We are With You - Rotherham

On this page

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

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We looked at 6 care records during the assessment. Staff completed a comprehensive mental health assessment of each person in a timely manner at, or soon after, referral. Staff assessed patients’ physical health needs in a timely manner, during the initial assessment.

Staff developed care plans, but they weren’t always comprehensive and easy to find. Some clients had handwritten care plans, but the service was working towards every person having these in place. There was evidence of personalised, holistic and recovery orientated goals being discussed with clients and these were well documented in daily notes from each appointment. Clients told us that they were clear about their care and next steps.

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 access to medication, one to one key working sessions and access to an extensive range of recovery groups.

The group work programme ran across 6 days and including several evenings to ensure that people who worked or had childcare commitments could maintain access to the support that they required. However, some clients told us that they felt access on an evening was limited. A range of groups were available which included information sharing, social activities, support groups and groups to help people develop skills, such as relapse prevention and job seeking.

Staff participated in clinical audit, they carried out a range of monitoring to ensure that they could assess and improve the quality and effectiveness of work that staff were carrying out. We saw a sample of audits which included medicines management, stock rotation, infection control and the management of clinical waste. These audits contained actions and suggested feedback where it was needed.

The team included, or had access to, a full range of specialists required to meet the needs of clients, which included those needing support for alcohol, opiates, non-opiates, young people and those in and around the criminal justice system. The team included doctors and nurse prescribers, key workers, hospital liaison, shared care workers, pharmacists and people with lived experience, some working as volunteers.

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.

Managers ensured that staff had access to regular team meetings. These meetings were well attended and covered a range of topics to meet the needs of staff who came. This included data and performance, caseload management, training and development, safeguarding and learning from incidents.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. For example, we saw evidence of training in relation to new and emerging drugs and trends that were relevant to the local community.

Managers dealt with poor staff performance promptly and effectively.

Staff held regular and effective multidisciplinary meetings. Staff used a system to book slots if they thought a multi-disciplinary approach would be helpful. Because the majority of staff worked in one building, it was easy for staff to collaborate and consult if they wanted to.

Staff shared information about people using their electronic client record, and, although some aspects of the care record required improvements, they were still well used to ensure that clients only had to tell their story once and staff knew where to find the most important information. This meant that different teams working across the organisation could work effectively with each other.

The teams had effective working relationships with teams outside the organisation for example, local authority social services and shared care GP’s and pharmacies.

Staff supported clients to live healthier lives, they did this through participation in smoking cessation schemes, offering healthy eating advice, screening for blood borne viruses and access to a range of harm minimisation equipment which included take home naloxone kits. Where necessary staff also supported clients to prepare for and access detox and rehabilitation programmes.

Activities were offered to promote a healthy lifestyle for clients such as walking groups and sports activities.

Staff used recognised rating scales to assess and record severity and outcomes. This enabled them to use data to track individual progress but also contributed to data sets which enabled staff to assess their performance as a complete service.

Staff used technology to support clients effectively for example, to gather feedback from clients and staff. They were also able to use visual aids such as charts and graphs to help people see what progress they were making and to set goals.

The organisation also had a bank of easily accessible practical exercises that staff could access for specific interventions that might support someone’s recovery journey.

Staff took all practical steps to enable clients to make their own decisions about their treatment, they made sure that people had access to all of the information that they needed. For people who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately.