Live Well East

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This is the first assessment for this service. This key question has been rated outstanding.

Staff treated clients with compassion and kindness. They respected clients' privacy and dignity. They understood the individual needs of clients and supported them to understand and manage their care, treatment or condition. Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff attitudes and behaviours when interacting with clients showed that they were discreet, respectful and responsive, providing clients with help, emotional support and advice at the time they needed it. We observed an appointment between a client and their keyworker and noted how well the keyworker interacted with them. They explained things clearly so clients could understand and manage their care, treatment or condition. The keyworker’s manner was kind, calm, supportive and respectful. The keyworker told the client they were flexible about the times of their appointments to allow them to seek treatment for a serious physical health condition.

We also attended a home visit to a client’s house and observed the interaction between the keyworker and client. The keyworker was kind and considerate towards the client and listened to their thoughts and opinions. The keyworker gave clear advice on how to minimise risk and harm associated with injecting and gave the client contact details of a buddy who could support them.

Throughout our assessment, we overheard conversations within teams that clearly evidenced how passionate, dedicated, considerate and caring staff were about their clients.

Staff directed clients to other services when appropriate and, if required, supported them to access those services. We saw evidence in care records that staff had referred or signposted clients to mental health services, the lung health clinic, mutual aid groups, debt management companies and primary healthcare services.

We spoke with 16 clients and 1 carer during our assessment. Clients said staff treated them well and behaved appropriately towards them. The feedback from the clients and carer was overwhelmingly positive and clearly evidenced how kind, respectful, compassionate and supportive staff were towards them. Comments included:

• They have helped me massively…. nothing bad to say’
• ‘This has been life changing…. the service is amazing’
• ‘They made me feel I was worth something…. I really appreciate the time they give’
• ‘I could not say anything bad about them…. everything I’ve had from them has been wonderful.’
• ‘I couldn’t ask for more’
• ‘I haven’t got the words for how good they are’
• ‘I’ve had a tremendous amount of support’
• ‘Really good…. they helped me more than other services’
• Brilliant…. reception staff are really good, as well as the keyworkers’
• ‘I’ve got my life back…. the service is amazing’
• ‘Very good…. staff are friendly and my keyworker keeps in contact between appointments’
• ‘My keyworker helped me boost connections with people who could help me when I was lonely and wanted a drink’
• ‘They make you feel understood…..I would recommend them’ and,
• ‘Very good experience…..they treated me with dignity and respect.’

Staff understood the individual needs of clients, including their personal, cultural, social and religious needs. We saw evidence in care records that staff had factored in these considerations into clients’ care and treatment.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards clients without fear of the consequences.

Staff maintained the confidentiality of information about clients. Staff received mandatory training in data protection, cyber-awareness and prescription security. The provider’s care records system required staff to use a login name and password to safeguard client information.

The service made adjustments for disabled clients or clients with serious medical conditions. had agreed for a client to be seen at their own home rather than the service’s premises as they were living with a life-limiting condition and seriously unwell.

Staff ensured that clients could obtain information on treatments, local services, how to complain and other topics. Information could be produced in a variety of forms to meet people’s needs such as other languages or easy-read for people with a learning disability.

Managers ensured that staff and clients had easy access to interpreters and signers when required.

Staff ensured that clients had access to appropriate spiritual support. For example, staff liaised with pharmacies in relation to adjusting substitute medicine collection regimes to allow for people of the Muslim faith to observe prayer times.

Staff encouraged families and carers to be involved in their loved one's care and treatment. Staff sought consent from the client and asked them how and to what extent they would like them to be involved. At the multidisciplinary team meeting for clients using opiates that we observed, staff agreed to offer a client who was currently living with a friend the opportunity for the friend to accompany them for support during their appointments.

Staff provided a range of activities and support groups to help clients manage their addictions and promote their independence. These included groups centred on changing behaviour, life skills, harm reduction, alcohol, cocaine and non-opiate substances.

There was a hard-to-reach vulnerable women's clinic on a night which offered support to women who sell sex. There was a café area at the Live Well West site where women could drop in on their working night. The service offered dual diagnosis, smoking cessation support, sexual health and support with infectious diseases. Staff ensured clients had naloxone, lip balm and lubrication. Naloxone is a medicine that rapidly reverses an opioid overdose, potentially saving the person's life. Sexual health support included the provision of contraception such as coils and smear tests. Staff provided self-testing kits so the clients could self-screen.

Staff were aware of and dealt with any specific risk issues and care planned for these accordingly or made referrals to other healthcare services that could address these issues.

Staff identified and responded to changing risks to, or posed by, clients. For example, we saw evidence in care records that staff had identified clients still using illicit drugs who were pregnant. Staff had responded promptly in alerting child protection services and had made safeguarding referrals to protect the mother and their unborn child.

There were dedicated staff within the service's criminal justice team who focussed on engaging with potential clients released from prison. They visited the person whilst they were still in prison to arrange a future appointment at the service for when they were released. If the person failed to attend this appointment, the team presented at a number of venues including probation and employment services to engage while the person was there and utilise any contact methods agreed prior to release. If the person presented at the service on an afternoon, they were seen as a priority by the assessment team, who were present every day. If the person did not attend their appointment on a Friday, and they were on a prescription, staff delivered a bridging prescription to the pharmacy and an appointment at the service was made for the following Monday to prevent missed doses.

Staff felt respected, supported and valued. They felt positive and proud about working for the provider and within their team.

Managers monitored and supported staff with their caseloads. Managers received supervision and reports via internal teams and compliance reports included current caseload numbers. Managers were able to support staff by reviewing cases to ensure they were being closed when required and also identified any training needs for individual staff members to encourage and support them to manage their caseloads more effectively.

Staff had access to support for their own health and wellbeing. Staff had access to an employee assistance programme and occupational health. Staff had undertaken team events such as water rafting, Pilates and yoga.

The provider recognised staff success within the service. Individual staff and teams had won or been nominated for awards. We observed a compliance meeting for leaders within the service, during which, positive feedback from clients and external partners was shared and celebrated.

Staff appraisals included conversations about career development and how it could be supported.