Acquiesce 2

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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 means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

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

We have not awarded this service a score for Caring.

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

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

People received care and support that was exceptionally compassionate and kind. Staff cared for individuals and each other in a way that exceeded expectations and fully respected their privacy and dignity. Staff demonstrated genuine empathy for the people they cared for.

All of the clients and their carers we spoke with were overwhelmingly positive about how all the staff and management treated them with kindness, compassion and dignity.

Staff had a strong understanding of people’s human rights to dignity and respect and were able to act creatively to uphold these rights, even in challenging situations.

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 staff being compassionate, caring and genuinely caring towards the clients.

Staff supported clients to understand and manage their care, treatment or condition. They made time for clients. On admission to the service, they discussed their care and treatment, provided 1-1 sessions weekly, and staff were always available to discuss any issues. There was a 24-hour duty staff member available, and this was used by clients. They used it when they were upset and where they had had difficult calls with their families and loved ones. The service also supported their families steering families to support groups and Support and Advice for Families in Addiction (SAFIA) which the service had developed.

Staff directed clients to other services when appropriate and, if required, supported them to access those services.

All the clients we spoke with said staff treated them exceptional and behaved appropriately towards them. Positive feedback had been received from all clients we spoke with. The service had also received positive feedback and ex patients who had sent gifts and cards thanking the staff for their care and treatment. All the cards we looked at were immensely positive.

Past clients visited the service and spoke with current clients about their successes and challenges at different times in their recovery.

Staff understood the individual needs of clients, including their personal, cultural, social and religious needs. Examples of this included purchasing Halal foods and providing places and time to pray. They also contacted the local Imam where clients needed to access this support.

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. The General Data Protection Regulation (GDPR) was included in their staff handbook and staff signed a confidentiality agreement as part of their contract of employment.

Staff consistently went the extra mile. Staying beyond shifts times and coming in on days off when clients were in crisis.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, goals, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, goals, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, goals, abilities, aspirations, culture and unique backgrounds and protected characteristics. Care plans demonstrated people were actively involved in decision making and were supported to make their own choices about their own care.

At point of consultation individual needs were identified regarding activities of daily living (personal care, medication regime, mobility, food preparation etc) and necessary reasonable adjustments were made. For example, a client whose medication required refrigeration was provided with a mini fridge to store the medication.

There was specialist equipment provided by their inhouse occupational therapist in the form of a shower chair handrails for clients following a full occupational therapy assessment.

To support client self-esteem and confidence they allocated 2 weekly peer leaders that completed sessions on self-esteem and confidence.

With consent of the client Acquiesce involved families and carers in the treatment process, aftercare planning was completed collaboratively in order to strengthen the transition period from treatment to home to improve outcomes for all. Acquiesce kept in touch with family members post client exit and feedback was gathered from families to evaluate and improve the service. All care plans were created with the client and their family and were unique to each individual.

Acquiesce combined 12 steps, cognitive behavioural therapy approaches, positive psychology, SMART recovery, behavioural activation, motivational interviewing and holistic therapies such as massage, reiki, yoga, acupuncture, gym, swim and health walks. The program could be adapted to accommodate the best interest of an individual clients need and or preferences.

Clients received weekly 1-1 sessions and completed daily diaries this made sure their care, support and treatment met their needs and preferences as individuals and this was closely monitored by staff. They also requested weekly written feedback in surveys from the clients.

All rooms were single occupancy.

The service made adjustments for disabled clients by ensuring disabled people had access to specific communication tools. They had made arrangements for clients to be assessed by an occupational therapist when client’s mobility needs had changed. They made hearing appointments for clients who were having difficulties hearing. The information provided was in a form accessible to the client group for example, in easy-read form for people with a learning disability They also made adjustments for clients with sight problems making text larger and handouts printed on larger paper. They also made adjustments for clients who had additional learning needs when delivering the programme.

During the initial telephone triage assessment with a prospective client, they discussed making appropriate and person-centred adjustments for individuals with disabilities. They discussed any cognitive impairments or other challenges that may impact the client’s understanding or ability to engage. The format, pace, and style of questioning were adapted as needed to ensure accessibility. Where appropriate, support from family members, carers, or advocates is facilitated in accordance with best practice.

Staff ensured that clients could obtain information on treatments, local services, clients’ rights, how to complain. Both the accommodation and the treatment centre had lots of information displayed including information about making a complaint. There had been no complaints raised in the last 12 months.

Staff made information leaflets available in languages spoken by clients if this was needed. The managers ensured that staff and clients had easy access to interpreters and/or signers if this was needed. The managers would translate documents into a person’s chosen language if needed.

Staff communicated effectively to ensure people understood their care and treatment, including adapting communication for those with specific needs. For example, staff supported a person who was hard of hearing by ensuring they could lipread, using blue overlays for handouts, and offering individual sessions when needed. Staff were transparent during assessments and were considering how to accommodate a person with a guide dog. Interpreters were contacted when required.

Staff ensured that clients had access to appropriate spiritual support and consulted with local chaplains and Imams to ensure clients’ needs were met.

Managers actively employed staff who had also completed their own recovery and clients we spoke to were positive about this.

