key elements in the infographic reproduced below are present: