Aspire Havering

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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.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

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

We reviewed 10 care records during the inspection.

Care records demonstrated that staff assessed needs comprehensively and delivered care in line with best practice, supporting individuals in their recovery journey.
We saw evidence that staff completed assessments of clients’ needs, including detailed histories of substance misuse. Assessments also considered individuals’ recovery goals, including their strengths, support networks, and wider social circumstances. Following assessments, clients received personalised care plans tailored to their individual needs and recovery goals. Care plans were holistic, recovery-oriented, and clearly identified the allocated key worker. They reflected a person-centred approach and included input from clients to support engagement in treatment.

Staff regularly reviewed and updated care plans to reflect changes in clients’ needs and circumstances. We saw evidence that staff responded promptly to deterioration in clients’ health or wellbeing, including appropriate management and support following relapse.
The service provided a range of evidence-based interventions to support individuals with drug and alcohol dependence. Treatment options included medically supported alcohol and opiate detoxification and stabilisation programmes, structured one-to-one key working sessions, and group recovery programmes.

Clients also had access to medical support through doctor and nurse-led clinics, where they received physical health checks and ongoing monitoring. The service worked collaboratively with other health and social care providers to ensure care was coordinated and met the holistic needs of clients.

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.

The service delivered care and treatment in line with best practice guidance and demonstrated ongoing efforts to improve pathways and interventions to better meet the needs of clients. Staff provided a range of care and treatment interventions appropriate to the needs of the client group. These interventions were evidence-based and delivered in line with guidance from the National Institute for Health and Care Excellence (NICE). Interventions included substitute prescribing, psychosocial interventions, structured activity groups, and blood-borne virus testing.

The service also supported clients to develop practical life skills through access to training and work-related opportunities, helping to promote independence and sustained recovery. One client told us the training programme had supported them to make significant progress in their recovery. They reported that they had recently gained employment and felt their life was now improving. They described the service as “really good”.

The service demonstrated a commitment to service development and continuous improvement. For example, staff identified a gap in provision for clients being discharged from acute hospital settings who required ongoing alcohol detoxification. In response, the service developed a clinical pathway to support continuity of care, enabling clients to continue their detoxification safely within the community.

The service developed a standard operating procedure (SOP) for community-based opiate detoxification. This provided staff with clear guidance to support safe and consistent practice when delivering detoxification in community settings. Staff used these interactions as opportunities to deliver brief interventions, including harm minimisation advice and safer injecting guidance, to reduce risks associated with substance use and support engagement with treatment.

Staff received a range of training relevant to their roles, including motivational interviewing, trauma-informed care, smoking cessation, autism awareness, needle exchange, and specialist drug and alcohol interventions. This supported staff to deliver safe and effective care to people using the service. The team included the full range of specialists required to meet the needs of clients in the service.

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.

We saw evidence of multidisciplinary working, which was well embedded, with effective communication systems in place to support safe, coordinated, and person-centred care. Staff held regular and effective multidisciplinary team (MDT) meetings to support coordinated care and information sharing. The service held three MDT meetings each week, including zoning meetings, alcohol MDTs, and opiate MDTs. These meetings enabled staff to review client risk, treatment progress, and care plans, ensuring appropriate oversight and timely decision-making. The service also held joint MDT meetings with mental health services and NHS providers to review shared clients, ensuring coordinated care for individuals with co-occurring mental health and substance misuse needs. In addition, a family service was available within the recovery hub, offering support to families affected by substance misuse and helping them cope with its impact and improve their overall wellbeing, supporting a more integrated approach to care.
Staff shared information about clients effectively through regular handover meetings within the team. Daily morning briefings, zoning meetings, and MDT discussions were used to maintain oversight of the caseload and respond to emerging risks.

The service demonstrated effective working relationships with other teams both within and outside the organisation. This included partnership working with local authority safeguarding teams, social services, and GPs to support holistic care.

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.

Clients told us staff supported them to improve their physical health and wellbeing.
Clients told us they received advice on healthier lifestyles, including diet, exercise, and smoking cessation, and were supported to access health clinics and external healthcare services such as GPs and sexual health services. For example, one client told us they had been referred to their GP due to concerns about high cholesterol and prediabetes and were also referred to a mental health nurse for additional support.

The service also supported clients to reduce or stop smoking through a vape support offer, including access to a drop-in vape service. This provided additional harm reduction support and encouraged clients to make positive changes to their health.

We scored the service as 3. The evidence showed a good standard. The service 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.

The service used systems and technology to support effective care delivery and monitor outcomes. The service maintained a clear dashboard, which provided oversight of key performance indicators, including caseload data and the provision of naloxone. Data was produced weekly, using the Treatment Outcomes Profile (TOP) tool to monitor patient progress during substance misuse treatment. This enabled staff and managers to track outcomes, identify areas for improvement and inform risk discussions in MDT meetings.

Staff used technology to support clients effectively. Care records showed that staff signposted clients to online self-help tools to support their recovery and promote ongoing engagement outside of structured sessions.
Staff submitted monthly reports about care and treatment outcomes to the National Drug Treatment Monitoring System (NDTMS), supporting national reporting requirements and contributing to wider service evaluation.

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 demonstrated a good understanding of consent and capacity, ensuring care and treatment were delivered in line with legal requirements and best practice.

Care records showed that staff assessed and recorded clients’ capacity to consent appropriately. Capacity assessments were completed on a decision-specific basis, particularly in relation to significant decisions about care and treatment.
Staff had received training in the Mental Capacity Act (MCA), which supported them in understanding and applying the principles in practice. Staff told us they knew where to seek advice within the organisation regarding the MCA, capacity assessments, and appropriate pathways into local community mental health teams when additional support was required.

We saw evidence that clients had provided informed consent to treatment, with signed consent forms clearly documented in care records. Staff also recorded clients’ preferences regarding information sharing, including which individuals or services they had agreed staff could share information with about their care, treatment, and current health status.
Where clients had children, appropriate information was recorded, including the age of children and any identified risks. Plans and support relating to children were clearly documented, and safeguarding considerations were discussed in multidisciplinary team meetings with social services where required. Consent processes in these cases were also appropriately completed and recorded.