Staff ensured recovery plans included their strengths, goals and any equality and diversity information pertaining to the client and how they wanted to be treated. The recovery plans were reviewed weekly with the clients and the practitioner.

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment. and wellbeing.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff offered clients alternative treatment options if they were unable to comply with specific treatment requirements. An example was that clients could choose the 12 steps or a cognitive behavioral therapy route.

Staff signposted clients to supportive services within the community such as mutual aid groups and services offering psychosocial intervention strategies.

Staff supported clients to maintain relationships and networks that were important to them. They supported clients to access their friends and family while they are using the service. They supported clients with housing and arranged access to recovery homes as some clients did not want to return home.

Staff supported clients to access activities and the local community to promote and support their independence, health and wellbeing. They have provided tailored employment support to clients, assisting them in identifying suitable job opportunities aligned with their interests, values, and long-term goals. They also supported clients in developing high-quality CVs and personal statements, offering guidance and feedback to strengthen their applications for employment opportunities and advised clients on further education pathways post-treatment.

Staff supported and enabled clients to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. They assisted clients in identifying meaningful volunteering opportunities, including roles in charity shops, food banks, and local drug and alcohol services, to help build confidence and gain experience. Staff assisted the clients with their recovery plans, and these were client led. Clients owned their own 1-1s with staff. If a client wanted to opt out of the programme, they would discuss it and staff worked with the client to support and understand their rational for the decision.

Recovery plans were detailed and reviewed weekly they included the clients’ choices and preferences. The recovery plans included a relapse prevention plan and a 7-day structure and routine plan. Staff described how they tried to promote clients’ choice and control wherever possible. Clients completed daily diaries and a self-esteem journal to capture clients’ positive experiences.

Staff supported clients to develop their recovery capital and personal strengths. They provided professional references to employers for clients who successfully transitioned into employment after completing treatment, supporting their reintegration into the workforce. Once the client left the service, support staff kept in touch and helped connect them to mutual aid, discussions about work and education and encouraged the client to reach out.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were aware of and dealt with any specific risk issues immediately, such as physical or mental health concerns and care planned for these accordingly.

They had daily morning grounding sessions with all clients and clients completed a daily diary and self-esteem journal. These allowed the clients to discuss planning their day as well as identifying their emotions and feelings with positive affirmation. Clients had access to weekly 1-1 meetings with their practitioner and could access additional support at any time. We observed that staff responded to clients’ immediate needs and made time for clients to discuss any concerns they had.

The service responded to the immediate needs of clients for example if any physical issues they sorted appointments out, they had taken clients to sexual health clinics, dentists, scans at hospital. They had completed court reports and attended with them if the appointment was whilst they were in the rehabilitation programme. They had consulted with eating disorder clinics to support clients.

A staff member was available to provide immediate support either by phone or in person at the accommodation where clients resided. Staff identified and responded to changing risks to, or posed by, clients.

Staff collaborated with clients to develop crisis plans and relapse prevention strategies. And these were discussed in 1-1 sessions with staff as well as part of their treatment programme.

Staff supported clients where they had got into difficulties with finances and debts. They helped clients to organise and prioritise their debts. They arranged sessions with their carers and loved ones to help them to understand addiction and to support them. Carers we spoke with told us these sessions had been invaluable to understand their loved one’s addiction.

They had many clients who suffered from bladder pain in early treatment once they had stopped ketamine use, they immediately activated the GP shared care pathway and provided the clients with aids to minimise any discomfort, concern or distress. Hot water bottles and support pillows were provided as well as providing bins to dispose of any incontinence pads. They immediately supported the clients to attend the pharmacy for assessment prior to the GP appointment. This was done with the client, to ensure they understood and had choice over their treatment options.

They also provided immediate enhanced emotional support to their clients if required, for example a client’s immediate family member passed away whilst they were residing at Acquiesce, they were offered immediate emotional 1-1 support by a trained staff member.

Ongoing review was completed of a client’s activities of daily living throughout their treatment period and any change in need was responded to immediately.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff felt respected, supported and valued. Staff felt very positive and proud about working for the provider and their team. The staff team worked together to support each other and had a handover book and daily flash meetings to discuss the clients in rehab. The managers at the service were always available to discuss any issues staff had and all staff had access to the managers contact details.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Staff could also access a private doctor, dieticians and various counselling services. They had accessed assistive technology to support staff in completing their work. Staff told us they felt able to suggest improvements to the managers and they were encouraged to do so.

The service’s staff sickness and absence were similar to the average for the provider. The average sickness absence rate within the service over the last 12 months as a percentage was 5.5%.

The provider recognised staff success within the service – for example, through staff awards. At their team meetings they had an above and beyond award, where a financial award was provided to the individual and a certificate presented. Summer socials were planned for staff, and they had away days, and Christmas get togethers. Staff received bonuses throughout the year also. Staff were praised in their supervision sessions. Staff were given cash on their annual anniversary and received a Christmas bonus.

When they interviewed staff, they focused on staff being caring and having empathy for others. They had completed sessions around culture of staff and working as a team.

Staff appraisals included conversations about career development and how staff were supported in work. Staff followed clear personal safety protocols, including for lone working. Staff were provided with employee safety, employee handbooks and driving for work handbooks.