Wear Recovery

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff assessed the physical and mental health of all clients. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for clients based on national guidance and best practice.

The team included or had access to the full range of specialists required to meet the needs of clients using the service. Staff from different disciplines worked together as a team to benefit clients.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We looked at 10 care records during our inspection.

We saw evidence that staff completed comprehensive assessments of need including the client’s history of substance misuse. Assessments identified clients’ recovery capital and support networks.

Staff ensured that clients had a full physical health assessment and knew about any physical health problems. Staff developed a comprehensive care plan for each client that met their mental and physical health needs and made referrals or signposted clients to external healthcare services when required.

Staff regularly reviewed and updated care plans when clients' needs changed.

Care plans were personalised, holistic and recovery-orientated and identified the client’s keyworker.

Staff responded promptly to any sudden deterioration in a client's health, for example the management and response to a client’s relapse.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence. These included substitute prescribing, psychosocial interventions, activity groups and blood born virus testing. Staff also provided clients with training and work opportunities intended to help clients acquire living skills.

Staff ensured that clients had good access to physical healthcare, including access to specialists when needed. Clients and carers commented that they had worked in partnership with staff to create structured treatment plans, care plans and relapse plans provided.

We saw evidence in care records that staff routinely offered blood borne virus testing to clients and supported them to access treatment for any viruses detected.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. These included the auditing of care records to ensure staff were including all relevant information such as clients’ goals, whether naloxone had been offered/accepted by the client and, to ensure there was evidence care and treatment was developed in partnership with the client and, if consent given, with their family and friends. The provider’s assurance team had also conducted a ‘mock inspection’ based on the Care Quality Commission’s inspection methodology and its findings were used to improve the service.

Managers tracked open safeguarding cases to ensure that any recommendations from the local authority were followed up and implemented where necessary.

The team included or had access to the full range of specialists required to meet the needs of clients in the service. This included nurses, recovery coordinators, social workers, a consultant psychiatrist, a consultant psychologist, counsellors, family support practitioners, a healthcare assistant, mental health professionals and primary healthcare professionals such as GPs.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the client group.

Managers provided new staff with appropriate induction. They ensured that staff had access to regular team meetings.

Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance.

The percentage of staff that had had an appraisal in the last 12 months was 76% and the percentage of staff that received regular supervision was 53%.

There were mitigating factors for the low supervision and appraisal compliance rates. At the time of our inspection 4 members of staff were absent from work due to long term sickness. One member of staff had changed role and had only completed induction in March 2025, so their appraisal was not yet due. Three staff members had only recently been appraised and were not reflected in the current data. Eighteen members of staff had received 3 supervision sessions, but their fourth session was not due at the time of reporting. In addition to 1 to 1 supervision, staff also had access to caseload support, reflective practice sessions led by a consultant psychologist, safeguarding support sessions, peer support and integrated governance team meetings.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge.

Managers ensured that staff received the necessary specialist training for their roles. Specialist training undertaken by staff included harm minimisation, safeguarding surgeries, suicide prevention, trauma informed care and motivational interviews.

Managers dealt with poor staff performance promptly and effectively. The provider had a performance management system which helped managers to manage poor performance in a timely and appropriate manner.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings.

Staff shared information about clients at effective handover meetings within the team.

The teams had effective working relationships, including good handovers, with other relevant teams within and outside the organisation such as local authority safeguarding teams, social services and GPs.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported clients to live healthier lives. Clients told us staff had provided a high level of support for their physical health, including free 3-month gymnasium memberships, health monitoring, and encouragement of healthy lifestyles such as nutrition and exercise.

Staff had signposted clients to counselling opportunities.

Clients had access to health clinics within the service hubs. These included a sexual health clinic, offering contraception, cervical screening and testing for sexually transmitted diseases and a fibro scan clinic providing diagnostic screening and onward referrals as required in relation to liver health.

routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record severity and outcomes. These included AUDIT (alcohol use disorders identification test) for clients with alcohol problems, DAST (drug abuse screening test), TOPS (treatment outcome profiles), SADQ (severity of alcohol dependence questionnaire), RAG (risk assessment grading) ratings and a wellbeing scale. The provider also had its own risk review built into its care records system.

Staff used technology to support clients effectively. We saw evidence in care records that staff had signposted clients to online self-help tools to aid with their recovery.

Staff submitted reports about care and treatment outcomes to the National Drug Treatment Monitoring System (NDTMS).

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable clients to make their own decisions.

We saw evidence in care records that staff assessed and recorded clients’ capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When clients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

We saw evidence in clients’ care records that clients had agreed and signed consent to treatment forms. We also saw evidence that staff had recorded which parties clients had agreed for staff to share information with about their care, treatment and current health status.

100% of staff had had training in the Mental Capacity Act.

Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. They were able to identify where mental capacity was a concern in a client consenting to treatment.

Staff knew where to get advice from within the provider regarding the Mental Capacity Act and capacity assessments or pathways into local community mental health teams for support.

When clients lacked capacity, staff ensured decisions were made in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

The service had protocols and policies in place to manage clients whose capacity was temporarily impaired due to the use of illicit substances or inebriation.