New Vision Bradford

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 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.

This service scored 79 (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 made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them. We reviewed 5 sets of care records and saw that recovery workers completed a comprehensive initial assessment of the client in a timely manner. Staff assessed clients’ physical health on admission and arranged referrals to external services for identified physical health needs. Staff monitored ongoing physical health needs during one-to-one sessions.

Recovery plans were personalised, holistic and recovery oriented. The plans we reviewed identified the client’s individual needs, wishes and preferences and set out ways to manage any risks. Staff updated care plans regularly.

The service continuously 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. Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance.

Staff protected the rights of patients subject to the Mental Health Act and Mental Capacity. This included arranging mental health assessments and referring clients to mental health services where necessary.

We observed a daily flash meeting, which staff used to hand over information and updates about clients. This included any hospital admissions, risk alerts, and safeguarding concerns. During the meeting we saw that staff referred to the psychological and emotional needs of clients, their relatives and carers.

Staff we spoke with told us they had the opportunity to discuss training needs with their line manager and were supported to develop their skills and knowledge. Staff spoke positively about a range of additional training and shadowing opportunities available to them and said their managers were proactive in developing their skills to enable them to progress within the service.

Managers made sure staff received any specialist training for their role. This included training on substance misuse and the impact on the body, harm reduction techniques, and training in how to reach out to people who were underrepresented within substance services.

Managers identified poor staff performance promptly and supported staff to improve either through one-to-one support or by implementing performance plans with support from the human resources team. There was a performance management policy which was up to date and subject to regular review.

We found that managers took a very proactive approach in recruiting and training volunteers to work with clients in the service. There was a dedicated volunteer coordinator to support clients who had been through the services to volunteer at the service. Staff had ongoing discussions with clients about the volunteer programme throughout their pathway, to encourage them to take part where it was appropriate. They also reminded them about volunteering opportunities during aftercare.

There were 33 active volunteers across the service, with 38 volunteers at the onboarding stage, and a further 9 due to be onboarded at the next cohort. Managers told us that volunteers accounted for approximately 17% of the total workforce, within this potentially increasing to over 30% once the onboarding of the next cohort was completed.

Roughly 30% of the current workforce had lived experience of substance misuse, although this figure fluctuated. Managers described how they often recruited into substantive posts from the volunteer pathway.

We spoke with 3 volunteers who were all extremely positive about their volunteer work. All 3 confirmed they had received a full induction. They also told us they received ongoing support and guidance from from staff and expressed an interest in applying for a substantive role. Volunteers told us managers considered their needs, skillset and availability which they used to personalise their work. They supported with a range of duties including initial contact calls, preparing indication packs, creating drink diaries, and supporting with group sessions. Managers also arranged for volunteers to attend a local college to complete health and social care training levels 1-3.

The service told us about their ‘beating hearts campaign’ which trained volunteers and clients in recovery in the use of cardiopulmonary resuscitation and defibrillators. Managers also arranged for the local ambulance service to deliver additional training to some volunteers to enable them to facilitate this training themselves.

Staff and client interviews, care records and a review of various documents provided by the service showed that staff worked across health care disciplines and with other agencies when required to care for clients. There was evidence of excellent, proactive joint working with social work teams, mental health services, GP practices and the local hospital.

Staff held regular and effective weekly multidisciplinary meetings to discuss clients to help improve their care. Recovery workers alerted managers to any clients they felt needed to be discussed or clients they needed support or guidance about. Multidisciplinary teams were well attended and included managers, doctors, nurses, clinical leaders, team leaders and recovery workers and volunteers.

Staff regularly liaised with GPs, and the electronic records system showed effective two-way communication. Staff liaised with GPs regarding prescribing or medicines issues, and alerted GPs to any treatments they administered to clients.

There was evidence of good joint working with the local hospital’s alcohol care team, with regular information sharing taking place. There were arrangements in place for the hospital to let staff know if a client was admitted to general hospital including treatment given and plans for discharge. Staff also shared information with the general hospital to escalate client’s physical health concerns and provide advance notice that a client was due to attend the hospital.

