New Vision Bradford

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 the first assessment for this service. This key question has been rated Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities. The provider’s clear vision and strategy had people at the heart of the service, which staff understood and supported.

Staff we spoke with knew and understood the provider’s vision and values and how they were applied in the work of their team. Many staff cited kindness as one of their integral values and could provide examples of how they applied this to their role. Some staff told us courage was one of their key values. Examples of how this applied to their role included being resilient to challenges and being persistent when seeking support or referrals to other services.

The organisation was in the process of developing a new strategy. In the interim, managers developed an 18- month bridging strategy. The strategy set out five key aims including maintaining high quality services, focussing on the people it supported, and further developing local services and partnerships to make sure more people get the support they need in their communities.

The organisational vision was to break down the barriers that stopped people getting the support they needed to live a life they value. Staff and leaders could give extensive examples of how they aimed to do so, including projects and campaigns which aimed to reach out to the community, and to improve access to those people least likely to access the service.

The management team told us the provider was a values driven organisation. Key partners echoed the excellence of the vision, direction and culture of the service. One staff member at the local ambulance service told us, " [New vision] is a fantastic service. What they do for the clients is unbelievable. The support I have seen them offer clients first hand is incredible. Everything they do- the way that they encourage clients. They do everything in their power to make sure that the service users get the best out of themselves.

Managers had embedded key aims within the organisational strategy into the day to day running of the service. For example, staff recognition at quarterly all staff meetings was aligned to some of the key aims within the organisation strategy. This meant staff received awards and recognition for areas including going above and beyond, delivering results, working together, and by leading and inspiring others.

The culture of the service was extremely person centred, inclusive and empowering. Personalised care based on equal rights for all, was pivotal to the services beliefs and operation. This was brought about through the exceptional and clear leadership and through the values and goals shared by all. Staff had the opportunity to contribute to discussions about the strategy for their service and other changes to improve service delivery. There were staff working groups to discuss changes within the organisation. Staff at all levels told us there was a consultative approach to work across the service.

Managers could explain how they were working to deliver high quality care within the budgets available. For example, they told us they had reduced the caseloads for their rough sleeper’s team and made changes to the criteria for this client group. They told us this enabled staff to work with a broader range of clients, which freed up their capacity to support other teams.

The service had competent and 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 and experience to perform their roles. They had a good understanding of the services they managed and could explain clearly how the teams were working to provide high quality care.

Leaders were visible in the service and approachable for clients and staff. Staff spoke extremely positively about managers and senior leaders. The Director of services visited the site once a week and the Chief Executive of the organisation also visited sites regularly. Staff told us managers were easily accessible. Several staff fed back that they felt there was no hierarchy within the service.

Leadership development opportunities were available, including opportunities for staff. Many staff described how they had progressed within the service and told us this was something managers actively promoted. One manager told us that nearly all staff within the senior leadership team had progressed from front line roles, including recovery coordinators.

Staff fed back that there was accountability within the service at all levels. They told us that management were very transparent and listened to staff and clients. Staff advised us that their leaders were accessible and transparent. Staff felt confident in their leaders and able to go to them for support whenever they required this. Staff advised us that the leaders of their service were inclusive and reflected that of the local community, as they had leaders of different races, culture and religious backgrounds.

There was overwhelmingly positive feedback about people’s experience of the service. The inspection team noted that when they spoke to clients they spoke very highly of the staff and the care and support they received. Clients told us clearly about the care, dedication and compassion received from the staff teams who supported people.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The provider valued and listened to the views of staff. Staff were given opportunities to provide feedback about the service and their opinion was valued.

There was a concerns process in place which allowed staff to submit concerns either anonymously or directly by email, telephone or through an online portal. All submissions were directed to central services within the organisation. They ensured there was process for the concerns to be reviewed independently outside of the senior leadership team. The service ensured staff could provide feedback via an annual staff survey. Staff could also provide feedback or raise concerns at daily flash meetings and quarterly all staff meetings.

Managers and staff had access to the feedback from clients, carers and staff and used it to make improvements. Staff were invited to senior leadership meetings to feedback on information they gathered from the workforce.

