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Registration Number: {{org_field_registration_no}}

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Alcohol, Drugs, and Substance Misuse Policy

1. Purpose

This policy sets out how {{org_field_name}} prevents, identifies, and responds to alcohol, drugs, and substance misuse in a way that is lawful, proportionate, person‑centred and safeguarding‑led. It supports the CQC Fundamental Standards (notably Regulations 9, 10, 12, 13 and 17) and ensures we balance tenancy/human rights with safety and public protection. It applies alongside our Medication, Safeguarding, Incident Management, Mental Capacity & Consent, Professional Boundaries, Smoking & Vaping, and Lone Working policies.

2. Scope

• People we support (adults aged 18+).
• Employees and workers of any kind.
• Visitors, family, carers, advocates, and professionals on our premises.

3. Definitions

• Alcohol — Ethyl alcohol (ethanol) in beverages.
• Drugs — Includes illicit drugs (controlled under the Misuse of Drugs Act 1971), prescribed and over‑the‑counter (OTC) medicines, new/novel psychoactive substances (including those controlled under the Psychoactive Substances Act 2016 or subsequently classified, e.g. nitrous oxide now controlled as a Class C drug), and volatile substances (e.g. solvents, gases).
• Controlled Drugs (CDs) — Medicines controlled under the Misuse of Drugs Regulations 2001 (e.g. morphine, methadone).
• Substance misuse — Use of any substance causing, or with a significant risk of causing, harm to an individual’s health, wellbeing or ability to function safely; or causing risk to others or to property.
• Harm minimisation — Strategies to reduce risks associated with use (e.g. brief interventions, safe storage, overdose awareness, referral to treatment).
• Cuckooing/County Lines — Criminal exploitation where a person’s home is used for drug dealing or related activity.

4. Legal and regulatory framework (summary)

• Care Act 2014 (s.42 safeguarding duties) and statutory guidance.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 — CQC Fundamental Standards (Regs 9, 10, 12, 13, 17, 18, 20).
• Misuse of Drugs Act 1971; Misuse of Drugs Regulations 2001 and amendments (Controlled Drugs).
• Psychoactive Substances Act 2016 and subsequent designations/classifications.
• Mental Capacity Act 2005 (MCA) & Code of Practice; Court of Protection case law.
• Human Rights Act 1998; Equality Act 2010.
• Health and Safety at Work etc. Act 1974; Management of Health and Safety at Work Regulations 1999.
• Data Protection Act 2018 & UK GDPR.
• Smoking and vaping legislation (Smoke‑free regulations).

Note: In supported living, people usually hold tenancy rights. Deprivation of liberty cannot be authorised under DoLS; where restraint or continuous supervision/control amounts to deprivation of liberty, route is via the Court of Protection under the MCA.

5. Principles

1. Person‑centred and proportionate: We respect autonomy, dignity, and tenancy rights, intervening only to prevent significant harm.
2. Safeguarding first: We recognise substance misuse can be a safeguarding concern (self‑neglect, exploitation, abuse).
3. Lawful practice: We do not permit illegal activity on our premises and we do not store or handle illicit substances.
4. Harm minimisation & recovery: We support access to treatment, brief interventions, relapse prevention, and reasonable adjustments.
5. Non‑discrimination: We apply this policy fairly, with reasonable adjustments under the Equality Act 2010.
6. Capacity & consent: Decisions follow the MCA (time‑ and decision‑specific). Unwise decisions alone do not indicate lack of capacity.
7. Confidentiality with safeguarding: We share information on a need‑to‑know basis, with consent where possible, or without consent where lawful and necessary to prevent serious harm.

6. Roles and responsibilities

• Nominated Individual (NI): Overall assurance of compliance and culture.

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• Registered Manager (RM): Implements policy; ensures safe systems, training, reporting to CQC/commissioners; oversees complex risk management and multi‑agency work.

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• Safeguarding Lead: {{org_field_safeguarding_lead_name}}, {{org_field_safeguarding_lead_role}} — point of contact for concerns, consultation, and external referrals.
• Medication Lead / CD Accountable Lead: Ensures safe management of medicines, including CDs, MAR documentation and audits.
• Data Protection Officer: {{org_field_data_protection_officer_first_name}} {{org_field_data_protection_officer_last_name}} ({{org_field_data_protection_officer_email}}, {{org_field_data_protection_officer_phone}}).
• All staff: Follow this policy; act if concerned; record and report; maintain professional boundaries; seek guidance.
• Tenants/People we support: Co‑produce risk assessments and house rules; respect others’ rights; avoid illegal activity on the premises.
• Visitors/Contractors: Comply with house rules and this policy while on our premises.

7. Risk assessment and care/support planning

• Offer routine, non‑stigmatising screening (e.g. brief questions) during assessment and reviews.
• Where risks are identified, complete/refresh a Substance Misuse Risk Assessment and Support Plan covering:
  • Triggers, patterns, settings of use; impact on health, mental health, nutrition, diabetes/epilepsy, falls, polypharmacy.
  • Risks to self/others (intoxication, overdose, fire risks, behaviour, finances, exploitation/cuckooing, safeguarding).
  • Capacity assessments for specific decisions (e.g. to use substances, manage medicines, consent to information‑sharing).
  • Agreed strategies: harm minimisation, boundaries, relapse/withdrawal plans, crisis contacts, naloxone availability (where lawful and commissioned), liaison with prescribers and local drug/alcohol services.
  • House rules (Appendix A) tailored to the address/premises.
• Review at least quarterly, and immediately following incidents, safeguarding concerns or changes in presentation.

8. Alcohol in supported living

• Adults (18+) may possess and consume alcohol in their own homes unless restricted by tenancy conditions, court orders, licence conditions, or individual risk plans.
• Staff do not purchase alcohol on behalf of individuals unless explicitly risk assessed, lawful, and agreed within the care plan (e.g. to support controlled use objectives).
• Alcohol is not consumed by staff on duty or on the premises when working.
• Common areas: Alcohol consumption may be restricted in shared spaces if it adversely impacts others; decisions must be recorded and proportionate.
• Intoxication: Where intoxication creates risk, staff implement the person’s plan (e.g. de‑escalation, observation, first aid, calling NHS 111/999), record, and escalate as required.
• Under 18s visiting: Alcohol must not be provided to minors. Staff challenge and record concerns; consider safeguarding referrals.

9. Illicit drugs, psychoactive and volatile substances

• No tolerance of illegal activity on the premises. Possession, supply or production of illicit drugs or illegal psychoactive substances is prohibited.
• Staff must not manage, store, transport or dispose of illicit substances.
• If suspected/observed:
  1. Prioritise immediate safety; do not put yourself at risk.
  2. Follow the incident response (Section 14).
  3. Seek advice from police if supply/trafficking/cuckooing is suspected, balancing confidentiality and safeguarding.
• Found items/paraphernalia: Do not handle needles or unknown powders. If safe, prevent access, follow sharps safety, and arrange safe disposal via local services/environmental health. Record and escalate.
• Harm minimisation: With consent, support access to treatment (e.g. OST, psychosocial support), BBV testing/vaccination, and safer‑use information via local commissioned services.

10. Controlled Drugs (CDs) and other medicines

• Managed under our Medication Policy. Key points:
  • Prescribed CDs (e.g. methadone, buprenorphine, oxycodone) are stored, recorded and administered in line with the Misuse of Drugs Regulations and best practice (e.g. CD register where applicable, secure storage, witnessed administration according to assessed level of support).
  • Self‑administration: Encouraged where safe; assess capacity and risk. Provide lockable storage for personal medicines.
  • Supervised/assisted administration: Use MARs; check identity, dose, timing, and interactions (including alcohol/illicit substances).
  • Diversion risk: Heightened monitoring, count‑backs, liaison with prescribers/dispensers; consider supervised collection/dosing if indicated.
  • Disposal: Return unwanted medicines to a community pharmacy. Staff must not destroy CDs unless authorised and trained under policy.

11. Staff fitness for work (alcohol/drugs)

• Staff must not work while under the influence of alcohol/drugs, or while impaired by prescribed/OTC medicines.
• Staff must disclose if prescribed medication may impair performance (seek occupational health or GP advice).
• Reasonable cause procedures may include removal from duty, post‑incident review, and—where policy allows—testing via a competent provider. Refusal to cooperate with reasonable investigations may be a disciplinary matter.
• Driving on duty follows our Driving at Work policy (legal limits and zero‑impairment expectation).
• Breaches may result in disciplinary action up to and including dismissal and/or referral to professional/regulatory bodies.

12. Visitors, contractors and professionals

• Must not bring or use illicit drugs on the premises.
• Alcohol consumption by visitors must be respectful, lawful and not impact others. Staff may require visitors to leave where behaviour risks safety.
• Children must be safeguarded at all times; see Appendix C for escalation routes.

13. Capacity, consent and restrictions

• Apply the MCA 2005: assess capacity for the specific decision at the time; support decision‑making; record reasoning.
• Where a person lacks capacity, act in best interests, using the least restrictive option. Consider independent advocacy.
• Restrictions (e.g. on alcohol in shared areas, safe storage, supervision) must be necessary and proportionate, regularly reviewed, and time‑limited.
• Deprivation of liberty in supported living requires Court of Protection authorisation where conditions are met. Seek legal/safeguarding advice via the RM.

