Sheffield Drug and Alcohol Service Also known as Likewise Sheffield

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 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.

Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected analysed data about outcomes and performance. They used this to identify improvements.  

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 service had very clear values, shared vision, strategy and culture. This was based around
kindness, courage and compassion. The provider had created a 10-year strategy of ‘save a
million lives and enhance a million more’. Staff had the opportunity to consult on this strategy through regional events, staff surveys and other feedback opportunities.

Staff we spoke with knew and understood the provider’s 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. 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. One example was the culturally sensitive engagement programme. This began by developing relationships with Imams at Sheffield’s Grand Mosque through small, informal meetings focussed on listening and understanding community perspectives. Staff received training on Islamic customs and appropriate etiquette before taking part in learning experiences at the mosque, ensuring engagement was respectful and culturally informed. Over time, conversation shifted from “we don’t have a problem” to “we need your help.” This trust led to Likewise facilitating a full-day health event at the mosque, with training and workshops co-designed and shaped by the community itself.

The management team told us the provider was a value driven organisation. Key partners
echoed the excellence of the vision, direction and culture of the service. Feedback from one
partner agency was that,

“Since mobilising the contract on the 1st of August 2023, Likewise have consistently demonstrated a commitment to delivering high-quality, person-centred care whilst supporting Sheffield's strategic ambitions to reduce drug and alcohol-related harm, improve treatment outcomes and strengthen recovery opportunities for residents”.

Managers had embedded key aims within the organisational strategy into the day to day
running of the service, for example, staff recognition in all staff meetings. This meant staff received awards and recognition for areas including going above and beyond, delivering results, working together, and 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 with lots of development opportunities.

Managers could explain how they were working to deliver high-quality care within the budgets available. The service had implemented a segmentation model. This model meant that clients were seen by appropriate teams and staff members dependant on their individual needs rather than a ‘one size, fits all’ model. This provided a consistent framework for staff, strengthening care planning and review, while giving managers clear oversight of individual progress and service performance. This represented an enhancement on traditional models and ensured treatment was purposeful, dynamic and tailored, rather than standardised, leading to more effective use of clinical resource and improved patient experience.
 

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.

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 built learning portfolios and encouraged staff to do the same through attending bitesize training sessions. These sessions included subjects such as alcohol awareness/pathway, prescription management, ketamine awareness/fast track and talking therapies.

Leaders were visible in the service and approachable for clients and staff. Staff spoke positively about managers and senior leaders. Senior leaders were visible throughout the service, often visiting sites. Staff told us managers were easily accessible. Managers practiced compassionate leadership, with a presence at internal and service wide team meetings and promoted an open-door policy and provided staff listening sessions in order to listen and gather feedback. 

Leadership development opportunities were available, including opportunities for staff. Many staff, including volunteers and people with lived experience described how they had
progressed within the service and told us this was something managers actively promoted. Since Waythrough became the provider of this service, 7 frontline members of staff had progressed into management roles through succession planning, coaching and mentoring. This equated to approximately 30% of management roles that progressed through internal structures.

The service had also acquired funding to develop a mental health practitioner from within the service. The successful candidate was a recovery navigator from within the service's community team. The service had supported them to acquire a post graduate qualification, 'Mental Health and Wellbeing Practitioner in Severe Mental Health and Drug and Alcohol'. The person who was successful had since completed their course and worked as a Mental Health Practitioner within the Integrated Recovery Team.

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.

There was positive feedback about people’s experience of the service. Clients spoke very positively about the staff and the quality of care and support they received. They described staff teams as great, caring, nice, caring and brilliant. Clients also highlighted the commitment staff showed them throughout their care and treatment.

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.

The service valued and listened to the views of staff. Staff were given opportunities to provide feedback about the service and their opinion was valued. The service gave the option of anonymous feedback in the form of a post box. Senior managers responded to this feedback and provided learning through staff meeting structures.

The service had policies and procedures to support whistleblowing and freedom to speak up, and staff told us they knew how to access the policies and who to contact if they had any queries or concerns. Local managers promoted an open and honest culture within the service. Staff we spoke with understood these policies and procedures and felt comfortable using them without fear of reprisal.

Clients, carers and external agencies had opportunities to give feedback on the service in a manner that reflected their individual needs.

