Impact Report 2011-2012

Drug, Alcohol and Mental Health Services

Faversham

MargateHerne BayWhitstable

Richmond

EalingReading

Wokingham

Wandsworth

BromleyCroydon

Barking & DagenhamSheerness

Reigate

Woking

Havering

CanterburyChatham

Gravesend

GillinghamRochester

MaidstoneTonbridge

Royal Tonbridge Wells

Sittingbourne

Folkestone

DoverAshford

Greenwich

Mental Health Services

Adult Substance Misuse Services

Young Persons’ Services

Where we are

www.kca.org.uk

www.kca.org.uk

Contents

What does KCA do? 1

Mission and Values 2

Message from our Chair of Trustees 3

Introduction from Chief Executive 4

Adult Substance Misuse Services 5

Mental Health Services 13

Young Persons’ Services 19

Training and Professional Development 23

Research and Publications 25

Directors’ and Trustees’ Report and Financial Statements 27

Statement of Financial Activities 29

Balance Sheet 30

Performance 31

Board of Trustees and Senior Management Team 32

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What does KCA do?

KCA is a registered charity providing specialist care to those affected by drugs, alcohol and mental health issues across south east England.

Our aim is to work within communities and families to help people unlock solutions to their difficulties. Our specialist services aim to prevent the harmful use of drugs and alcohol, by providing early intervention initiatives and effective recovery routes.

Our Mental Health Services offer holistic treatments for mild to moderate conditions and are tailored to each individual. We have become national leaders in delivering evidence based recovery focused services.

We have substantial experience of delivering high quality substance misuse recovery services including advice, information and harm reduction, needle and syringe programmes, specialist substitute prescribing, GP shared care, structured psychosocial interventions and structured day programmes.

We provide community based drug and alcohol services to adults and young people and deliver counselling within GP practices and community settings to ensure all services are inclusive.

In 2011-2012, we have seen more than 40,000 adults and young people across all of our services. Since the organisation was formed in 1975, we have continued to grow and in the previous year, services have increased by 22%. We now employ approximately 520 staff and more than 100 volunteers across a network of 35 specialist service centres to ensure our services are accessible and inclusive to all. Our annual turnover grew to approximately £21m.

In addition, we develop and deliver a wide range of training courses, research and benchmarking programmes to improve professional knowledge and skills of both our staff and external professionals. We are committed to significant investment in effective staff training and development. Our training policy complies with the Care Quality Commission’s requirements relating to the qualifications, knowledge, skills and experience of workers.

The previous year has seen us expand the breadth and type of services we deliver by operating services within the secure estates and providing integrated services in substance misuse. New additions also include mental health, substance misuse, young persons’ services and day programme contracts.

With a significant focus on families and communities, our services are well equipped to provide innovative and effective support to address substance misuse issues and relationship breakdowns. Our Family Intervention Project aims to improve service users’ parenting abilities to help them to create sustainable and safe environments for their children and the whole family.

Our services are focused on providing effective treatment and recovery routes to help all service users sustain their recovery and create opportunities for their future wellbeing. Our social enterprises provide innovative and meaningful activities for service users to help them focus on things other than their substance misuse; for example, our Cycle Recycle and Roots projects enable service users and volunteers to develop new skills and create opportunities for their futures.

All of our services provide the highest quality of treatment and support, and we are registered appropriately with the Care Quality Commission. Our ability to innovate and improve is in the quality and outcomes of our service users: these are higher than the national average.

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Mission and Values

KCA is committed to being progressive, responsive and effective in providing specialist care and empowering people affected by drug, alcohol and mental health issues.

We have 35 specialist service centres in London and the south east

Our values are: Progressive - helping people move forward by developing creative solutions that embrace their diverse and changing needs.

Responsive - committed to being prompt, constructive, aware and considered at all times.

Effective - working with service users, funders and the wider community to optimise outcomes and efficiency based on evidence, experience and research.

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This year has seen continued growth for us with the addition of new contracts across our Mental Health, Young Persons’ and Substance Misuse Services. This has enabled the organisation to spread its skills and knowledge into new sectors. Our ongoing development of creative partnerships with stakeholders helps us respond to the wider needs of individuals, families and local communities.

The economic environment has continued to be challenging, making it even more important for us to evidence our commitment to innovation, with effective service delivery focused on meeting the needs of service users and representing good value for money to our funders.

In 2012, after 10 years as Chief Executive, Anton Derkacz left KCA. An enormous amount was accomplished under Anton’s leadership, transforming KCA from a Kent based substance misuse charity to a regional charity with wider objectives, including mental health and social inclusion and a strong national reputation.

Douglas Smallwood’s appointment as Interim CEO has provided strong leadership to the executive team in its excellent work. As we look towards 2013, the values and principles all our staff work towards, together with financial stability, stand us in good stead for our commitment to continuing to develop quality services that are respectful, effective and caring.

The Board’s sound governance has been particularly important during this period of growth and change. We were delighted to welcome a new Trustee Robina Lawson to the Board and with a new Chair due to be announced in due course, I wish them every success.

I would like to take this opportunity to thank all of the Trustees for their support, dedication, time and expertise, all of which have helped to shape KCA into what it is today.

Elisabeth Hirlemann Chair of Trustees

Having completed my three-year tenure as Chair of KCA’s Board of Trustees, I am proud to reflect on the continuing successes of the organisation which have been achieved through the

commitment and motivation of the people working throughout KCA to achieve our charitable purpose.

Message from our Chair of Trustees

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The valuable work we do to help people recover is

what makes us successful and the 40,000 people we have seen across all of our services shows we are good at what we do. It takes a lot of effort and strength for people to get on the road to recovery and we encourage and support them every step of the way. Our focus is to provide vital support for families and carers of service users, to ensure they feel that our services are here for them too. Service users’ participation plays a vital role in our organisation and their views and experiences help us to consistently improve our services.

The past year has been a successful one for us as an organisation. However, with a desire to streamline and reduce bureaucracy, many commissioning structures have changed under the coalition government. The introduction of the Health and Social Care Bill (2011) has seen commissioning decisions localised via GP consortia with services being tendered on a larger and more integrated scale, which often incorporate both the housing and public health agenda.

We have expanded the breadth and type of services we deliver by moving into the secure estate and providing ‘whole treatment systems’ in substance misuse. We have also seen the addition of mental health, substance misuse and young person’s contracts within the Probation Service, Greenwich and Bromley. A huge success was being awarded the IDAS Wandsworth contract which provides an integrated substance misuse service across the whole borough. Within our Adult Substance Misuse Services, we are developing models to provide essential but effective services for service users and their families. This can be seen through our Family Intervention Projects (FIP) to develop and increase

parenting ability. We have also trained more than 500 people to use Naloxone, a life-saving intervention to prevent overdosing. We’ve had one significant loss in the last year: the West Kent substance misuse contract was a sad loss for us.

Our Mental Health Services continue to support people with a wide range of conditions and in the past year, we’ve had contact with more than 15,000 people. The service has grown in size with new contracts including IAPT in Kent prisons and counselling services within the Probation Service, bringing together our Substance Misuse and Mental Health Services. Raising awareness of mental health conditions still continues to be a high priority nationally with a drive to address conditions such as depression and anxiety. Our early interventions for mild to moderate conditions and high intensity treatments ensure that our clients receive the most effective treatments tailored to their specific needs. The Young Persons’ Service has continued to develop with new service additions in Greenwich and Bromley, as well as offering services in a young offenders’ institute at Cookham Wood. Our service strives to engage with vulnerable young people and their families and carers at an early stage.

The quality of our relationships with our partners and stakeholders across all of our services is of great importance to the organisation. These will continue to be developed and nurtured to ensure our services are effective and tailored to meet the needs of our communities. The progress of this organisation is solely due to the hard work and passion of our staff, volunteers, trustees and service users who ultimately help to improve the quality of life for so many people.

Douglas SmallwoodInterim Chief Executive

The skills, knowledge and commitment of staff and volunteers are at the heart of KCA and its achievements.

Introduction from Chief Executive

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Our Substance Misuse Services are for adults who are experiencing problems related to their own, or someone else’s drug or alcohol use. We deliver a wide range of specialist interventions to support adults in their recovery. We provide individuals with a tailored programme of support to address their substance use to enable them to fulfil a journey to recover fully from the damage it has caused and improve their wellbeing and quality of life.

Within our tier 2 services, we provide a full range of open access services which offer rapid access to informal advice and education, overdose training and intervention, needle and syringe exchange and treatment to prevent the spread of blood-borne viruses. We work with individuals to minimise harm and support them until they are ready and motivated to engage with more formal treatments.

In the last year, we have had some very positive results. Hepatitis C among injecting drug users is

30% below the national average in many areas that we work in. This is attributable to our continued effective and accessible provision of needle and syringe programmes. We also provide blood-borne virus testing across many services which has enabled intravenous drug misusers, both past and present, to understand their health status and make informed choices about continuing to use and treatment options.

Throughout the year, our focus has been on the recovery agenda and how we can help our service users to improve their relationships with their families and find their place in the community again. Our aim has been to help people to identify their strengths - both in themselves and the support systems around them. Our goal has been to work with everyone in treatment as a whole person, not just concentrating on the problems, but on the resources they have to help them sustain their recovery.

Adult Substance Misuse Services

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Service users are given the opportunity to share their views and experiences to inform and improve our services and the Service User Involvement Group (SUIG) has been developed to have representation from each locality. The group meets every month to report on activities from each service centre and has been attended by Margaret Bell, chair of the quality and assurance sub-committee of the Board of Trustees. Five service users attended the National Service Users’ Conference in Birmingham in February 2012 which inspired more people to attend the Service Users’ Group. Over the year, six service user representatives have gained paid employment, and eight became volunteers at KCA.

Teaching people to save lives with NaloxoneDuring the past three years, we have integrated Naloxone prescribing and training as a potential life saving intervention into many of our services. The benefits of Naloxone prescribing are now more widely understood and we are among the leaders in the field nationally. This year, we have trained 598 service users, carers, staff and other professionals to administer Naloxone in an overdose situation and 371 pre-filled Naloxone syringes were dispensed to service users, with 32 reports of Naloxone being used.

Jenny, Service User from ThanetJenny was encouraged to do the Naloxone training after seeing a poster advertising the course in the service centre. This helped her to save a life. “There have been a few times when my friends have overdosed in front of me and I’ve had to call an ambulance. Waiting for them to arrive is awful. I was encouraged to do the training after seeing a poster in my local service centre. The training only took fifteen minutes. Not long after the training, I actually had to use Naloxone on my friend. She was upset and overdosed, but by giving her the Naloxone, I saved her life. If we’d waited for an ambulance, she would be dead. I felt really pleased with myself after. My friend is very grateful too. I’ve now encouraged many others to do the training. It’s quick to learn and so much safer knowing people know what to do in that situation.”

IDAS WandsworthAcquiring this new service was a momentous achievement for KCA. Launched in December 2011, IDAS Wandsworth provides open access and structured treatment at four main sites; St Johns, Garratt Lane, Queen Mary’s Hospital and Battersea. Service users can access any sites for treatment and the average waiting times for triage assessments are below the national average.

