Acquiesce Ltd

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question Outstanding. At this assessment the rating has remained Outstanding.

This meant people’s needs were met through good organisation and delivery.

Staff managed access and flow well. The design, layout, and furnishings of the service’s premises supported clients’ treatment, privacy and dignity. Staff supported clients with activities outside the service, such as work, education and family relationships. The service met the needs of all clients – including those with a protected characteristic. Staff helped clients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

We have not awarded this service a score for Responsive.

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

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

The evidence showed an exceptional standard. The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

They supported clients by adjusting collection times during the programme to allow for people of the Muslim faith to observe prayer times during Ramadan. They sought halal food and allowed for prayer time during the treatment programme. If clients needed ground floor bedrooms, they provided these and offered sessions at the treatment centre on ground floor if clients couldn’t use the stairs. They provided separate kitchenware (e.g. utensils, pans, plates) to accommodate dietary laws such as Halal or Kosher.

During the initial telephone triage assessment with a prospective client, Acquiesce demonstrated a strong commitment to making appropriate and person-centred adjustments for individuals with disabilities. This process followed a structured approach, aligned to the urban residential model, to ensure that the level of care they provided was tailored to the individual’s specific needs. The Acquiesce urban recovery model provided a confidential, highly structured and safe environment within the community. This made transitional periods when leaving treatment a much smoother process. The clients we spoke with told us they had learnt new skills for example planning meals, cooking, cleaning, budgeting and supporting each other in the house they lived in, resulting in a more sustainable recovery journey.

The management team put people at the heart of the service and people’s goals, wishes and aspirations drove the service. The management had a can-do attitude to meet the needs of the clients. Feedback from clients confirmed care was person-centred and unique to each client, and how the service was exceptional in the way they tailored people’s support. Staff and clients gave examples of how the service tailored client care around individual needs and preferences.

During 1-1 sessions the client was given a choice of treatment pathways either the 12 steps or a cognitive behavioural therapy route. 1-1 sessions were adapted to suit the pace and cognitive ability of clients with learning disabilities or neurodivergence. They provided reading and writing support tools to clients diagnosed with dyslexia, promoting accessibility and inclusion. Client’s ware supported in line with their gender identity, including use of preferred pronouns, gender-affirming language, and access to gender-appropriate facilities.

Clients completed weekly client questionnaires, end of treatment client questionnaires.

All staff had completed working in a person-centred way and effective communication training as well as counselling level 4, level 3 substance misuse practitioners award, SMART recovery training and level 3 motivational interviewing training. Staff had received appropriate mandatory learning disability and autism training.

Staff arranged wound care with district nurses to support and enable clients who used colostomy bags catheter care, stoma management to access the service. Staff collaborated with clients who used ketamine and who were incontinent providing yellow waste bins and supporting clients to access relevant GP appointments and mutual aid support groups to encourage independence.

Staff empowered clients to make their own decisions about their care and treatment. This was provided in their 1-1 time to discuss any issues about their care and treatment. Clients completed daily check ins and checkout records where they reflected on their emotions, feelings and set themselves a goal for the day. Clients completed daily diaries to build on person centred care. They provided tailored information and training about the client’s individual addiction using a solution-based focus. As well as completing a full session on strengths and goals and at the end of their treatment they collaborated with the client to identify their own relapse prevention plan with 2 long term and 2 short term goals that were reviewed weekly.

Family members told us that when their family member left rehab, they had a greater understanding of their loved one’s addiction.

Care plans reflected the strengths and goals of clients and included actions to develop their recovery capital. They completed a full session on strengths and smart goals.

Some clients needed additional time in the service, and their rehabilitation programme was extended. This was sometimes funded by the service.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. When appropriate, staff supported clients to have access to education and work opportunities. Staff collaborated with clients and their employers to enable clients to get back to work following their discharge. Clients we spoke to confirmed this and said they wouldn’t have been able to do this without their support to get back to work. Staff assisted clients identify meaningful volunteering opportunities, including roles in charity shops, food banks, and local drug and alcohol services, to help build confidence and gain experience.

Staff supported clients to maintain contact with their families and carers. Staff made contact weekly or more often with families and carers where the client had consented to this.

The service has undertaken work to understand local demographics and the diverse needs of the local community. They had been involved in local Pride events for LGBTQ+ celebrations.

Managers monitored and took action to facilitate attendance for the rehabilitation programme. They consulted with detoxification (detox) centres and arranged transport where needed. They maintained contact with the client to ensure the transition onto the programme went as planned. They visited other services for example detox providers to establish links and ensure the pathways of care were in place.

The service had developed partnerships with other services and third sector organisations, (for example groups representing specific ethnic minorities) and the service collaborated with other providers and community organisations to offer joined up care.

Staff provided gym access, yoga, Reiki, meditation, acupuncture and massage. They also linked in the local community working with families holding sessions at their local football club that supported the community of Bolton.

Staff made arrangements and informed clients of services they could access once they had returned to their local area. Advocacy work involved referring clients to mental health support, domestic violence support and recovery homes for ongoing support and housing. Staff signposted clients to enable them to access emergency mental health support if needed and staff consulted with services they needed to access. Clients confirmed this and told us how the service had been in direct contact with mental health services.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. These included statutory notifications to Care Quality Commissions and safeguarding referrals to the local authority.

Information governance systems included confidentiality of client records. There were systems in place to password protect and data and cyber security was in place. Policies were in place to support these.

The provider had a working from home policy that staff signed and worked toward the General Data Protection Regulation (GDPR) and work in line with the information commissioning office and Caldicot principles.

The service complied with the Accessible Information Standards and made information available in an accessible format, for example they had made large print available during their programme, and they would provide audio and braille and British Sign Language support where needed. The information provided was in a form accessible to the particular client group (for example, in easy-read form for people with a learning disability). Staff made information leaflets available in languages spoken by clients. They did what was best for client and used other experts to support decision making and supported clients into treatment

Staff ensured that clients could obtain up to date information on treatments, local services, clients’ rights, how to complain. They provided accessible information in all the group work and the programme content, providing approximately 14 handouts per week to clients and copies of all tools used.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

In co-production with previous clients, they had developed and printed a new ‘Welcome Brochure’ which was given to clients on admission as well as being available on their website. Former clients had become staff members and were actively involved in making decisions about the service.

They had no complaints in the last 12 month. There had been a suggestion/informal complaint where clients wanted to change the timing of the evening session, and this was facilitated. Clients knew how to complain or raise concerns. When clients complained or raised concerns, they received feedback.

Staff protected clients who raised concerns or complaints from discrimination and harassment. Staff knew how to manage complaints appropriately. There was a complaints policy and procedure.

Staff received feedback on the outcome of investigation of complaints or concerns raised and acted on the findings.

People who used the service were active partners in their care and staff empowered them to have a voice. Staff enabled clients to give feedback on the service they received these included weekly meetings with individual clients and 1-1 time and daily check ins and checkout meetings. Post discharge clients were provided with a feedback form to give feedback on their care and treatment. The service had a website where clients had all left positive reviews about their treatment. Managers had weekly meetings to review feedback they had received and fed this back to staff.

The service ensured stakeholders and other community groups could give feedback about the service and input into service delivery. They worked with charitable groups and other independent hospitals as well as voluntary and charitable organisations regarding referrals into the service.

The service supported past clients to have access to a member only space online that was attended by a staff member weekly. This allowed clients to still be involved with the service and was where clients shared their experiences, successes and challenges and were listened to. They offered continued access to resources, community, and support beyond formal treatment.

Clients participated in co-production work to support service development. At all core programme sessions clients are asked daily for feedback about the sessions and produced a daily diary. They completed weekly questionnaires and provided exit feedback. They incorporated sessions to meet individual needs, for example sessions on anxiety. The new welcome pack was co-produced with feedback from clients. Suggestions were sought from clients to improve their relapse prevention plans and additional sessions clients suggested may be useful were facilitated for example, a session on triggers and intensities. Every 2 weeks clients attended an open group which was led by clients to discuss what do they want delivered additional to the current programme.

Staff provided carers with information about support groups and carers assessments. Family handouts were sent to concerned others with resources for further support. 3 staff had been trained in 5- step family method, this was a structured approach to support family members affected by issues like addiction.

Clients had access to and information about advocacy services and a full list of services was available.

We make sure that everyone can access the care, support and treatment they need when they need it.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

People had equal access to care, treatment and support because the provider complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.

The provider prioritised and allocated resources and opportunities as needed to tackle inequalities and achieve equity of access. Staff ensured the needs of clients with mobility issues were met for example, buildings were accessible. If the service was unable to meet the needs of the individual, then this was discussed at the earliest point on contacting the service.

Staff made reasonable adjustments for clients, an example of this was where someone had been in alcohol addiction and was unsteady on their feet. Staff arranged an occupational therapy assessment and installed a handrail for support.

There was adequate medical cover, and the service could access support from mental health services, via 111, A&E referrals for mental health assessment and GPs. Staff also supported clients to access other medical support. Examples of these included staff helping clients access urology appointments and assisting in seeking a diagnosis for attention deficit hyperactivity disorders and autism as well as accessing support for incontinence issues.

Staff ensured clients had access to post-discharge care for example, mutual aid groups and a members area group. After care sessions were completed by the recovery practitioners and clients had the practitioners work mobile contact numbers.

The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. For example, if clients needed to access a detoxification they referred clients onto services.

The service did not have a have a local catchment area. However, staff facilitated access to services in their locality. Clients could access the local gyms, cafes, and parks.

The service worked with groups that were difficult to engage or underrepresented in treatment (for example specific ethnic communities, LGBT+ communities and groups such as sex workers). Staff worked in partnership and referred clients onto various organisations where needed.

The service’s programme required daily and weekend attendance, which meant it was not accessible to people in full-time employment.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. This was done daily and after their treatment programme had finished.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. They made reasonable adjustments to assist clients and staff. Staff treated clients with dignity and respect and encouraged them to treat each other with dignity and respect.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. One example was a staff members pregnancy, thorough risk assessments were completed and tailored adjustments made, and monthly pregnancy meetings were held.

The provider provided assistive technology and skill matched staff to deliver the daily programme and assist in other ways when delivering sessions along with support where they may have been having difficulties. The provider helped staff with computer skills and had paid for training in using computers to assist staff members.

Staff were trained in equality, diversity, inclusion and human rights and compliance rates were 96%.

The service considered and addressed barriers to access for specific communities and those with protected characteristics. For staff this was discussed in monthly supervision where wellbeing was discussed as well as protected characteristics. An example of this was where they had accommodated staff to reduce their days and work on a more flexible basis where needed.

The service reviewed client outcomes in line with protected characteristics and took actions to address inequitable outcomes. This was ongoing with clients daily. They observed and monitored any prejudice with clients and where this was seen they acted through mediation with both parties. An example of this was where a client had used derogatory language against another client. They spoke with both clients about the use of language and how it may make others feel.

Client feedback was analysed by protected characteristic and the service developed action plans where appropriate. They developed care plans and discussed these on referral to the service and on admission.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

The evidence showed an exceptional standard. People were given exceptional support to plan for important life changes, so they could make informed decisions about their future.

Staff supported clients to make decisions about their care and treatment and their future. This was addressed throughout the whole programme through regular check-ins and 1-1 sessions. We saw staff and management being responsive and making time to discuss issues where clients were having a difficult time. There were members of staff with specific skills to understand and meet the needs of people and their families in relation to emotional support and the practical assistance they need.

Discharge planning started on admission and support needs, and future plans were discussed. We looked at 6 electronic records, and we saw detailed recovery plans and relapse prevention plans. Staff provided holistic support to clients preparing for discharge, addressing their individual needs to ensure a smooth transition. They helped clients getting back into employment and supported writing curriculum vitae. They helped clients seek housing, leisure activities and interests as well as remaining abstinence upon their discharge providing essential information to support this.

They worked with families where the client was returning home. People we spoke to told us how they had helped them plan for the future stating they wouldn’t be where they are now without the ongoing help, guidance and support.

Staff created personalised care plans to account for the client’s needs, wishes and feelings. All relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.

Staff supported clients to create and review crisis and relapse plans. Client’s feedback included they ‘wouldn’t be here if it wasn’t for the treatment’, and ‘it has saved my life’.