Forward Leeds - Kirkgate

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• 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 newly registered 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.

We have not awarded this service a score for Well-led.

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

We scored the service as 4. The evidence showed an exceptional standard. 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.

The organisation had developed a new 10- year strategy which was due to launch in June 2026. The strategy set out key aims related to quality improvement, clinical safety, retention, and targeting high-risk cohorts. The service was due to hold an all-staff event in London to celebrate this event. Managers had communicated the strategy launch through various platforms and there was a page on the organisations intranet which provided staff with ongoing updates.

We reviewed various documents relating to the development of the strategy and saw that managers had used extensive engagement across leadership, governance, workforce, and lived experience to shape the strategy. Managers had ensured staff were invited to contribute through webinars, listening sessions, and during one-to-one sessions.

Staff we spoke with knew and understood the current vision and values and how they were applied in the work of their team. The organisational vision was to break down the barriers that stopped people getting the support they needed to live a life they value. This was driven by 3 core values: kindness, courage and respect. Staff and leaders provided examples of how they aimed to do so through projects, campaigns and in their day to day roles. Staff at all levels spoke positively about the work they did and about the culture of the service.

Staff could explain how they were working creatively to deliver high-quality care within the budgets available. An experienced Recovery Coordinator within Forward Leeds recognised a gap in existing provision and with her manager, developed considerable expertise in supporting individuals affected by these addictions. The success of this approach and the positive outcomes achieved for service users provided the evidence base for investment in this area. As a result, senior leaders committed funding to establish a specialist team, including a lead practitioner and three dedicated recovery coordinators, working in partnership with GP practices, clinical services and pharmacy teams to deliver a coordinated citywide response.

Interviews with staff, leaders, clients, carers, and partners showed an extremely person- centred, inclusive and empowering culture. Personalised care based on equal rights for all was pivotal to the services beliefs and operation. Managers delivered clear leadership underpinned by the organisations vision and values. There were staff working groups in place to discuss changes within the organisation and staff at all levels told us there was a consultative approach to work across the service.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally 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, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The service had competent and inclusive leaders 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 operated confidently at system level. They could describe many examples of how they helped shape shared priorities across the health system and how they embraced opportunities to have a positive impact on the wider health and care system.

There was service-wide leadership development and succession processes in place, aligned to strategic priorities and future risk. This actively identified and progressed talent, which reflected the communities served, and ensured and long-term sustainability of leadership capacity. Leaders demonstrated a strong commitment to developing leadership capability. A comprehensive leadership development programme provided managers with structured learning opportunities throughout their career, ranging from induction management programmes to advanced leadership qualifications, including Level 5 management apprenticeships and Chartered Management Institute diplomas. Senior leaders also completed director development programmes.

Managers described having access to extensive role-specific training and a well-established network of peer support. They told us regular leadership forums and professional development groups enabled them to share learning, reflect on practice and support one another in responding to operational challenges. Leadership development also focused on creating psychologically safe teams through training in reflective practice, performance management and managing staff wellbeing, alongside disciplinary and grievance processes.

Leaders were proactively visible, accessible and responsive. They demonstrated integrity, honesty and openness, and built strong, respectful relationships with staff, clients and local communities through inclusive and transparent engagement. Throughout the inspection we saw managers and leaders interacting positively with clients. Clients appeared comfortable approaching senior staff, and interactions demonstrated a genuine interest in their wellbeing and recovery.

Leaders’ visibility, engagement, and a range of targeted projects resulted in demonstrable improvements in experience, access and outcomes, including for marginalised and under-served groups.

Leaders actively created and sustained a culture of psychological safety. Staff consistently told us they felt confident to speak up, challenge and provide ideas for innovation. Staff spoke positively about managers and senior leaders and told us they were easily accessible when they needed support. Leadership development opportunities were available for staff. Multiple staff described how they had progressed from recovery workers to more senior roles.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Clients and staff 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.

The service ensured staff could provide feedback through an annual staff survey. Staff could also provide feedback or raise concerns at daily flash meetings and quarterly all staff meetings.

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 newsletters, Microsoft teams channels and by email.

Senior managers attended the ‘working together’ group to ensure they could identify and act on any concerns raised. Managers provided examples of when they had met with clients to discuss concerns.

Clients 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.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us managers could make reasonable adjustments to accommodate their individual needs and personal circumstances. Long term changes were made through 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 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.

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.

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. Managers did so at the point of recruitment. 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.

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

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

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 client 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.

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.

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 this set out key risks related to finance, governance, and operational issues. Each risk was graded in terms of severity, with actions in place to mitigate the risk, and regular review dates in place.

Ward, team, and directorate level meetings had clear frameworks and agendas to ensure that essential information, such as learning from incidents and complaints, was shared and discussed.