This unique service is run in partnership with Blenheim CDP to offer every service user the best possible chance to choose recovery and become drug or alcohol free. The service inherited an experienced Primary Care Liaison team, made up of nursing staff who work alongside GPs to provide both specialist alcohol and drug support to the community. Social workers from the local authority have also been seconded to work alongside our specialist staff, which offers seamless and integrated support for all service users.

The service works closely with a wide variety of agencies including community matrons, ambulance staff, probation services and social work teams. All sites offer blood-borne virus testing, vaccinations and provide needle exchange facilities. The new prescribing services offer substitute prescribing for opiate dependence, alongside community alcohol detoxification services.

Over the next year, the service will look at ways of increasing tier 2 access by primary alcohol users. We provide a wide range of specialist services for alcohol users as part of our integrated treatment service. In particular, we operate an ambulatory detox services, structured psychosocial interventions

Open Access contacts

4,505

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and an assertive case management team, who focus on alcohol users who have presented at accident and emergency more than twice in the last 12 months with alcohol related needs. A range of alcohol focused groups already take place across the borough. We aim to build further links with AA.

Community and Shared Care PrescribingOur community prescribing and shared care services are offered in a number of community facilities which make them easily accessible for service users. This year has seen the start-up of localised SMART recovery groups developed in services which have proved very popular for service users accessing treatment.

We have also welcomed partner agencies into our premises to make it more convenient for service users. This also provides collaborative multi-agency working for our partners. Partners include the Women’s Refuge who are currently working from the Folkestone office on a weekly basis, allowing quick access to its services for our staff.

Our Swale service centre has also continued to offer placements to police students, which has again been nominated for a Police Community Award.

Horizon Services (Intensive Community Support and Activity Programmes)Our Horizon programme offers intensive community support through a range of activity programmes which are tailored to meet service users’ needs. They provide service users with practical support in the form of social skills, vocational training and experience to support their formal therapy and provide links with local representatives from the Job Centre Plus, colleges, universities and libraries, as well as family support initiatives. Popular workshops have included gardening, cooking and nutrition, arts and crafts, as well as physical sports such as Air Football in Medway.

All localities have skilled practitioners who deliver one to one and low intensity interventions, such as the Birmingham Treatment Effectiveness Initiative (BTEI) node mapping, which helps individuals focus on obtainable goals towards their recovery.

Social enterprise has also been at the heart of many projects including Cycle Recycle in Thanet and the wood recycling project Roots, in Gravesend. This particular project has seen a significant growth over the last year with the employment of two ex-service users.

In Wokingham, we have seen a 50% increase in referrals. The programme emphasises the importance of aftercare and groups are held twice a week, with a Saturday group planned for the future. Service users are also contacted three months after leaving the service to check on their progress and offered on-going tier 2 support if requested.

Community Prescribing

Total number of clients seen 4,975

Shared Care

Total number of clients accessing the service throughout the year 906

Horizon Day Programmes 2011-2012

Total number of clients attended 1,018

Services in Kent, Medway, Berkshire West, Ealing, Croydon, Bromley and Wandsworth

The programme is provided in Thanet, Canterbury, Ashford, Dover, Folkestone, Faversham, Sittingbourne, Sheerness, Gillingham, Wokingham and Barking and Dagenham

Open Access contacts 2, 013

Number of triage assessments offered 183

From December 1st 2011 to March 31st 2012

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Alcohol ServicesWe know how to provide effective alcohol services - it’s ingrained in our history and is why KCA was originally formed in 1975. We’ve seen specific alcohol work reappear in many areas which reinforces the objectives of the Government’s Alcohol Strategy. Reducing alcohol consumption nationally is high on the agenda and the focus on alcohol services represents a change in prominence of alcohol related harm as a key driver for commissioners.

Providing services for alcohol misuse will be the responsibility of local authorities with funding for alcohol services. This will be supported by Public Health and enable partnerships in the local community to be developed. This way, alcohol services will be tailored with the local community in mind, to maximise the scope for early interventions and meet the needs of the people that need the services.

Barking and DagenhamDedicated alcohol services in our Barking and Dagenham service are provided by the Community Alcohol Team (CAT). They provide key working, counselling, group work, community detox and outreach (including home visits, assessments and detox for those unable to physically attend our service). The CAT work with safer neighbourhood teams and an alcohol offender worker to tackle street drinking.

This year, the service took over the Drugs Day Programme and counselling contract, and combined the service with the Community Alcohol Team. The launch of the new service was well attended by councillors, local stakeholders, service users, carers’ representatives and staff. Lunch was provided by an ex-service user who has received support to set up a catering company.

As GPs are the main referrers to the Community Alcohol Detoxification service, we have developed close links with them to continually improve the service provision. The primary care project enables a Detox Nurse to provide training and information sessions for GPs on a regular basis.

The Queen’s Hospital A&E liaison service started in April 2011 and the team pick up referrals from A&E departments and various wards. Outreach work has been provided with partner agencies in people’s homes and on the streets. Street outreach is offered at night for local sex workers and during the day targeting the rough sleeping Eastern European community. The service provides a wide range of satellite services across the borough for group work and counselling sessions.

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Pioneering ProjectsKCA’s ability to innovate and improve is seen in the quality and outcomes of our services. For us, innovation is about bringing creative ideas to life for the benefit of our service users. We encourage our staff to think about new ways of developing and delivering services as our practitioners’ best understand what service users need.

Family WorkWe recognise the devastating impact that alcohol or drug misuse can have on families but also know how important families can be in enabling recovery. We are a charity committed to supporting and caring for families affected by substance misuse and helping to improve family relationships and we believe that family involvement is at the centre of recovery.

