Turning Point Drug and Alcohol Wellbeing Service - City of Westminster and RBKC

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is our first inspection for this service. We rated this key question as good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff and leaders were proud of the strong organisational culture which championed the employment of people with lived experience in a variety of roles, including leadership. We heard that around a third of staff working for the service had lived experience. The service had developed a dedicated workshop to support staff to use their lived experience safely and effectively.

The service provided opportunities for clients to train as peer mentors and progress to employment. The peer mentors we spoke with were extremely positive about the service and the support they received. One said: “It’s my second home. I have support and connection here”. They were motivated to use their lived experience to help other people. A peer mentor said: “It gave me a feeling I’m needed”. Clients were positive about staff with lived experience and found them empathetic. Feedback from partner agencies supported this. One stakeholder told us that Turning Point inspired them as a partner agency to utilise the benefit of having staff with lived experience.

Staff and managers said they felt they could contribute to the provider’s strategic priorities and understood how they were applied in the work of their teams. Staff, volunteers and clients had opportunities to participate in these discussions. These included reflective practice sessions, surveys, listening events, away days, forums and networks, employee engagement meetings, the provider’s National Service User Council and focus groups. Service user representatives recently took part in consultations with the local authority to support the development of the Borough’s substance use strategy.

Senior leaders actively encouraged the participation of client representatives in developing and improving the services. For example, leaders recently proposed to involve people with lived experience in the commissioning process and on the provider’s research committee.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service had a well-established team of operational and clinical leaders with the skills, knowledge and experience to perform their roles effectively. Leaders had an in-depth understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

Leaders held regular meetings where information was shared and participated in the National Service User Council meetings. Leaders were visible in the service and approachable for staff, clients and carers. Staff reported a friendly, open and supportive culture and a good team morale. They described the leaders as easy to talk to, responsive and supportive. Feedback from partner agency representatives echoed this. They said they found the Turning Point leaders approachable and “very responsive”.

Leadership development opportunities were available for staff. Staff had access to training and development to support their career progression. Several managers we spoke with previously worked for the provider in other roles before progressing to their current positions. One said the leaders were encouraging and supportive in this process. In addition, the leaders were proud of the organisational culture which promoted the value of lived experience and provided opportunities for clients to progress to training, volunteering and employment.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Freedom to Speak Up information for staff was clearly displayed on the premises. Staff we spoke with said they were confident to raise concerns, should they need to. Most said they would be comfortable to do so by approaching the managers.

Clients and carers were involved in decision-making about to the service. They could meet with members of the provider’s senior leadership team to give feedback at various forums. For example, a peer mentor told us about attending the Board meeting, and the provider’s executive and senior leaders regularly attended the National Service User Council meetings.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The service had a number of initiatives around equality, diversity and inclusion. These were inclusion passports for all staff, reverse mentoring (staff from diverse backgrounds mentoring more senior colleagues), inclusion networks (such as autism, neurodiversity, ethnic diversity, disabilities, LGBTQ+), allyship roles, dedicated support for colleagues with lived experience, awareness day calendar and Moving Up (a programme aimed at empowering leaders from minoritised backgrounds). The provider was accredited as a disability, neurodiversity and menopause-friendly employer. The service was also working towards accreditation as a period-friendly workplace.

Staff we spoke with said that the service they worked in was open and inclusive. Staff received training in Equality, Diversity and Inclusion and 99% of staff had completed it.

Staff were able to work flexibly and managers put reasonable adjustments in place for staff if needed. Through a regular staff survey, the provider monitored if staff felt that they were being treated equally and fairly irrespective of protected characteristics under the Equality Act 2010. For example, the staff inclusion passports and reverse mentoring scheme were the outcome of the most recent survey.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service had a clear framework of what must be discussed at meetings on a local or national level. There were mechanisms to share essential information, such as learning from incidents and complaints.

Staff had implemented recommendations from reviews of deaths, incidents and complaints. Staff undertook local audits and participated in the provider’s audit programme. The provider’s central teams carried out additional audits. The audits provided assurance and staff acted on the results when needed. Leaders were aware of areas where improvements could be made and responded promptly to our feedback during the inspection.

Staff worked with other teams effectively, both within the provider and external. The service submitted notifications to the relevant external bodies.

The service had a risk register which detailed an appropriate range of risks specific to the service and mitigations for these. The service had plans in place to ensure business activities could continue at each of its hubs in the event of emergency, such as adverse weather or loss of utilities.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the electronic records system, worked well. Systems used to collect data were not over-burdensome for staff.

Information governance systems included confidentiality of personal records. Managers had access to information to support them with their role. The data on performance, staffing and treatment outcomes was integrated into the provider’s electronic dashboards. The information system allowed timely, accurate oversight and identified areas for improvement.

Staff clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

We received feedback from 8 partner agencies who regularly worked with the service. The stakeholders’ feedback was overwhelmingly positive. They consistently praised the service as an excellent, proactive, open, inclusive and responsive partner, who equally valued and respected their input in the partnership. We heard that despite the somewhat complex health and social care provision in the 2 boroughs, the Turning Point teams had built strong working relationships across all the pathways involved. One stakeholder said: “They are brilliant at working where they had identified gaps”.

Staff and leaders collaborated effectively with a wide range of external stakeholders, such as commissioners, service delivery partners, voluntary and community organisations, statutory agencies and others. This was not limited to professional interactions. For example, staff at the Acorn Hall hub told us about the good relationships they had built with the local residents, church and park wardens.

Staff, peer mentors and clients could meet with members of the provider’s senior and executive leadership team and commissioners. A peer mentor told us about attending a recent Board meeting. The Chief Executive, Medical Director and Clinical Director regularly attended the National Service User Council meetings.

Jointly with other local partners, the staff had developed substance misuse training for other professionals which they provided free of charge. For example, in 2024 the team delivered 89 training sessions to attendees in the 2 boroughs including NHS staff, police, housing and social workers. Staff were planning further training in response to emerging local priorities.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. Leaders always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff actively contributed to safe, effective practice and research.

Innovation and improvement activities were taking place in the service. For example, staff told us about `Click and Deliver', the provider's initiative to widen access to Naloxone (a life-saving medication that can reverse an opioid overdose). Anyone at risk of experiencing or witnessing an overdose could order Naloxone for home delivery free of charge. Staff additionally took this opportunity to promote harm reduction and raise awareness of support available. The service was an early adopter of this initiative.

The service facilitated access to an innovation fund for its staff, local organisations and community groups. People could apply for funding grants for projects aimed at improving the lives of local communities. For example, we heard about projects such as a community garden for clients and mindfulness workshops for local women.

In partnership with other services, the team had developed training for other local professionals to help improve their understanding of substance misuse. Its content was informed by the local priorities. Colleagues from other agencies could access, free of charge, a comprehensive range of training, including an accredited qualification. Staff delivered peer-led substance misuse training for trainee doctors and paramedics at the local universities. Turning Point staff also joined other organisations' training sessions to learn how their respective services operated.

The service had developed a workshop for staff with lived experience to support them to use it safely and effectively. The workshop received positive feedback and was due to roll out across Turning Point nationally.

Staff participated in the provider's annual programme of national audits and learned from them. For example, actions identified from the recent audit of medical reviews included refresher training on using clinical templates. Actions, good practice and lessons learnt from audits were discussed in supervision and clinical meetings to ensure continuous improvement.

The service participated in the provider's accreditation schemes. The service also worked towards accreditation as a period-friendly workplace and had identified improvements to be made in this area.