There were business continuity plans in place for each site which set out plans for emergencies and issues affecting service delivery.

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 client records.

We scored the service as 4. The evidence showed an exceptional standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The service routinely worked collaboratively with partners across the health, social care and voluntary sectors to improve outcomes for clients.

Partnership working was fully embedded within the organisation and staff at all levels understood their role in delivering coordinated, person-centred care. People accessing the service often presented with multiple and complex needs, including co-existing mental health conditions, physical health needs, safeguarding concerns, homelessness, exploitation and involvement with the criminal justice system. Staff worked seamlessly with partner agencies to ensure these needs were addressed through joined-up care and shared decision-making.

Inspection findings across all quality statements demonstrated consistently strong multi-agency working. There were well- established partnerships and pathways across areas including acute hospitals, palliative and respiratory services, probation, prisons, sexual health services, safeguarding teams and the Leeds Naloxone Network. This enabled clients to access specialist support promptly.

Care records and staff interviews further evidenced positive relationships with a range of partner organisations. Staff regularly worked with GP practices, hospitals, mental health services, social care, criminal justice agencies, community organisations, charities and faith groups to coordinate care. Staff were encouraged to develop specialist expertise, share learning and provide advice and training to partner agencies.

The service had completed an extensive workforce development programme. Between March 2025 and March 2026, staff delivered a comprehensive programme of training on substance misuse, safeguarding, trauma-informed practice, harm reduction, mental health, stigma reduction and brief interventions to professionals across Leeds. Training was delivered to staff working within health services, education, children’s services, family hubs, social care, universities, foster care and voluntary sector organisations. More than 205 professionals attended targeted training during the initial phase, and the programme had been expanded to deliver between 30 and 40 training events each quarter.

The service maintained a visible presence at local events, including Leeds Festival, where staff provided advice, support and harm reduction information to members of the public, helping to raise awareness of substance misuse issues and available support services.

Staff actively worked with community organisations and peer-led services to enable people to access ongoing psychosocial support, volunteering opportunities, mutual aid and recovery groups.

We scored the service as 4. The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service demonstrated an outstanding culture of learning, improvement and innovation. Staff were encouraged to identify opportunities for improvement, test new and use research, audit findings, performance data, feedback from clients and national policy developments to drive improvement.

There was a Quality and Compliance Team within the service who provided assurance to senior leaders through internal inspections, thematic reviews, complaints and mortality reviews, and quality improvement monitoring.

Findings from audits and inspections resulted in targeted improvement plans, with progress monitored through robust governance arrangements.

The service had developed an Opiate Mortality Risk Assessment (OMRA) tool to strengthen the identification of people at increased risk of overdose or drug-related death. The tool set out personalised harm reduction interventions, including enhanced clinical monitoring, naloxone provision and multi-agency escalation where appropriate. Managers monitored the impact of this tool through supervision, audit and governance processes.

Leaders used additional national investment to redesign services in response to the identified needs of clients. This included the introduction of a range of specialist roles, teams and project work. Examples included an Enhanced Support Team for clients with complex needs, a dedicated Chemsex practitioner, a non-residential abstinence day programme, a strengthened Single Point of Contact, a Collegiate Recovery Programme supporting university students, and a Peer Mentor Coordinator to strengthen lived experience involvement.

The service had introduced Mental Health and Wellbeing Practitioners to provide self-help interventions for clients with co-existing mental health and substance misuse difficulties. Managers told us they were working with the service’s research lead to evaluate the role’s impact on both mental health and recovery outcomes.

Staff were encouraged to participate in research and service evaluation to improve the quality and effectiveness of care. Recent projects included evaluating the use of Buvidal, a long-acting injectable medicine used to treat opioid dependence, as part of community-based detoxification for people with complex needs.

The service had also evaluated the impact of using FibroScan, a specialised ultrasound scan that assesses liver damage, to improve referrals to specialist liver (hepatology) services. In addition, staff collaborated with local universities on research exploring patterns of cocaine use to better understand emerging trends and inform future service development.

The service demonstrated how quality improvement methods were used to achieve measurable improvements in prescribing outcomes. Managers had reviewed the opiate prescribing pathway after identifying delays in clients accessing opioid substitution treatment. This led to the development of a redesigned assessment process in April 2024. Managers monitored its effectiveness through performance data, which showed a significant reduction in waiting times from an average of 10.6 days to 2.1 days between assessment and prescribing. By March 2026, 73.5% of new clients received their prescription on the same day as their first appointment with a prescriber. Managers evaluated the effectiveness of the new pathway and following its success, shared the model across the wider organisation, which led to this being adopted by other services.

Managers regularly completed cases studies of client care. We saw reviewed a sample of these and saw they were used for reflective learning and to strengthen practice.