The Family Intervention Project (FIP) works with families as an intensive intervention to help support the whole family to make sustainable changes. Family units can be one or both parents/carers of a child and extended family. Our FIP workers are assertive and persistent in their efforts to try and engage and support families to break the cycle of substance misuse, worklessness, truancy and offending behaviours.

As part of the Troubled Families agenda, the project aims to help reduce crime and anti-social behaviour; get children back into school; get parents into recovery and back into work; and, help reduce overall costs for the government.

The workers agree an action plan that can be achieved for the whole family by improving and sustaining a safe environment to increase their parenting ability. FIP workers take the role of the lead professional for the Common Access Framework (CAF) process and work within a multi-agency action plan.

We now have a number of specialist facilitators for the Strengthening Families Strengthening Communities parenting groups. The groups have are planning to link with fathers who have contact with their children to take part in structured learning and activities through activities such as our social enterprises Cycle Recycle.

Substance Misusing Parents (SMP) project works with parents who are known to children’s services, aiming to reduce the number of looked after children. They support them to access essential community services such as family centres, parenting programmes and health centres. Service users are seen in various venues to give them access to treatment and support. Interventions offered include assessments, testing and keyworking aiming to improve the outcomes for children subject to safeguarding plans.

The team are pro-active in bringing awareness, knowledge and focus of hidden harm and the priority of safeguarding to the KCA workforce, as well as advising social services and other professionals involved in families. SMP workers also attend neo-natal/special care baby unit meetings to improve liaisons and support for pregnant women. This project is available in Thanet, Dover, Canterbury and Swale.

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RootsA wood recycling social enterprise, Roots is located in Gravesend. Established in 2011, it’s part of an award winning national scheme and employs two ex-service users, one full and one part-time, as well as four regular volunteers. In its first year, the project made a successful profit and has saved more than 2,500 cubic yards of timber from going to landfill with the majority being recycled.

Roots has been involved in a number of community projects including donating timber and resources to the Gravesham Social Education Centre, a centre for people with disabilities. The team built raised planters so they can grow their own vegetables. They donated timber and built a wobbly bridge for the children’s play area at the Cascades Leisure centre.

The project has had much support from local councillors, the local MP and many residents. Recent donations have included £400 from the Kent Police Property Fund and £250 from Diamond CIC.

Future growth plans include building new workshops to be able to build quality products to sell and also train people in woodworking skills, with the possibility of gaining NVQ qualifications.

Air FootballAir Football was established in east London by Colm Whitty and has had notable success working with disadvantaged client groups across London boroughs. We work in partnership with the Air Football project in Medway using funding from Probation and Drug Action Team commissioners.

The project offers training twice a week, as well as social skills training sessions including time management, healthy living, diet and food, ethics and team building, communication skills and CV writing. All players are offered one to one support and group sessions and support with job, training, volunteering and college applications.

To maintain close contact and develop successful relationships with players, all receive phone calls and texts either once or twice a week. Sixteen players from Medway started their FA Coaching Level 1 course in February 2012 and referrals continue to remain high with new players joining on a regular basis.

There are now more than fifty registered players, with sessions regularly attended by twenty or more. Staff have participated and hosted Air Football tournaments and commissioners have agreed to fund the project for a further year.

www.airfootball.co.uk

For more news and information about our Adult Substance Misuse Services visit www.kca.org.uk

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We provide prescribed substitute medication

to more than 6,000 people each year

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“My name is Emma and I’m 38. I started using Cannabis and Speed when I was 14, which rapidly progressed to using anything and everything. At the age of 25 I started injecting and soon, that took over my life. I lived a life of crime – my boyfriend was a big time drug dealer and our house was full of stolen goods. He eventually went to jail and soon after I was arrested and sent to jail on a drugs charge too. I detoxed in prison and managed to stay clean for a year after I was released, but I had no support and started using again.

I fell in with the wrong crowd and started dating a known gangster. At the time I thought he was the answer to my problems because he could support me financially, but I ended up in an endless circle of getting clean and then using again.

In 2010 I self-referred into KCA because I knew I had a problem and I wanted to get help. I was put on a script but was still using drugs as well. Despite this, KCA were there for me and supported me. Over the course of that first year I was still caught up with the wrong people and regularly being threatened by drug dealers. However, after a house fire I was reminded of how transient life can be and KCA helped me in making the decision that I needed to change. In April 2011 I used drugs for the last time and in June 2011 I walked away from my boyfriend to start a new life.

I’ve never been able to stay off the drugs before, but KCA were genuinely interested in helping me and they made me realise there’s more to life. They created a proper care plan for me and asked me what I wanted to get out of my time with them. There were lots of activities and groups to keep my mind off drugs and they have worked with other services to help me move on.

I’m about to start a certificate in community justice, I’ve received help for an eating disorder and I’m booked in for plastic surgery to fix some of the damage on my arms from years of injecting. I’m also a service user representative for KCA, supporting key workers in their role and showing other service users that recovery is possible. I’ve done more in my time with KCA than I ever have before.

KCA treat you as an individual and you can speak to them about anything. I know that they’ll support me in accessing help and achieving my goals. It’s the little things, like letting you use the phone to ring up about your housing or going to the doctors with you, that’s what makes the difference. I think KCA are brilliant and I can’t praise them enough.”

Case Study

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Mental Health Services We have been supporting people to improve their mental health and wellbeing since the organisation began in 1975. Over the years, the range of Mental Health Services that we provide has grown and to reflect this, the services have expanded and continues to increase. Being awarded the contract to provide primary care mental health services across Surrey in 2010 saw our mental health delivery double in size, and this was an addition to services we were providing in east Surrey, east Kent, Havering and Medway.

Our most outstanding achievement in the last year was being awarded a new contract to deliver IAPT in-reach services to east Kent prisons, in partnership with Oxleas NHS Foundation Trust. This enables us to provide safe and personalised treatments for prisoners with mild to severe common mental health disorders in Sheppey Cluster, HMP Canterbury and Dover Immigration Removal Centre.

Our Mental Health Services were heavily supportive of the organisation’s successful new five-year contract in Feltham Young Offenders Institution, in partnership with RAPt. We are really focused on providing services for those individuals who don’t have access to mental health support and treatment and this contract has enabled us to provide integrated mental health and substance misuse services to those who really need it.

We also worked hard to retain our contract with Kent Probation as we are really committed to providing these integrated psychological therapy services to service users before, during and after their sentences have been carried out.

Other key successes include the set-up of the popular ‘Move to Improve’, programme which helps to support service users to boost their wellbeing through exercise with regular walking, swimming

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and cycling groups in local venues. The introduction of Feel Well, Live Well and Depression groupwork programmes have received good feedback from service users and have high take-up and low drop-out rates.

Our Mental Health Services in Kent cover Ashford, Canterbury and Coastal, Swale, Thanet and Medway.

East Kent Services in east Kent are highly valued by GPs and other professionals indicated by the high rates of referrals. The expected referral rate was 9,785 and the actual was 10,314.

Focus on ThanetWe have provided psychological therapies in Thanet for more than 20 years and in this time, have seen significant changes in the number of people accessing our services. In the past year, we received 2,788 referrals for therapy which illustrates the considerable impact that the IAPT initiative has had on the local community. When compared to ten years ago, the Thanet team received 497 referrals.

The service moved to new premises in Margate town centre which enables people to drop in when they want, and receive therapy in warm and encouraging surroundings. As well as the main centre, services are provided at a number of GP surgeries and community locations throughout the area. IAPT has allowed us to expand the team and the range of different therapies including CBT, IPT and Couple Therapy for Depression, alongside counselling interventions that we previously offered. One to one sessions are offered by phone, face to face and by Skype, to make sure they are accessible for all. Group interventions are also available and include coping with depression, Feel Well Live Well and anger management.

Our ‘Move to Improve’ programme offers clients the opportunity to enjoy a free walk or swim with a Psychological Wellbeing Practitioner and other clients. In the last year, the Moving to Recovery figure for clients treated by the Thanet team was 51%, higher than the national average and 8% came off sick pay and benefits, against a national threshold of 5%. This indicates that services delivered are genuinely effective.

MedwayFocussing on diversity to improve service access for patients from black and ethnic minority communities, the teams undertook significant networking and outreach work with local agencies to raise awareness of the service with local communities and partners, particularly for the black and ethnic minority residents. We have been supported in this work by a community development worker from Re-think.

Medway has also consistently achieved clinical outcomes that are above the national threshold of 50%.

New Thoughts Surrey Now running for a year, this service has received additional funding to establish the Respond team, a dedicated resource to work with clients who had been waiting for therapy. The Respond team enabled assessments to be delivered to all waiting clients ahead of the target date and allowed the main service to focus on new referrals and see these clients more quickly.

Staffing has been focused to make sure we meet the needs of local people by having a competent and qualified workforce. As an organisation we invest heavily in staff training and work in partnership with Surrey University. We provide a number of training placements for students as psychological wellbeing practitioners to enable them to complete on-the-job training and learn from qualified staff within KCA.

In response to clients’ feedback, we now also have a full time post of Client Engagement Manager, who is fundamental in enhancing our clients’ experiences of our services and helping to ensure we benefit from any ideas on how we can make improvements.

Fresh Start HaveringProviding primary care mental health services including one to one treatment programmes with clients has enabled this service to deliver some remarkable improvements to its already impressive outcomes. In the last year, its rate of clients moving to recovery was consistently well above the national threshold of 50% and was frequently among the highest in London at 65-75% month-on-month.

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The step three pathway provides the most effective evidence based treatment which is specifically tailored to meet the needs of the individual. It is monitored closely, allowing refinement of treatment to ensure it is effective for each client.

Alongside this achievement, the team worked together to reduce average waiting times for treatment by half. In the coming year, the team aims to increase the number of student volunteer placements and research, develop and pilot new therapeutic group work programmes.

The announcement of Any Qualified Provider (AQP) commissioning will mean we will be contracted to deliver IAPT services alongside a range of other providers in Kent and Medway, and Surrey. This will enable clients to choose which provider they would prefer to see for their treatment. To meet these challenges, we will increase our services within local community venues and continue to develop and expand our groupwork programmes and ‘Move to Improve’ activities.

We will continue to focus building our IAPT services and increase our breadth of services by supporting practitioners to deliver a range of models.

Our focus is to develop and strengthen our links and reputation with local partners and GPs, and ensure we provide effective promotion of our services. This includes working closely with commissioners to address groups who are not accessing mental health services.

What our clients say

“Flexible with appointments, overall very satisfied with the treatment and it really, really helped me.”

“Thanks to my therapist, I am now a new person. For the first time in my adult life I am happy and enthusiastic about life. Things that seem important for so many years are no longer so. Thank you for giving me my life back.”

“Before I didn’t go anywhere, but now I have plans to do things and able to try things and to cope better when they are not manageable due to my physical health. My wife and son have noticed a difference in me.”

