Forward Leeds - Kirkgate

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated outstanding: This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

We have not awarded this service a score for Responsive.

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

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service provided exceptional person-centred care, with people consistently placed at the heart of decisions about their treatment, recovery and support. Care was tailored to people’s individual needs, circumstances, preferences and goals. Feedback from clients and external services confirmed that care was highly personalised and that the service was exceptional in the way it adapted support to meet individual needs.

The service demonstrated a strong understanding that different groups of people required different approaches to achieve positive outcomes. We found examples of care being specifically tailored to people’s needs, including access to dental provision and targeted support for people involved in sex work. The service also invested in staff knowledge and skills through areas such as chemsex training, enabling staff to better understand emerging and specific substance misuse issues and provide more appropriate support.

Recovery workers had received motivational interviewing training to strengthen their interactions with clients. Staff told us this had improved their ability to communicate in a way that encouraged engagement, supported people to identify their own goals and helped them achieve better outcomes. Staff used these skills to build trusting relationships and ensure people remained actively involved in decisions about their care.

Care records demonstrated that staff routinely sought people’s views about their goals, preferences and desired outcomes and used this information to shape their support. Staff and managers provided numerous examples of adapting care in response to individual circumstances, including changes in people’s needs, levels of engagement, risks and personal preferences.

People were supported to make informed choices about their treatment and recovery, with staff working in partnership with them to agree how their needs should be addressed. Staff demonstrated flexibility in how and where support was provided, ensuring that practical barriers did not prevent people from accessing care. This included adapting appointments and providing support in people’s homes when they were unable to attend the hub.

Staff worked collaboratively with other agencies where this was needed to ensure people received coordinated support that reflected their individual circumstances.

We scored the service as 4. The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had a deep understanding of the health and care needs of clients and their local communities. Care was joined-up, flexible and supported choice and continuity.

Managers planned and organised services, so they met the changing needs of the local population. Staff advised us of the diverse health and cultural needs of the local community, including clients of different ethnic origins and cultures, women with health needs, rough sleepers, and clients with refugee status. There were many joint working arrangements set up to support the needs of the local community. For example, the service had formed a working relationship with a homeless outreach partnership to ensure a multi-agency approach to supporting people living street-based lives. The service had strong partnership working with various agencies and organisations working to support people who were living street-based lives including begging, sex working and those that contributed to antisocial behaviour.

Staff ensured that clients had access to education and work opportunities through an individual placement support team. Dedicated practitioners met with clients to support with writing their curriculum vitae (CV) and making job applications. Staff also provided ongoing support for clients when they started in their roles. The team had built strong connections with local employers including NHS, hospitality, and transport services.

The service had a fully integrated system in place to ensure clients had access to aftercare at 5 Ways, the sustained recovery service. Clients confirmed they could have discussions about aftercare at any point in their pathway.

Care records showed that staff supported clients to maintain contact with their families and carers. Staff ensured family and carers were involved in care at every opportunity. Care records and staff interviews confirmed that staff signposted carers to the local carers support service. We received feedback from this service who spoke positively about Forward Leeds, describing the partnership as “a strong, embedded approach to collaborative working.”

The service had a ‘young carer friendly action plan’, further evidencing a proactive approach to identifying and supporting carers, particularly young carers. The action plan aimed to embed carer awareness within assessments, deliver staff training, improve safeguarding processes and service pathways, and strengthen links with partner organisations, to ensure carers received the appropriate support and signposting. Managers told us they recognised the critical role families and carers played in supporting client’s recovery and wellbeing.

Facilities and premises were appropriate for the services being delivered. Managers completed various health and safety checks, including fire alarm checks, clinical checks, and quarterly audits to review the environment at each site. There were also annual health and safety reviews carried out.

Managers monitored and took action to minimise missed appointments. Data showed that 26% of all appointments offered between April 2025 and March 2026 had been missed. Managers ensured clients who did not attend appointments were contacted in line with the service’s ‘did not attend’ policy.

Staff supported clients to access their chosen place of worship within the community. Staff also signposted clients to enable them to access emergency mental health support if they needed support, particularly out of hours.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. These included statutory notifications to the Care Quality Commission and safeguarding referrals to the local authority.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured that clients could obtain information on treatments, local services, and how to complain. The information provided was in a form accessible to the client group. There were easy read versions of leaflets and information provided to clients. Staff made information leaflets available in languages spoken by clients.

Staff ensured carers, families and commissioners were regularly updated about the client’s progress. Staff confirmed they encouraged families and carers to be involved in the treatment plan, but shared information only if clients consented. Staff logged information sharing using a designated template to ensure themselves and others were cited on information sharing arrangements.

Managers attended fortnightly and monthly meetings with commissioners where they shared up to date and accurate information.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

The service demonstrated an outstanding commitment to listening to clients and ensuring their views, experiences and feedback influenced the development and delivery of services. There was a strong culture of co-production across the service, with clients actively involved in shaping service improvements.