Staff referred patients for mental health assessments when they showed signs of mental ill health such as depression. Staff and managers knew who the designated points of contact were at the local mental health crisis teams, and inpatient mental health services.

There was evidence of good working relationships with residential rehabilitation services, and staff worked with these services to facilitate placements for clients who were clinically appropriate for treatment.

Staff provided an example of how they worked with other services in response to a crisis. This included working with a housing service, social services, adult social care services and a GP practice to support a vulnerable client who was homeless. Staff fast tracked the client to the rough sleeper workers caseload, implemented robust interventions and recovery plans. They worked with other services over a 48- hour period to ensure the client’s safety and meet multiple complex needs. During that period staff arranged for the client to receive a physical health assessment and an alcohol assessment.

They also worked with stakeholders to arrange accommodation for the client and supported the client to attend a local job centre and benefits agency. Staff also liaised with the local general hospital to arrange for the client to attend an appointment. Managers spoke passionately about the work of staff in managing this situation and told us the recovery coordinator had worked continuously for 2 days to support the client.

The service monitored all client’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of clients themselves. Clients were involved in discussions about planning their own outcomes including their goals and specific achievements.

Staff supported clients to live healthier lives through participation in smoking cessation schemes, healthy eating advice, managing cardiovascular risks, screening for cancer, and dealing with issues related to substance misuse.

The service had relevant information promoting healthy lifestyles and support at each site. Clients had access to free gym memberships. Clients under the aftercare service could access bowling and equestrian clubs.

One client we spoke with told us they were provided advice about lowering their sugar consumption. Another told us they were directed to the NHS website for information regarding their mobility problems.

Nurses provided advice and support around achieving a balanced diet and encouraged clients to consume health food and fluid.

Clients told us staff supported them in creating plans to prevent relapse, reducing their potential future need for care and support. This included providing access to a range of internal group sessions, and signposting clients to external services including Alcoholics Anonymous and Narcotics Anonymous. One client told us staff supported them to attend ‘Sober Butterfly’, a voluntary alcohol-free community which aimed to combat social isolation and raise awareness of social anxiety.

Staff completed screening relating to risks of viruses not related to substance misuse and offered information and guidance about what the screening involved, and any future treatment that might be needed as a result. Clients told us they had been offered holistic support around their health needs from the service.

Care records showed that staff used a nationally recognised screening tool to monitor client at risk of malnutrition. Specialist support from staff such as dietitians and speech and language therapists was available for clients who needed it, and staff arranged this via the local GP.

The service monitored client’s care and treatment to continuously improve it.

Clients told us that they were supported by the staff team and attended meetings with a range of different professionals involved in their care.

Recovery plans contained appropriate assessments which were updated frequently to measure outcomes and progress. Managers completed audits of care records to ensure these were comprehensive and that recovery plans and risk assessments were updated and reflected individual client need.

We observed that clients discussed their expectations around outcomes for the care they received with their recovery workers. Staff discussed clinical and personal expectations during individual and group sessions. We saw staff communicating positive progress with clients during the group sessions we observed.

The service monitored client readmissions. 14% of clients who were successfully treated for opiate use had re-presented at the service within 6 months. This was 11% for non-opiate use, 15% for alcohol use, and 13% for alcohol and non-opiate use. This information helped the service better understand what they could do differently to support people to remain abstinent.

Staff assessed and recorded capacity to consent clearly each time a person needed to make an important decision. Records showed that staff gave people a wide range of support to make specific decisions for themselves before deciding they did not have the capacity to do so. When staff assessed clients as not having capacity, they made decisions in their best interests and considered the individual’s wishes, feelings, culture and history.

We observed a client appointment and saw that the staff member gave the client the full information required to make the specific decision in relation to their care.

There was evidence in care records that staff routinely recorded client’s consent to care and treatment.

Staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff we spoke with understood how and when to assess whether a client had the capacity to make decisions about their care. They understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act, Mental Capacity Act 2005 and they knew who to contact for advice. They could describe and knew how to access policy and get accurate advice on Mental Capacity Act and Deprivation of Liberty Safeguards.