Mental Health Services 2011-2012

Attendance rate (average) 79%

Total number of clients seen (entered treatment) 15,476

For more news and information about our Mental Health Services visit www.kca.org.uk

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1 in 4 people suffer with depression at some point in their life

73% of patients showed statistically reliable improvement over the course of treatment in Mental Health Services

We provide Mental Health Services to

more than 15,000 people each year

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What our clients say... (These can be used in bold boxes like stats)

“Thanks to my therapist, I am now a new person. For the first time in my adult life I am happy and enthusiastic about life. Things that seem important for so many years are no longer so. Thank you for giving me my life back.”

“Before I didn’t go anywhere, but now I have plans to do things and able to try things and to cope better when they are not manageable due to my physical health. My wife and son have noticed a difference in me.”

“I was referred to KCA by my GP for Cognitive Behavioural Therapy as I had concerns about my anxiety, which had started to become unmanageable. After completing an in-depth questionnaire and telephone assessment, I was referred for treatment. At my first session, I had time and space to discuss my anxiety and how it affected my life. We decided to discuss my driving phobia, which had affected me since childhood and I had held a provisional driving licence for 10 years. I’d never succeeded in learning to drive because of my anxiety and I knew that by overcoming this, would give me a huge sense of achievement.

My therapist talked to me about two potential courses of action - CBT and EMDR. We discussed which would be best and chose EMDR as a good starting point for treatment, as my fear related back to one particular incident. I wasn’t sure what treatment would be like but my therapist was very knowledgeable and I was confident she could help me.

I had treatment for a number of weeks and at each stage, my therapist explained clearly what we would do and how it would happen. The process of EMDR seemed strange a first but I was also excited about the prospect of being free from my anxiety and was determined to see it through. My therapist was very understanding and explained that in order to benefit from the treatment I had to commit to it and be prepared to ‘go with it’. From the start of treatment, I noticed that the changes actually happened quite rapidly (over a period of about 4 weeks), and I started to feel much calmer - even as a passenger in a car. By the time treatment finished, I no longer felt anxious about the idea of driving, had booked my driving theory test and arranged driving lessons. On my first lesson, I was able to use the strategies and visualisations we had practised in the sessions to help me stay calm, and for the first time ever, I didn’t feel like I was about to dissolve into tears.

In the six months since I had my first session and three months since I contacted my driving instructor, I have passed my driving test. I am delighted that I have been able to overcome my driving anxiety and achieve something that I never thought possible. EMDR is definitely something I would recommend to people experiencing similar issues. It has changed my life and I am indebted to my therapist for her help.

I cry over silly things

Case Study

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Young Persons’ Services Our Young Persons’ Services have gone from strength to strength this year with great results. This is reflected in continued faith by commissioners in our services with increasing expansion.

The service provides specialist drug and alcohol support and advice for 11 to 17 year olds, in a number of service centres in Kent, Medway, Greenwich, Bromley, Reading and Wokingham. Our overall aim is to help young people address the harms and effects caused by their substance misuse and help them to reach their full potential.

During the past year, we have come into contact with more than 15,000 young people across our services. With a successful track record of providing quality young persons’ services, this year was no exception as 90.5% of young people participating in our service in Kent would be happy to use our service again, according to our satisfaction survey in 2011.

Our work in promoting young people’s participation within our services’ development has continued to thrive. A number of focus groups were held with young people throughout the year when they were asked to consider issues such as new leaflets and the outcomes of our annual satisfaction survey.

The highlight of the year was being awarded a new contract in Greenwich to deliver early intervention and structured treatment intervention services. From April 2011, we were commissioned to deliver interim services across the Royal Borough of Greenwich for six months and we were successful in being awarded with the new contract until March 2013.

In October 2011, we were commissioned to deliver Young Persons’ Services in Wokingham and in December, we retained our contract to continue delivering services in Bromley. New developments in Medway have enabled us to diversify into offering

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services inside a young offenders’ institute at Cookham Wood and we have been contracted to deliver group work. This has been challenging yet very rewarding and we had some positive feedback from the boys we work with.

We have recently won a five-year contract to deliver substance misuse services for young adults in Feltham Young Offenders Institution, run in partnership with RAPt. The service model of intervention was developed from our successful work within the community.

We have continued to deliver the RisKit project in mainstream secondary schools, youth centres and pupil referral units. Now in its third year, the innovative early intervention programme has been developed by KCA and the University of Kent and addresses risk taking behaviour. It was formally launched at a multi-agency event and the University of Kent presented their evaluation of the project to date. More than 160 young people have been through the programme during the year and good outcomes have been evidenced in relation to reductions in young people’s patterns of substance misuse. Schools’ feedback has been incredibly positive on the project, including its influence on improving students’ behaviour and also on the

excellent knowledge and professionalism of our staff. Kent staff have also trained in the ‘Strengthening Families Strengthening Communities’ model of engaging families and we will roll this programme out to include parents of young people we are supporting. Practitioners in Kent and Medway have become very knowledgeable on legal highs, offering a high level of consultation and training to other professionals. We have developed a range of young people friendly leaflets, with the latest editions being MDMA and mental health conditions.

All of the services have adopted the ‘Teen Star’ outcome tool to evidence the impact of our one to one and group interventions. By adopting this system, we will be able to give commissioners a fuller picture of our effectiveness in working with young people, which we believe will show our added value in a time of highly competitive tendering processes.

For more news and information about our Young Persons’ Services visit www.kca.org.uk

94% would recommend us to another young person

90.5% of young people participating would be happy to use our service again according to our satisfaction survey in 2011

Tier 2 Clients (groupwork)

Tier 3 Clients assessed

15,289 713

96.5% of young people leaving specialist services in 2011/12 achieved their care plan goals in Kent compared to the national average of 88%

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Paul is 15 and has had a problem with drugs since the age of 11.