14. Incident response (including overdose and acute intoxication)

1. Immediate safety: Do not place yourself at risk. Use PPE if exposure risk exists.
2. Clinical response: Follow first aid; call 999 for altered consciousness, breathing difficulty, seizures, suspected overdose or severe intoxication. Provide handover details (substances taken if known, time, quantity).
3. Naloxone: Where lawful, issued and staff are trained/authorised, administer naloxone for suspected opioid overdose per training; immediately call 999 and continue basic life support.
4. Safeguarding & crime: Consider risks of exploitation, cuckooing, domestic abuse, and children present. Contact police if there is significant risk, supply/trafficking, weapons, or violence.
5. Preserve the scene if a crime may have occurred; avoid handling items.
6. Record & escalate: Complete incident report, inform on‑call/{{out_of_hours}} arrangements, notify the RM and Safeguarding Lead.
7. Notifications: Where criteria are met, notify the Local Authority (Care Act s.42) and CQC statutory notifications (e.g. serious injury, abuse/allegations of abuse, police involvement, death).
8. Post‑incident learning: Debrief with the person (and multidisciplinary team), update plans and risk assessments, and log actions.

15. Exploitation, cuckooing and County Lines

• Indicators include unusual visitors, loss of control of the property, intimidation, unexplained possessions/debt, and marked changes in behaviour.
• Act immediately: raise a safeguarding concern to {{org_field_local_authority_authority_name}} ({{org_field_local_authority_phone_number}}, {{org_field_local_authority_authority_email}}) and liaise with police as appropriate.
• Use multi‑agency meetings to coordinate safety planning (target hardening, safe spaces, tenancy support, legal remedies).
• Consider Modern Slavery and PREVENT pathways where relevant.

16. Searches, property and confiscation

• Staff do not conduct body searches.
• Room/possessions searches only with the person’s informed consent and a clear, documented justification, or in an emergency to prevent serious harm (record rationale and actions; seek police support where appropriate).
• Items that are illegal or pose an immediate and serious risk may be secured out of reach while awaiting police collection. Document chain of actions.
• Respect tenancy rights and privacy at all times; entry to rooms must follow tenancy agreements and emergency protocols.

17. Smoking, vaping and fire safety

• Follow our Smoking & Vaping and Fire Safety policies.
• Do not smoke or vape in smoke‑free areas; use designated outdoor areas safely.
• Manage heightened fire risk where alcohol/drugs are used (e.g. bed‑smoking, oxygen therapy, reduced awareness). Implement controls (PPE, fire‑retardant bedding, safer ash disposal, checks) and document in risk assessments.
• Fire safety leads: {{org_field_the_fire_safety_lead_name}} ({{org_field_the_fire_safety_lead_role}}) and {{org_field_the_fire_warden_name}} ({{org_field_the_fire_warden_role}}).

18. Information sharing and confidentiality

• Apply UK GDPR and the Caldicott Principles.
• Share the minimum necessary, with consent where possible.
• Share without consent where there is a legal basis (e.g. risk of serious harm, safeguarding, crime prevention).
• Record the decision‑making, legal basis, and what was shared with whom.
• DPO contact: {{org_field_data_protection_officer_email}} | {{org_field_data_protection_officer_phone}}.

19. Training, competence and supervision

• Mandatory: Safeguarding (adults; and children awareness), Mental Capacity Act, Incident Management/First Aid including overdose awareness, Medication (including CDs), Lone Working/Personal Safety, Professional Boundaries.
• Role‑specific: Substance misuse awareness & brief interventions, de‑escalation, trauma‑informed care, risk assessment, cuckooing/County Lines, naloxone (if applicable), sharps safety.
• Supervision & debrief: Regular reflective supervision and debrief after incidents to support staff wellbeing and learning.

20. Monitoring, audit and quality improvement

• CD and medication audits; MAR reviews; incident trend analysis; safeguarding themes; house‑rules adherence; training compliance.
• Seek feedback from people we support and partners.
• Report learning to governance meetings and the Nominated Individual.

21. Breaches of this policy

• For staff: managed under disciplinary procedures; may involve suspension from duties, referral to the Disclosure and Barring Service (DBS) and/or professional bodies where applicable.
• For tenants/visitors: proportionate responses including boundaries agreements, exclusions from communal areas, and—in serious cases—police involvement and/or tenancy action via the landlord (with multi‑agency oversight).