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 there was a process for concerns to be reviewed independently outside of the senior leadership team.
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 all staff meetings.
Managers and staff had access to the feedback from clients, carers and staff and used it to make improvements, such as the review of staff pay, availability of desk and locker space and the review of the staff induction process. 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 through flexible working
applications, but managers could also 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.

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 completed equality and diversity training. Training compliance across the service was
99% at the time of inspection and there were equality and diversity leads within the service.

The service had an equality and diversity lead who worked with local communities to identify and address barriers into treatment. Awareness was raised to staff through delivery of ‘learning lunches’ delivered by staff who represent under-represented groups and communities, such as neurodiverse and LGBTQ working groups. This resulted in staff within the LGBTQ group having increased knowledge around Chemsex, embedding a pathway into the service for this cohort and working in partnership with Sexual Health Sheffield. 

Likewise had developed and lead on a city-wide equality, diversity and inclusion meeting 'Professional EDI Network Meeting' that brought together services to share good practice, improve inclusivity across Sheffield. At the time of our inspection this meeting had 50 active members regularly attending.

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 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 recognised and were proactive in ensuring the workforce met the client’s needs.
We saw evidence that the service was 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.

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, timely, accurate and identified areas for improvement. There were effective systems in place, such as compliance dashboards and induction sign off processes that ensured staff received mandatory training in a timely manner. Training figures were collated centrally and the senior management team had oversight of any fluctuations or anomalies to allow them to act and rectify these.

There was a clear framework of what must be discussed at 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 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. For example, 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 regularly to identify any prescribing outliers.

Managers had fully embedded the arrangements for working with other teams, both within the service and externally, 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 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. Staff concerns matched those on the risk register.

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.

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 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.

From our review of care records, and speaking with staff, we found 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. The service achieved micro-elimination of Hepatitis C (a targeted public health strategy that breaks down broad national eradication goals into manageable, measurable targets for specific high-risk or localized populations) in January 2026. The service met the required micro-elimination targets, including offering Hepatitis C testing to 100% of people in structured treatment, testing 100% of those with a history of injecting, ensuring at least 90% of current and previous injectors had a Hepatitis C test recorded within the last 12 months, and ensured that at least 90% of people who tested positive for Hepatitis C had commenced treatment.

This was achieved through effective partnership working with The Hepatitis C Trust, the South Yorkshire, Bassetlaw and North Derbyshire NHS Operational Delivery Network, NHS hepatology services and internal organisational champions. The service delivered focused and incentivised testing events, closely monitored performance data and developed targeted action plans to identify and engage people who had not yet been tested or treated.

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 were supported and encouraged to acquire new skills, use their transferable skills, and
share best practice with external stakeholders.

Likewise Sheffield had taken a proactive, citywide approach to preventing drug-related deaths by extending the availability of naloxone (a life-saving medicine that reverses opioid overdose) beyond traditional drug and alcohol services.

The naloxone strategy focussed on training and equipping professionals who may encounter someone experiencing an opioid overdose, ensuring that lifesaving medication was available where and when it was most likely needed.

The service had also formed a partnership with South Yorkshire Police Force to provide force-wide naloxone training.  Training began in December 2024. 451 officers were trained to recognise an opioid overdose and respond appropriately. Approximately 20% of those trained were carrying nasal naloxone at the time of inspection, with uptake continuing to grow.

Likewise had also targeted people working within Sheffield’s night-time economy, including door supervisors, who may have been among the first to encounter an overdose. The value of this approach was demonstrated when a door supervisor used the training and naloxone kit supplied by Likewise to save a person’s life. This case received coverage in the Sheffield Star, on BBC Radio Sheffield, the BBC News website and BBC Look North as part of International Overdose Awareness Day.

To further strengthen Sheffield’s response, Likewise led a citywide naloxone conference in partnership with South Yorkshire Police, the University of Sheffield and Sheffield City Council. The event sold out and was attended by more than 180 people. Delegates heard from leading speakers about the importance of naloxone and participated in practical workshops designed to increase knowledge, confidence and access across the wider professional network.

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.

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. These
included the opening of the Sheffield ‘Juice Clinic’, a specialist harm-reduction service for people using steroids and other performance and image-enhancing drugs (PIEDS). This provision placed Sheffield among a relatively small number of areas offering a dedicated service for this population.