Staff told us managers could make reasonable adjustments to accommodate their individual needs and personal circumstances. Long term changes were made via flexible working applications, but managers could make short- term adjustments, for example to working hours if needed. Some staff had adapted workspaces, work from home arrangements, and amended hours in place.

Staff and leaders all described a transparent culture and told us they felt comfortable raising concerns if they needed to. There were many means of communication to ensure an open and transparent culture including weekly newsletters, Microsoft teams channels and by email.

Patients and carers had opportunities to give feedback on the service they received in a manner using a variety of avenues in a way that reflected their individual needs.

Staff and leaders described how they valued diversity within the workforce. They gave examples of how they worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff completed equality and diversity training. Training compliance across the service was currently 100%. There were equality and diversity leads within the service who worked alongside the marketing and communications team to ensure events were well promoted and that regular communication and information was shared with staff.

There was an equality, diversity and inclusion forum, within the organisation who arranged various events throughout the year including facilitating a stall at the local pride festival. Staff also spoke passionately about a recent art exhibition celebrating black artists as part of black history month.

On international men’s day the service held a session which managers described as a safe space for male employees. This included lunch, exercises and open discussions about people’s experiences. Managers said this was very well attended and that they received positive feedback about the event.

Staff could apply to work flexibly to account for personal circumstances such as caring responsibilities and health issues. Managers put reasonable adjustments in place for staff members to help them carry out their role.

The service undertook equality monitoring of staff within the service to ensure it was diverse in its make-up and representative of the client group. Information about the background and demographic of staff was stored on an electronic dashboard which managers captured during the recruitment process.

The service had a diverse workforce that reflected the needs of the local community. The workforce had individuals from different race, backgrounds, sexuality, gender, culture and religion. The service recognised and were proactive in ensuring the workforce met the client’s needs. Managers had recently introduced a European worker who was of the same nationality as a specific group of clients. This was following feedback about language barriers and communication needs. Managers spoke positively about this and told us feedback within the district had been very positive. During a morning ‘flash’ meeting we observed that managers allocated the task of completing a client assessment to a staff member who spoke the same language.

Staff advised us that leaders were sensitive to cultural and religious events such as Ramadan, Pride and Disability events.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support.

Managers had access to all information needed to support them with their role. This included information on the performance of the service, staffing and patient care. Managers received and reviewed reports concerning different elements of the service including successful completion of treatment rates, risk assessment and recovery plan compliance, and waiting times for initial assessments. Information was in an accessible format, and was timely, accurate and identified areas for improvement. There were effective systems in place that ensured staff received mandatory training. These figures were collated centrally and the senior management team had oversight of any fluctuations or anomalies to the figures.

There was a clear framework of what must be discussed at a ward, team or directorate level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level. Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. The service audited and completed stock checks of medicines and pharmacists audited prescriptions charts and provided managers with information on prescribing patterns. Managers reviewed these regular to identify any prescribing outliers.

Managers had fully embedded the arrangements for working with other teams, both within the service and external, to meet the needs of the clients. Staff we spoke with fully understood and could explain the joint working arrangements in place to provide high quality care.

There were very effective systems in place for the management of risk, issues and performance. Managers used an electronic ‘priority tracker’ to monitor core interventions, pending reviews and appointments and completed tasks. Recovery workers used the tracker to manage their caseloads.

Staff maintained and had access to the risk register at site and overall service level. Staff at site level could escalate concerns when required. We reviewed the risk register and saw that each risk was graded in terms of severity, with actions in place to mitigate the risk, and regular review dates in place.

The service had plans for emergencies – for example, adverse weather or a flu outbreak. There were continuity plans in place for each site which had been reviewed within the last 12 months. These set out contingency plans for key areas of potential service impact including staffing, loss of internet or adverse weather.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care. Information governance systems included confidentiality of patient records.

The service understood their duty to collaborate and work in partnership, so that services worked seamlessly for people. They shared information and learning with partners and collaborated to identify and implement improvement. The provider collaborated closely with local, regional and national stakeholders and partners to develop, review and evaluate the service to ensure it consistently met people's needs.