22. Related policies and documents

• Safeguarding Adults; Children & Young People (awareness).
• Medication Management (including Controlled Drugs).
• Incident, Accident & Near‑Miss; Death/Serious Incident.
• Mental Capacity & Consent; Court of Protection.
• Equality, Diversity & Inclusion.
• Confidentiality & Data Protection.
• Professional Boundaries; Lone Working; Search & Seizure.
• Smoking & Vaping; Fire Safety; Visitors; Driving at Work.
• Tenancy/House Rules (Appendix A).

House Rules (template for each address)

Address: {{org_field_door_no}}, {{org_field_building_name}}, {{org_field_street_line_01}}, {{org_field_street_line_02}}, {{org_field_city_town}}, {{org_field_county}}, {{org_field_post_code}}
Service contact: {{org_field_phone_no}} | {{org_field_email}} | {{org_field_website}}

1. No possession, use, supply or storage of illegal drugs or illegal psychoactive substances on the premises.
2. Alcohol use must not impact other tenants, staff or visitors; no alcohol in [list shared areas] unless agreed.
3. No providing alcohol to under‑18s.
4. Visitors must follow these rules; staff may ask visitors to leave if behaviour is unsafe.
5. No smoking or vaping indoors; use designated outdoor areas and dispose of waste safely.
6. Keep exits and communal areas clear; follow fire safety instructions.
7. Respect others’ rights to quiet enjoyment of their home.
8. Staff may seek consent to check rooms/belongings where there is a clear and immediate risk; police may be called if necessary.
9. Weapons are prohibited.
10. Breaches will be discussed and managed through support planning and, where needed, multi‑agency action.

Key Contacts

• Safeguarding (Adults): {{org_field_local_authority_authority_name}} — {{org_field_local_authority_phone_number}} | {{org_field_local_authority_authority_email}} | Info: {{org_field_local_authority_information_link}}
• Children’s Safeguarding (awareness/concerns): {{org_field_children_safeguarding_local_authority_authority_name}} — {{org_field_children_safeguarding_local_authority_phone_number}} | {{org_field_children_safeguarding_local_authority_authority_email}} | Info: {{org_field_children_safeguarding_local_authority_information_link}}
• MASH (Children): {{org_field_children_multi_agency_safeguarding_hub_authority_name}} — {{org_field_children_multi_agency_safeguarding_hub_authority_phone_number}} | {{org_field_children_multi_agency_safeguarding_hub_authority_email}} | Info: {{org_field_children_multi_agency_safeguarding_hub_authority_information_link}}
• Local Drug & Alcohol Service (commissioned): [insert local provider/service].
• GP/Primary Care: [insert details].
• Local Pharmacy (CD returns/advice): [insert details].
• Infection Prevention & Control Lead: {{org_field_infection_control_lead_name}}, {{org_field_infection_control_lead_role}}.
• Public Health (outbreaks): Local HPT — {{org_field_outbreaks_support_local_health_protection_team_phone_number}} | {{org_field_outbreaks_support_local_health_protection_team_email}} | {{org_field_outbreaks_support_local_health_protection_team_website}}
• Local Public Health: {{org_field_reporting_outbreaks_local_public_health_phone_number}} | {{org_field_reporting_outbreaks_local_public_health_email}} | {{org_field_reporting_outbreaks_local_public_health_website}}
• Police (non‑emergency): 101 | Emergency: 999.
• Out‑of‑hours management: {{out_of_hours}}.

Safeguarding thresholds and referral prompts

• Adult at risk: Care Act s.42 criteria met (needs for care/support; experiencing or at risk of abuse/neglect; unable to protect themselves). Indicators: exploitation, cuckooing, financial/sexual/physical abuse, self‑neglect, chaotic use, repeated overdoses, domestic abuse. Action: Consult Safeguarding Lead and refer to {{org_field_local_authority_authority_name}}.
• Children (awareness/visitors): Any concern that a child may be at risk of significant harm warrants immediate contact with Children’s Services/MASH and/or police.
• Modern Slavery/County Lines: Follow local pathways; consider National Referral Mechanism (NRM) for adults with consent (or without where necessary under statutory guidance).
• Domestic Abuse: Follow MARAC pathways where high risk.

Documentation checklist

• Assessment including substance use screening.
• Capacity assessment(s) and best‑interest decisions where applicable.
• Substance Misuse Risk Assessment and Support Plan (including house rules).
• MAR charts; CD register entries (as required).
• Incident forms; body maps (if applicable); safeguarding referrals; CQC notifications.
• Multi‑agency meeting notes and action plans.
• Training records; supervision/debrief notes.
• Audit tools and governance reports.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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