Managers and staff recognised the importance of ensuring people fully understood the treatment they were receiving. Feedback from recovery workers identified that the existing treatment agreement was lengthy, contained duplication and could be difficult for some clients to fully understand. In response, the service’s trauma informed practice group undertook a comprehensive review of the document, revising the language and content. Managers ensured that clients played a central role in this process, with the revised versions of the treatment agreement being presented to clients at a ‘working together’ group, a forum comprising of clients and those in recovery. Members of the group reviewed the proposed changes, shared their experiences and made recommendations. Their feedback directly informed further amendments to the document prior to this being approved.

Managers could evidence how feedback informed continuous improvement and service development. The service had strengthened its approach to client involvement at the point of discharge. Recognising that recovery continued beyond formal treatment, managers had introduced a STEP (Supportive Treatment Exit Pathway. This ensured clients received a follow-up check-in after discharge, regardless of whether they chose to engage with ongoing recovery services. This enabled staff to seek feedback on client’s experiences, understand longer-term outcomes and ensure clients felt supported beyond the completion of structured treatment.

Managers spoke passionately about the service’s ‘working together’ group. The group met monthly and was routinely consulted on proposed service developments and changes. Senior leaders regularly attended meetings, ensuring that clients had direct access to decision-makers to provide feedback. Members of the group also visited service hubs to engage with clients currently accessing treatment to gather their views

There was evidence that client feedback resulted in improvements. Clients had fed back that they wanted a dedicated space for reflection and remembrance. Working collaboratively with clients, the organisation developed plans for a memorial area close to the Kirkgate hub. Managers secured funding through the local authority, and the memorial was established as a peaceful space where people could reflect on and remember loved ones who had died because of drug and alcohol use.

The service ensured that underrepresented groups were actively involved in shaping services. Staff described how they had consulted with women in treatment and members of the ‘working together’ group to better understand how services could be made more inclusive, welcoming and psychologically safe for women. Following this, the service introduced additional women’s health initiatives, including education and awareness sessions on menopause and wider women’s health issues. The service established female-only groups, with women themselves agreeing the agenda and content of discussions. Managers told us the service also routinely offered women the choice of a female worker when entering treatment, recognising the importance of choice, and trauma-informed care.

Managers investigated complaints, categorising these based on severity or impact. The service managed complaints effectively and actively encouraged clients to submit a complaint if they had concerns about their care. There was information on display about how to submit a complaint, and clients told us they knew how to do so. There had been 28 complaints within the last 12 months. We reviewed 5 complaints and found that managers had acknowledged these in a timely manner, completed comprehensive investigations and identified learning or actions where appropriate.

Staff we spoke with knew how to handle complaints appropriately and could describe the various stages within the complaints process. Staff received feedback on the outcome of investigations of complaints during meetings. Managers and leaders reviewed complaints during information governance meetings and acted on the findings.

The service had received 202 compliments during the previous 12 months demonstrating a sustained increase in positive feedback over previous years. This compared with 114 compliments received in 2023/2024 and 120 in 2022/2023. Staff and managers told us they actively sought both positive and negative feedback from clients through a range of forums and had made a significant effort the increase the amount of feedback the service received. The service had developed a range of processes to gather client feedback. Suggestion boxes were available across all service hubs, and clients were routinely invited to complete surveys at the end of treatment. Managers told us that gathering and responding to service user feedback was embedded within the organisation’s strategic objectives and formed one of the ‘key pillars’ of the service’s performance framework.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Managers could demonstrate how ensuring equitable access was a priority for the service through a range of well embedded pathways and projects.

There was evidence of extensive outreach work to ensure staff reached out to marginalised groups. Managers had recognised that clinic-based appointments did not meet the needs of everyone accessing the service. Following consultation with staff and partner organisations, they developed an extensive community treatment model, supported by training and investment in community working.

At the time of inspection, staff were delivering one-to-one appointments from more than 25 community venues across Leeds, including community centres, fire stations and partner organisations, enabling clients to receive treatment closer to home. Clinicians also delivered treatment directly within partner services, including organisations supporting women, people involved in sex work and other vulnerable groups.

Outreach work targeted communities that were traditionally less likely to engage with substance misuse services. Staff worked closely with organisations supporting Gypsy, Roma and traveller communities, refugee and migrant populations, faith groups, LGBTQ+ communities, young people, people with special educational needs and disabilities, and those affected by emerging issues such as Chemsex. This included targeted awareness campaigns delivered at community venues, markets and the nighttime economy.

The service had identified veterans as a population who may experience additional barriers to accessing treatment. A senior leader within the service acted as the organisation’s veteran lead and completed a ‘data dive’, analysing service data to better understand the needs of veterans accessing treatment. The service had also delivered training sessions to staff to help them better support veterans. There were 63 veterans in treatment with Forward Leeds at the time of inspection, with managers telling us they anticipated supporting approximately 172 veterans over the course of the 2026. Managers could evidence a well-established working relationship with the local veteran’s service. They also told us they had delivered presentations and facilitated table discussions about supporting veterans at the local health and wellbeing board, demonstrating effective collaborative working across the NHS, community sector and the local council.