“In my first year of secondary school I started smoking weed with my mates, only occasionally at first but soon I was smoking more and more until it was a habit.

At that age I never had much money so I was doing anything I could to be able to afford drugs – I would rob and mug people and I didn’t care. After about six months my criminal behaviour was starting to affect my family and I’d met my girlfriend who didn’t approve, so I stopped. However, I didn’t give up the weed.

At first it didn’t affect me much but after a while, I started to get paranoid and anxious. Soon I was hearing voices and seeing things. In particular, I kept seeing a scary image from a film and I couldn’t get it to go away. All of this was influencing the way I behaved at home and school and soon I couldn’t cope. In the end I spoke to my teacher and she suggested I get in touch with KCA.

That was when I met Zara, my KCA worker. I was 13 at the time. Together we talked about why I was smoking weed and what I wanted to change. Slowly I started to cut out weed, but because of the paranoia I was still scared to leave the house. Zara taught me lots of ways of dealing with this – from imagining I was the Incredible Hulk to learning to say how I felt.

Zara also put me in to touch with the Mental Health team, who I saw a couple of times. She came with me to my appointments and supported me when I asked my parents to come as well. I was having problems with my girlfriend at the time and Zara helped me work through those too. I found that I became more confident and I started to do things I wouldn’t have done before. I got involved in KCA focus groups and I even sat on interview panels for new members of staff. Things just kept getting better and better.

I finished treatment with KCA 10 months ago and life is great. I’m getting on well at school – before I used to bunk off, walk out and argue with teachers. I’m much better now and my attendance is good. I’ve completed work experience in a primary school and they’ve offered me more work after my exams. Drugs aren’t a part of my life anymore.

KCA are really good and I couldn’t have asked for a better service. I like that I can say what I want and it’s not turned back on me. Without KCA I wouldn’t be doing anything – I’d probably be worse. They’ve helped me with everything.”

Case Study

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Training and Professional Development

KCA is committed to significant investment in effective staff training and development. Our training policy complies with the Care Quality Commission’s requirements relating to the qualifications, knowledge, skills and experience of workers.

In the past year, our training team has significantly increased its geographical range of delivery to reflect the wider development of the organisation and ensure all staff can access training.

Training delivery sites now include Maidstone, Bromley, Wokingham, Woking, Barking and Dagenham, Richmond, Thanet, Sittingbourne, Ashford, Reading, Wandsworth and Woolwich.

Staff trainingAs our staff numbers have continued to increase, there has been a higher demand for the delivery of internal training. We have also utilised our premises for training, making it more cost effective.

New additional training programmes have been developed to meet the needs of our rapidly expanding organisation to allow our staff to exceed the competencies required by their roles.

Our training department provides Open College Network (OCN) accredited training. All learning is assessed and we use a range of techniques including online training. New training has been specifically commissioned and developed for the Young Persons’ Service which includes; Young People with Disabilities, Young People Sexual Health and Orientation, Young People and Blood-Borne Viruses and Teen Star.

A three-day managers’ training course has been developed and is mandatory for all managers with line-management responsibility. A wide range of subjects are covered and include: Understanding employment law; managers’ obligations; conducting disciplinary hearings; managing capability; managing absence and conducting appraisals. Managers are also regularly supported to attend external training suitable to their role.

External trainingThe team have delivered training to a range of Drug and Alcohol Action Teams, service providers, looked after children organisations, the Kent Safeguarding Children Board, Kent Probation, Kent Police, Kent County Council, universities and colleges.

In the future, we will look towards developing training opportunities with external agencies, to bring together expertise, knowledge and experience.

For more information on our training programmes visitwww.kca.org.uk/training

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We have trained more than 500 people to save lives with Naloxone – and we’re among the national leaders at doing it

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Research and Publications Research is an important dimension of KCA’s drive to promote and share evidence-based best practice. We employ a number of staff who have led or collaborated with original research which has extended our understanding of effective practice in substance misuse and mental health. Publications with a KCA authorInjecting drug use via femoral vein puncture: Preliminary findings of a point-of-care ultrasound service for opioid-dependent groin injectors intreatment (Senbanjo, R., Tipping, T., Hunt, N., Strang, J. Harm Reduction Journal 2012, 9:6 doi:10.1186/1477-7517-9-6)

The needle and the damage done: Clinical and behavioural markers of severe femoral vein damage among groin injectors (Senbanjo, R., Strang, J. Drug and Alcohol Dependence, 2011: 119: 161 – 165)

Cessation of groin injecting behaviour among patients on oral opioid substitution treatment (Senbanjo, R., Hunt, N., Strang, J. Addiction, 2011; 106: 376 – 382)

PresentationsAnton Derkacz - NTA & RSA joint Recovery Champion Expert Seminar, Recovery Capital - Identifying it, working with it, building it, 26 May 2011

Dr Richard Senbanjo - Can the Use of Ultrasonography in Drugs Clinics help improve our Knowledge and Response to Groin Injecting? The Institute of Psychiatry, Kings College, London, 27 June 2011 AuditClinical audits are embedded into practice across all areas of KCA’s service delivery. A large number of internal audits are undertaken annually.

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93% of patients who completed a Patient Experience Questionnaire reported being satisfied/very satisfied with their practitioner in Mental Health Services

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Directors’ and Trustees’ Report and Financial Statements

We have examined the summary financial statements for the year ended 31 March 2012 set out on pages 29 to 30.

