Acquiesce 2

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 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 service. This key question has been rated as Outstanding.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted 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 have a shared vision, strategy and culture that is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

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 a 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 senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in this service. As well as the external non-executive director’s board.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. The team showed empathy, empowerment, kindness and had an open and transparent culture, based on honesty, and a culture driven by learning. The team was small, and we observed all the team were respectful and kind to each other. The team had a culture where they learned from each other.

Where staff may have made a mistake or could have done something differently, they reflected on this at team meetings and shared any learning. They involved clients and staff to reflect on actions taken.

The service put their clients at the centre of their care and provided person centred care. They supported staff to have a good work life balance and had low sickness rates and staff turnover.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service had expanded. They shared information with staff by presentation using change models and theories. Management had completed change management training.

Staff could explain how they were working to deliver high quality care within the budgets available. Managers had embedded key aims within the organisational strategy into the day to day running of the service. For example, staff received recognition and awards at team meetings for staff going above and beyond to deliver results, working together, and by leading and inspiring others.

We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively and do so with integrity, openness and honesty.

The evidence showed a good standard. The service had 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 did so with integrity, openness and honesty.

Leaders had exceptional skills, knowledge and experience to perform their roles. They also had an understanding of staff and people’s diverse needs and the context behind their care experiences. These were central to their methods of leading an inclusive and highly effective organisation. They had 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 and did so with integrity, openness and honesty.

Leaders had high levels of credibility. They consistently did what they said they would and communicated in transparent and accessible ways.

The organisational vision and values were meaningful, and people were at the heart of the service. They were developed, monitored and owned by everyone. Risk management was consistently professional, proactive and preventative.

Leaders at all levels were highly visible. They collaborated with people and staff and gained feedback about their leadership style which they used to improve. They were approachable for clients and staff.

There was substantial investment and support for leadership competency and development. Leadership development opportunities were available, including opportunities for staff. Many staff described how they had progressed within the service and told us this was something managers actively promoted.

Leaders had insightful and impactful oversight of service quality priorities and risks.

Leaders had access to high-quality resources, support and development in their role.

Robust credible frameworks ensured leaders had a strong awareness and oversight of organisational culture dynamics. All concerns were listened to, and preventative action quickly taken.

Leaders within the service provided clinical leadership to staff. Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

We create a positive culture where people feel that they can speak up and that their voice will be heard.

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 had policies and procedures to support whistleblowing and the freedom to speak up. They had an open-door policy where staff could speak with management. Staff had 1-1 sessions and supervision. Staff were open and transparent and non-judgemental. Managers promoted an open and honest culture.

Staff understood these policies and felt comfortable using them without fear of reprisal. Managers and staff had access to the feedback from clients, carers and staff and used it to make improvements.

Managers at the service were aware of the risks around closed cultures or actions to address this. There was professional boundaries training for all staff. Managers developed, discussed, promoted, and implemented innovative ways of ensuring people and staff felt safe to speak up and there was a culture of ensuring everyone’s voice was heard.

Staff and leaders 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. These included, supervision, 1-1 meetings, team meetings, email and the managers having an open-door policy.

The service found innovative and creative ways to enable people to be empowered and voice their views, concerns and feedback. Everyone could express their needs and had their voice heard and responded to. Patients and carers had opportunities to give feedback on the service they received, they did this by leaving online reviews, sending in letters and cards and by telephoning the service.

All staff felt psychologically safe. There are consistently high levels of constructive engagement with staff and people who used the service. Rigorous and constructive challenge from people was welcomed and lessons identified and acted on quickly.

Leaders and staff apologised and responded quickly with humility and candour when things went wrong. People were meaningfully involved in implementing actions to prevent reoccurrence.

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

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

There were 11 equality and diversity champions allocated throughout the staff team, they raised awareness of protected characteristics and supported and highlighted any potential inequalities. Staff training in equality, diversity, inclusion and human rights compliance rate was 96%.

Equality was monitored through individual supervision sessions by the team manager. The team manager tracked the percentage of protected characteristics to address any potential inequalities. The provider undertook equality monitoring of staff within the service to ensure it was diverse in its make-up and representative of the client group.

Staff were able to apply to work flexibly e.g. flexible working agreements to account for personal circumstances such as caring responsibilities and health issues. Some staff had reduced their hours to accommodate childcare.

Managers put reasonable adjustments in place for staff members to help them carry out their role. All staff received the same induction, and interviews were scored to ensure consistency was applied. No staff member was treated differently.

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

The evidence showed an exceptional standard. 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. They always act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Governance was well-embedded into the running of the service. There was a strong framework of accountability to monitor performance and risk leading to the delivery of demonstrable quality improvements to the service.

Information about risk and performance was shared securely and proactively when it is appropriate to do so. There were systems and procedures to ensure that the service premises was safe and clean. They ensured there were enough staff, that staff were trained and supervised, clients were assessed and treated well, the service adhered to the Mental Capacity Act, discharges were planned, and incidents were reported, investigated and learnt from.

Performance management processes were effective, reviewed regularly, and staff consistently performed their roles in line with best practice. Leaders and managers drove an awareness of positive accountability, support and sustainable improvement across the organisation.