Care records and staff interviews demonstrated that staff had excellent working relationships with a wide range of external partners and agencies. Staff regularly liaised with stakeholders including local hospitals, GP practices, mental health services, social services, charities, local religious centres, criminal justice services and community groups.

Staff worked collaboratively and had found effective ways to deliver joined-up care and treatment. This included the introduction of a dedicated women’s clinic which took place at the Pelican House site. This was attended by a local GP, sexual health services and a domestic violence advocate. The clinic offered a range of activities for clients and provided a safe place for clients to speak with staff, a range of health professionals, and their peers. Clients could receive support with birth control, sexually transmitted infection testing and cervical cancer screening

Staff and managers at all levels demonstrated knowledge of their responsibilities around partnership and collaboration with services to meet the needs of their clients and ensure they could access other services locally if needed. This included supporting clients to attend volunteer – led services in the community that provided a range of support including psychosocial interventions, groups sessions and aftercare for people including those with substance misuse issues. Staff worked with a local charity who supported clients from the service to attend group sessions focussed on the specific substance they had a problem with.

Staff were supported and encouraged to acquire new skills, use their transferable skills, and share best practice with external stakeholders. Staff had provided training on Naloxone to several supported housing sites and pharmacy staff.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. It always encouraged creative ways of delivering equality of experience, outcomes and a better quality of life for people. Staff were given the time and support to consider opportunities for improvements and this led to positive changes. Mangers could describe a range of quality improvement projects within the service. There was an ongoing project to review the community detox pathway to widen the availability of the pathway for those clients who were suitable for it. This involved working with staff to ensure they were confident delivering the pathway and able to identify the criteria for community detox. Managers told us they recognised that there was potential for more scope within the community detox team.

The service had completed a ‘You Can Save a Life Campaign’. This involved partnering with the local university, general hospital, police service and a private medical provider. The campaign focussed on raising awareness about how Naloxone reverses the breathing difficulties for individuals who are experiencing an overdose of opiates, and how this can save the lives of people with substance misuse issues. The service produced a campaign video which was shared on social media and via a big screen in the city centre. This led to media interviews on television, the radio and in a local magazine. The service also created posters about Naloxone and described the overall aim as to raise awareness about the medicine and to train as many people as possible to be able to administer it.

As part of the campaign, staff trained more than 200 external partners including fire and rescue and probation staff to administer naloxone. Managers told us that one fire and rescue worker had used this training in practice to support an individual in the community who was found unresponsive. The campaign also resulted in staff delivering Naloxone training to members of the public, outreach workers at the local water company, and staff at various housing associations. The service had also trained over 1000 student nurses in the use of Naloxone. This campaign was the first of its kind nationally and won a Student Nursing Times national award.

Staff and leaders told us that increasing awareness around substance misuse and reaching out to those people least likely to access treatment was one of the service’s key priorities. They hosted several events during alcohol awareness week, which they said played a key role in delivering the service’s annual engagement strategy. The campaign aimed to encourage individuals and workplaces in the area to reflect on their drinking habits, make healthier choices and seek support where needed. Nurses, recovery coordinators and team leaders held stalls at across Bradford and Keighley, offering interactive sessions, which they advertised on social media. Staff used educational resources from Drink Coach, Alcohol Change UK, and Public Health England to engage the public. They also provided people with a range of tools to support them to monitor their own alcohol consumption or reflect on their drinking habits including alcohol cups, unit wheels, and alcohol diaries There were also stalls at each of the hubs for clients to engage with staff. Managers told us the event was successful and led to number of new referrals throughout the week.

Following concerns about the use of synthetic opiates in the local area, managers created a crisis response plan and standard operating procedure in response. This was shared with the government who highlighted this as good practice and was acknowledged in a published government report.

Quality performance managers completed annual mock CQC inspections to measure the performance of the service against. Their most recent mock inspection led to improvements regarding noticeboards, mental health information, the complaints processes, a review of the needle exchange environment, and family/ carers engagement.

Managers completed client case studies which they used to identify good practice. We reviewed four case studies and saw that these contained action taken and staff interventions which had supported clients throughout their pathway. Managers shared the case studies with staff to embed learning throughout the service.

Other recent innovations included setting up a specialist support team for individuals who used substances as a form of pain management.