The service had also developed specialist pathways to reduce health inequalities for underrepresented groups. For example, the older drinker’s pathway supported earlier identification and tailored treatment for older adults with complex needs, including frailty, cognitive impairment and alcohol-related brain damage.

There was a dedicated team in place who worked with young adults between the age of 18 and 24 and staff had developed strong links with the student population. The service had a non-residential ‘DayHab’ programme and a collegiate recovery programme embedded within local universities.

Staff risk assessed new referrals through a single point of contact team, with clients at greatest risk, including those who were pregnant, experiencing homelessness, involved in sex work, subject to safeguarding concerns or at risk of exploitation, prioritised for rapid assessment and treatment. Recovery workers visited people sleeping rough, usually within 24 hours of referral.

Two full time staff members within the marketing and communications marketing and communications team led a ‘We Understand’ campaign to increase awareness of the service.

Managers worked to keep the number of cancelled appointments to a minimum. In the previous 12 months, only 1.8% of all appointments booked on the system were cancelled by the service. When clients did have their appointments cancelled at the last minute, managers made sure they were rearranged as soon as possible and within national targets and guidance.

Staff supported clients who left prison to ensure continuity of care. Data from 1 April 2025-31 March 2026 showed that 64% of prison leavers with a continued treatment need were seen by the service within 21 days compared to national average of 56%, according to the National Drug Treatment Monitoring Service.

We scored the service as 4. The evidence showed an exceptional standard. Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views.

The service demonstrated a strong commitment to reducing inequalities in outcomes by developing specialist pathways for groups whose needs were not being met through traditional treatment models. Managers understood the local population and client group. They could evidence how they used feedback from clients and performance data to identify gaps in provision and could provide examples of targeted interventions to improve treatment outcomes.

One example was the development of a dedicated Chemsex pathway. Through additional funding, the service established a specialist practitioner role providing assessment, case management and harm reduction interventions for people engaged in Chemsex. The practitioner also delivered outreach through sexual health services and community partners and provided specialist training to staff and stakeholders to improve awareness of this client group.

We reviewed various documents relating to the Chemsex pathways and saw that staff had developed innovative methods of engagement with the client group, including through digital platforms. Staff offered all clients accessing the pathway blood-borne virus screening and rapid access to specialist support where required. The number of people accessing the pathway increased from 16 in 2024/25 to 22 in 2025/26. Successful treatment completion rates had also increased from 56% to 68% over the same period. Across both years, the pathways had seen a 100% successful discharge rate with no unplanned exits, transfers or deaths. This compared favourably with the wider non-opiate service completion rate of 33% and the national average of 31%.

The service also demonstrated improvements in outcomes for children and young people. There had been no re-presentations to children and young people’s service during the 2025/26 financial year, compared with 1.2% in 2024/25, 3.3% in 2023/24, 2.6% in 2022/23 and 5% in 2021/22. Managers felt these improvements were due to a comprehensive redesign of the young people’s service, including the creation of dedicated children and young adult teams, increased staff training in psychosocial interventions, the introduction of an in-house counsellor and strengthened joint working with community mental health services.

The service had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Staff were trained in equality, diversity, inclusion and human rights. Training compliance was 92%. Staff also completed anti-racism training.

We scored the service as 4. The evidence showed an exceptional standard. People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The service demonstrated a proactive and timely approach to planning for the future. Managers had introduced a supportive treatment exit pathway which aimed to embed exit planning earlier into the client’s treatment journey. This aimed to ensure safe expected and unexpected exits from treatment by ensuring staff began exit planning at the point of admission.

Managers told us the pathway ensured that all clients were offered a telephone call post treatment, that clients were aware of treatment choices both within the service and the community including aftercare, and ensured that naloxone was always offered at the point of exit from treatment where appropriate. Prior to the introduction of this pathway data showed that 122 clients had taken up the offer to sustain aftercare during the 3-month period of November 2024- January 2025. After the launch of the pilot this figure rose to 717 clients for the same period the following year, seeing an increase of 253%.

Care records, staff and client interviews demonstrated that clients were aware of their future plans, and that staff had begun discharge planning at the earliest opportunity. Recovery plans were personalised and captured client’s needs, wishes and feelings regarding discharge.

Staff planned for client’s discharge in collaboration with a range of stakeholders to ensure identified needs could be met. Staff signposted clients to the recovery academy and did so at any point in the pathway. Staff enabled clients to visit the 5 Ways recovery hub whilst still in treatment if appropriate to enable them to familiarise themselves with the hub and fully understand the support and advice available to them after completing treatment.

The services’ inhouse individual placement support team supported clients to access employment support services in preparation for discharge.