Staff and leaders actively anticipated current and future performance and risks to the quality of the service. There was an informed approach to positive risk taking to support innovative ways of working.

There were robust systems for capturing data to provide excellent quality information for relevant data or notifications submission requirements. These requirements were consistently met.

Data management systems consistently operated to a high standard. Information was analysed and used to drive significant improvements to care quality.

Quality frameworks were designed to be intelligent and responsive to best-practice and applicable standards. They supported systems and policies that resulted in improved equity in care experience and outcomes and reduce known inequalities.

There was a clear framework of what must be discussed at team or directorate level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. These meetings had agendas and minutes were available on a shared system. Board meeting minutes were completed, and the report was discussed. The board also reviewed the finances of the organisation.

Staff had implemented recommendations from incidents, complaints, and safeguarding and these were discussed at team meetings, managers meetings and practitioners’ meetings.

Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. Schedule of audits and provided audits and how we learn.in evidence provided.

Staff understood the arrangements for working with other teams, both within the team and external, to meet the needs of the clients.

Staff could escalate concerns when required. The service had plans for emergencies – for example, adverse weather or a flu outbreak, loss of power in their business continuity plan.

The service used systems to collect data, and these were succinct and streamlined.

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. All staff had a works mobile, and they had access to computer systems.

Information governance systems included confidentiality of client records.

Team managers had access to information to support them with their management role. This included information on the performance of the service, staffing, and client care. They also completed management courses, training supervision, and appraisal training. Management had access to separate files for managers.

Information was in an accessible format, and was timely, accurate and identified areas for improvement. Board meetings, managers meetings and team meetings were all documented and shared with the team.

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

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 share information and learning with partners and collaborate for improvement.

The service worked in partnership with others to build seamless experiences for people based on good practice and people’s informed preferences. The service drove a focus on delivering care in a way that supports people’s care pathways.

The service had a systematic approach to working with other organisations to improve care outcomes. This included building and maintaining credible, safe and effective data sharing across the system.

Leaders invested in developing diverse networks at a local level. Effective and creative changes were made in response to better meet the needs of local people.

Leaders engaged with external stakeholders – such as The National Drug Treatment Monitoring Service (NDTMS)and the Department of Health. They had formed a partnership with LGBTQ+ organisation. They sponsored a local football team and were involved in their local community.

Clients and staff could meet with members of the provider’s senior leadership team to give feedback. Monthly managers meetings were followed up in team meetings. There were separate meetings with practitioners and admission coordinators. Board members had visited the service and attended events to recognise staff awards. Board members and senior leaders had visited the properties and overseen the facilities.

The service worked with partner agencies and with local and national charities who supported clients from the service to attend group sessions focussed on the specific substance they had a problem with on discharges to promote joined up care and facilitate access. The service took part in local community activities for example, Pride events. They made sure clients accessed local support groups for alcoholics anonymous, narcotics anonymous and cocaine anonymous and other meetings. They also directed clients to these groups.

Staff had organised events in Manchester for clients at an alcohol-free bar.

Acquiesce had strong partnerships with external partners they outsourced elements of work to ensure excellence, for example, payroll and finance, human resources, employee assistance programme, health and safety, marketing and information technology support.

Acquiesce had well founded care pathways in place with their partnerships and communities for example, national recovery homes, benefits agencies, GP shared care, mental health services, mutual aid, LGBTQ+ organisations, local Council of Mosques, detoxification units and dental practices. They had key staff members trained and allocated to lead on the various care pathways.

Any trends or data was shared, and they worked collaboratively to improve partnership working, for example, Acquiesce experienced an increase in clients experiencing pain related issues from ketamine use and withdrawal. They shared this information with their GP provider to ensure that a shared care approach would be provided to support the client’s physical health need to enable them to improve their recovery outcome.

A community initiative that Acquiesce was involved in was a campaign to highlight the dangers of ketamine for local television. They have hosted multiple open social events for recovery communities.

Acquiesce has an Instagram social media digital platform that provided education, information and support for the community. This was an open channel for any individual to access.

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome, and quality of life for people. We actively contribute to safe, effective practice and research.

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 contribute to safe, effective practice and research.

The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. Staff 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 discuss opportunities for improvements and innovation and this led to changes. They did this through team meetings, supervision and personal development and discuss what interests’ staff had in the service. They had 3 staff on level 4 substance misuse, motivational interviewing. They have funded other specific courses that staff could access.

Staff had opportunities to participate in research. They were a member of the British Psychological Society and linked into Liverpool John Moores university online regarding research in substance misuse. They had implemented positive psychology into the service and completed some modules with clients. They had staff trained in behavioural couple’s therapy and level 4 counselling.

Innovations were taking place in the service, and this was captured in a document called above and beyond. They had introduced digital remote working for mutual aid meetings in the evening for clients to provide increased level of respect and privacy. Aftercare was offered lifelong to clients with weekly online meetings hosted by a staff member. The member’s area also has a social aspect for all previous clients of Acquiesce.

Staff used quality improvement methods and knew how to apply them. Anything new was introduced gradually and they monitor outcomes and feedback.

The service participated in accreditation schemes relevant to the service and learned from them. Staff completed a pathway to become a practitioner and subscribed to an addiction professional’s registration which is a voluntary registration body.