The clinic provided confidential, non-judgemental advice, sterile injecting equipment and health interventions aimed at reducing risks associated with PIED use. It had adapted as new patterns emerged, including people accessing needle and syringe provision in connection with unlicensed tanning products and injectable weight-loss drugs. This enabled the service to identify and respond to risks that may otherwise remain hidden from mainstream health and treatment services.

The Juice Clinic attracted national attention when it was featured in a Guardian article exploring the growing use of body- and performance-enhancing drugs. This helped raise awareness of an emerging public health issue and demonstrated the specialist knowledge being developed within Sheffield.

Following feedback from people using the service, the clinic was relaunched with Saturday-morning sessions, making it more accessible to those whose work or had other commitments preventing weekday attendance. A new partnership was also established with Bloodworks, a specialist PIEDs organisation. Clients were able to access appropriate blood testing alongside a clear, jargon-free explanation of their results, provided directly to them. This supported people to understand potential health impacts, make informed decisions and seek further medical attention where necessary.

The service was part of an anti-stigma campaign and undertook outreach programmes to
groups that were difficult to engage.

The service identified Ketamine as an emerging and significant local risk, with increasing use reported amongst both adults and young people. In response, the service delivered a citywide conference in April 2026. The event aimed to strengthen professionals’ understanding of ketamine-related harm and ensured people received informed, joined-up support across Sheffield. The 250-place conference sold out, demonstrating significant unmet demand for knowledge and guidance. Attendees included GPs, mental health practitioners, social care teams, housing and supported accommodation staff, and other professionals working with people affected by ketamine use.

Support available locally was outlined, alongside expert speakers from across the UK covering ketamine use among young people, pain management and urological harm. Lived experience was central to the programme, including a personal recovery story and a workshop led by members of Likewise’s ketamine group. This ensured the event combined clinical expertise with a clear understanding of people’s real experiences.

Feedback was overwhelmingly positive, with delegates particularly valuing the blend of medical and public health information, practical guidance, lived experience and opportunities for cross-sector networking. Attendees reported increased confidence in explaining treatment pathways and supporting people experiencing ketamine-related bladder problems.

Likewise had also launched its ‘Ambassadors Programme’ as a structured 12-month learning and work-placement pathway for people who had completed treatment and were progressing in their recovery from drug and/or alcohol use. The programme recognised that recovery is not simply about ending substance use; it is also about rebuilding confidence, developing purpose and creating opportunities for a fulfilling life.

Participants combined practical work experience with education and skills development, preparing them to become peer mentors, volunteers, recovery leaders or paid employees within the drug and alcohol sector. Their lived experience was recognised as a valuable strength, enabling them to inspire hope, connect authentically with others and contribute directly to the development and delivery of recovery support across Sheffield.

Through a partnership with Northern College, ambassadors could complete accredited and non-accredited learning, tailored to their needs and future aspirations. Alongside formal learning, they developed transferable skills, confidence and workplace experience, providing a realistic pathway into further education, volunteering or employment. 
The programme strengthened Sheffield’s visible recovery community while ensuring that people with lived experience were not only consulted but were supported to become an active part of the workforce of local recovery services.

Likewise also worked with staff at The Greens Recovery Housing in the implementation of two recovery beds at The Greens. This represented an innovative response to a clear gap between community treatment and inpatient detoxification. The programme was developed for people who were physically dependent on alcohol or prescribed opioid-substitution medication and who needed more support than could safely or effectively be provided within their own home. This included people who had previously been unable to complete a community programme or whose housing and social circumstances created barriers to recovery. 

Residents had access to a structured timetable of recovery-focused groups and activities at the Likewise Recovery Hub, including SMART Recovery, relapse prevention, confidence building, weekend planning and the Cycle of Change. Transport was provided to remove practical barriers to participation. Residents were also supported to develop daily routines, prepare meals, contribute to the shared living environment and begin rebuilding the confidence and practical skills needed for greater independence.

This model brought clinical, housing and recovery support together around the individual. It gave people whose circumstances may otherwise prevent them completing community treatment a realistic opportunity to become substance-free in a safe and supportive environment, while also preparing them for sustained recovery beyond the detoxification period.

This model demonstrated a clear strategic commitment to partnership working, service innovation and recovery-oriented care. It brought together clinical expertise, supported housing, the Likewise Recovery Hub and lived-experience support within one coordinated pathway. Defined responsibilities, structured care planning and regular reviews provided oversight, while the use of recovery buddies showed that people with lived experience were active contributors to service delivery rather than passive recipients of care.