Sheffield Drug and Alcohol Service Also known as Likewise Sheffield

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 service. This key question has been rated good.
This means we looked for evidence that client’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence. 
People’s outcomes were consistently good, and people’s feedback confirmed this. Staff assessed the physical and mental health of all clients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for clients based on national guidance and best practice. The service included or had access to a range of specialists required to meet the needs of clients. Staff from different disciplines worked together as a team to benefit clients. 
 

We have not awarded this service a score for Effective.

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

We scored the service a 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

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.

We reviewed 6 care records and saw that staff 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 when necessary and staff responded promptly to any sudden deterioration in a client's health, for example management and response to relapse or deterioration in mental health.
 

We scored the service as 3. The evidence showed a good standard. The service 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 and current evidence-based good
practice and standards.

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 provided a range of care and treatment interventions suitable for the patient group. The service adopted the use of the long-lasting injectable buprenorphine (Buvidal). This gave clients further treatment options when traditional opioid substitution treatment did not fully meet their needs. The service had continued to develop personalised approaches across different client cohorts, including people who struggled with daily pharmacy attendance, those at risk of diversion (accessing prescription drugs illegally for personal use or sale), people excluded from pharmacy provision, prison leavers, working people, parents, and women involved in sex work where daily supervised consumption can increase stigma, risk or instability. The service also offered naloxone to clients at risk of opiate overdose. 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 misuse services.

The service had developed an in-house Individual Placement and Support service (IPS) for people accessing drug and alcohol treatment. This service is an evidenced-based employment support model. This is designed to help individuals secure and sustain paid employment.

The service delivered an evidence-based employment model as part of treatment, rather than as a separate intervention. This supported wider recovery outcomes, including independence, confidence and social inclusion. This provided practical, personalised support with job searching, CV writing, application forms, cover letters, interview preparation, understanding job roles and ongoing in-work support. This helped people build confidence, routine, financial stability, purpose and independence as part of their recovery journey.

Staff ensured that clients had good access to physical healthcare, including access to specialists when needed. Staff routinely offered blood borne virus testing to clients and supported them to access treatment for any viruses detected.
Staff protected the rights of clients subject to the Mental Capacity Act. This included referring clients to mental health services where necessary.

We observed a daily flash meeting. This was attended by 50 staff members. This meeting contained a standard agenda, which included any incidents or new risks from the previous 24 hours, and staff also used the meeting 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. The meeting also highlighted designated roles such as first aiders, fire marshals and health and safety leads for the day.

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. We saw evidence of a host of additional training programmes that staff could access. These included training around the use of Ketamine, neurodiversity awareness training, sexual harm training and mobile Electrocardiogram (ECG) training.

Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance.  During the previous 12-month period, the compliance rates for supervision was 98%.

The organisations executive team approved a pause to the formal annual appraisal cycle for the period April 2025-March 2026. 
This included both annual and mid-year reviews. This was a planned, time-limited decision to support system implementation and allow for a full review of the service’s approach to performance management across the organisation.

During this period, a comprehensive review was undertaken, drawing on input from colleagues across all levels of the organisation, alongside current best practice in performance management. This informed the development of Waythrough’s new, values-led approach referred to as ‘My Waythrough’. 
While formal appraisals were paused, ongoing performance management remained a core expectation. Colleagues were expected to set and review objectives, discuss performance and development, as well as maintain regular supervision and one to one conversations.

Managers were required to continue holding supervisions or one-to-ones at least every 12 weeks, in line with existing organisational expectations. From 1 April 2026, the new performance management approach was introduced, which included a move to anniversary-based reviews, replacing a fixed annual cycle. There was a continued emphasis on regular supervision/one-to-ones as the primary mechanism for performance, wellbeing, and development conversations, as well as access to supporting learning, including training on quality performance conversations and giving and receiving feedback effectively.

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. 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.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

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 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 and to help improve their care. Recovery workers alerted managers to any clients they felt were at
increased risk and needed to be discussed or clients they needed support or guidance about. Multidisciplinary team meetings were well attended and included managers, doctors, nurses, clinical leaders, team leaders and recovery workers and volunteers.

There were many joint working arrangements set up to support the needs of the local
community, such as domestic abuse services including Ashiana Sheffield, who work with Black, Asian, Minority Ethnic and Refugee (BAMER) adults, children and young people fleeing domestic and sexual abuse, including forced marriage, human trafficking, female genital mutilation, gang violence and ‘honour’ based violence. The service had also formed a working relationship with Sheffield Working Women’s Opportunities Project (SWWOP)in a 2-year funded project to support female sex workers.

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 provided for clients.
There was evidence of good joint working with the local hospital’s Hepatitis C clinics, with regular information sharing taking place. Staff 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 and managers knew who the designated points of contact were in the local mental health crisis teams, inpatient mental health services and local authority. There was evidence of effective working relationships with social care services and housing teams.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.
 

Staff supported clients to live healthier lives through participation in groups such as;

•    Arts and crafts
•    Mixed martial arts
•    Women’s wellbeing
•    Mindfulness and movement
•    Weightlifting
•    Singing
•    social games

The service also supported people to access smoking cessation and nicotine replacement therapy, healthy eating advice, managing cardiovascular risks and dealing with issues related to substance misuse.

Clients told us staff supported them in creating plans to prevent relapse and 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.
 

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service monitored client’s care and treatment to continuously improve it. The service used technology to effectively support clients such as electronic dashboards that tracked priority and risk.

Staff used recognised rating scales to assess and record severity and outcomes and used recognised withdrawal scales to monitor detox and ensure medicines were reviewed and
adjusted accordingly. This included the use of the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIW-AR) and the Severity of Alcohol Dependency Questionnaire (SADQ). The service also accessed The National Drug Treatment Monitoring System; a national database used across England to collect anonymised information on adults and young-people receiving treatment for drug and alcohol misuse. This allowed providers to track whether treatment interventions were successfully helping people achieve recovery.

The service monitored outcomes of clients receiving treatment for opiates, non-opiates,
Alcohol, and alcohol and non-opiates. In the latest period, 7.2% of opiate, 37.9% of non-opiate, 42.7% of alcohol and 33.7% of alcohol and non-opiate clients successfully completed treatment. This data was fed back to the National Drug Monitoring Treatment System (NDTMS).
 

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.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable clients to make their own decisions. For clients who
might have impaired mental capacity, staff assessed and recorded capacity to consent
appropriately and would carry this out on a decision specific basis with regards to significant decisions.

Staff assessed and recorded capacity to consent clearly each time a person needed to make an important decision and 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. At the time of our inspection, the compliance rate for Mental Capacity Act training was 94%.

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 and Mental Capacity Act and they knew who to contact for advice.