Respective responsibilities of Trusteesand AuditorsThe trustees are responsible for preparing the summarised financial statements in accordance with applicable United Kingdom law and the recommendations of the Charities SORP. Our responsibility is to report to you our opinion on the consistency of the summary financial statements with the full annual financial statements and Trustees’ Report, and its compliance with the relevant requirements of section 427 of the Companies Act 2006 and the regulations made there under.

We also read the other information contained in the Impact Report and consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the summary financial statements.

This statement, including the opinion, has been prepared for and only for the charitable company’s trustees as a body in accordance with Section 427 of the Companies Act 2006 and for no other purpose. We do not, in giving this opinion, accept or assume responsibility for any other purpose or to any other person to whom this statement is shown or into whose hands it may come save where expressly agreed by our prior consent in writing.

Basis of OpinionWe conducted our work in accordance with Bulletin 2008/3 issued by the Auditing Practices Board. Our report on the charity’s full annual financial statements describes the basis of our opinions on those financial statements and on the Trustees’ Report.

OpinionIn our opinion, the summary financial statements is consistent with the full annual financial statements and the Trustees’ Report for the year ended 31 March 2012 and complies with the applicable requirements of section 427 of the Companies Act2006, and the regulations made thereunder.

Reeves & Co LLPStatutory AuditorChartered AccountantsCanterbury19 July 2012

Auditors’ statement on the summarised financial statements for the year ended 31 March 2012.

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91% of patients who completed a Patient Experience Questionnaire reported being satisfied/very satisfied with the type of treatment they received in Mental Health Services

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UnrestrictedFunds

DesignatedFunds

RestrictedFunds

Total2012

Total2011

£’000 £’000 £’000 £’000 £’000Incoming resources:Incoming resources from generated funds: Investment Income 20 - - 20 18 Incoming resources from charitable activities 20,768 - 95 20,863 17,315

Other incoming resources 146 - 5 151 157

Total incoming resources 20,934 - 100 21,034 17,490

Resources expended:

Charitable activities 20,242 114 122 20,478 17,506

Governance costs 92 - - 92 85

Exceptional expenditure - - - - 151

Total resources expended 20,334 114 122 20,570 17,742

Net income/(expenditure) before transfers 600 (114) (22) 464 (252)

Transfers

Gross transfers between funds (117) 117 - - -

Net movement in funds before other gains and losses 483 3 (22) 464 (252)

Other recognised losses Losses on investments - - - - (5)

Net movement in funds 483 3 (22) 464 (257)

Reconciliation of funds:

Total funds brought forward 2,093 999 136 3,228 3,485

Total funds carried forward 2,576 1,002 114 3,692 3,228

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The results above arise wholly from continuing activities. KCA has no recognised gains and losses other than those included in the results above and therefore no separate statement of total recognised gains and losses has been presented.

Statement of Financial Activities (incorporating the income and expenditure account) for the year ended 31 March 2012.

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The financial statements were approved by the Board of Trustees on 18 July 2012 and signed on its behalf byE Hirlemann, Trustee and J Boraston, Trustee.

Balance Sheet as at 31 March 2012.

2012 2011

£’000 £’000

Fixed Assets

Tangible assets 1,138 1,138

Investments - -

1,138 1,138

Current assets:

Debtors and prepayments 1,671 837

Cash at bank and in hand 3,856 2,898

Total current assets 5,527 3,735

Liabilities:

Creditors: Amounts falling due within one year 2,973 1,645

Net Current Assets 2,554 2,090

Total assets less current liabilities 3,692 3,228

Net assets 3,692 3,228

The funds of the charity

General 2,576 2,093

Designated 1,002 999

Unrestricted income funds 3,578 3,092

Restricted income funds 114 136

3,692 3,228

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Performance

As a leading provider in the south east, we are very proud of our part in delivering positive treatment outcomes.

30.0%

25.0%

20.0%

15.0%

10.0%

5.0%

0.0%

Number of people successfully completing drug treatment

KCA

England

This includes Kent, Medway, Berkshire West and Barking and Dagenham

Successful completions as % of number in effective treatment

2010/11 2011/12

60.0%

50.0%

40.0%

30.0%

20.0%

10.0%

0.0%

Number of people successfully moving to recovery in mental health treatment

KCA

National average*

* Approximate average taken from Department of Health’s IAPT three-year report, November 2012

2010/11 2011/12

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Board of Trustees and Senior Management Team

Senior ManagersColm Keegan, Assistant Director of Development and MarketingKerry Smith, Assistant Director of Mental Health Jane Wright, Assistant Director of Young Persons’ Services Tricia Armstrong, Assistant Director of Training and Workforce DevelopmentAnthony Crocker, Assistant Director of FinanceLucia Langley, Assistant Director for HRAbigail Cooper, Assistant Director Compliance and Governance

Senior Management Team

Douglas Smallwood, Interim Chief Executive

Karen Tyrell, Director of Development and Marketing

Pavlo Kanellakis, Director of Psychology and Caldicott Guardian

Howard Newman, Director of Business Systems

Dr Richard Senbanjo, Clinical Director

Tracey Tipping, Director of Practice and Standards

Sam Downie, Director of Mental Health

Karen Sharp, Director of Operations (Substance Misuse)

John HolroydeJudith RichardsMargaret BellRob VerityWilliam Willis

Board of TrusteesThe Lady Pender (President)Elisabeth Hirlemann (Chair)Anne Chapman (Vice Chair)Colin GrayDebbie WinchesterJo Boraston

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www.kca.org.uk

KCA is the trading name of KCA (UK), a company limited by guaranteeRegistered in England No 1955497 Charity Number 292824Registered Office: Dan House, 44 East Street, Faversham, Kent ME13 8AT

“KCA treat you like an individual and you can speak to them about anything.”