Archived: CGL Manchester

On this page

• 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 Good. At this assessment the rating has changed to Outstanding.

Outstanding: This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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.

• Clients told us that the service was responsive if their preference was for one to one support rather than groups. A client who had missed a couple of days of treatment explained how responsive the service was to accommodate an appointment for their review to enable a prescription so that they could restart their treatment.
• We spoke with clients who were receiving the buprenorphine prolonged-release injection (Buvidal) injection. They were pleased with this treatment as it was less frequent and contributed to their independence rather than having to regularly visit the pharmacy to collect methadone.
• We observed a client review and saw that the prescriber reviewed the client’s mental health, housing and home situation as well as explaining the medicine options and the process for moving from one to another. The client was given time to consider their options and agreed to discuss further at the next appointment.
• Clients spoke of their experience of other services and told us that this service made them feel safer and part of their treatment. Clients acknowledged that the service also offered support with past trauma and said that psychological interventions were available.
• There were specific groups for people with similar experiences, including a veterans support group, we saw a client being signposted to this during the assessment. The service also offered groups in relation to alcohol awareness, and a group for people who used stimulants.
• There were lists of groups and support organisations that clients could drop into or contact for support related to mental health, sexuality, domestic abuse, housing, or fellowship substance misuse groups that were provided to clients. Also lists of helplines for clients to access if needed, relating to mental health, gambling, grief, domestic abuse and housing.
• The outreach team that supported people who were homeless were proactive in meeting clients where they spent the majority of their time, this included at day centres, temporary accommodation or on the street. The service gradually made progress with individuals by building relationships, sharing information about harm reduction including developing testing kits for Nitazenes (synthetic opioids), which were small compact kits and staff gave these out to clients.
• The service had recently launched a Telehealth service for people at a low level of risk and non-opiate substance users. Clients were triaged and then if appropriate offered the Telehealth service which included a remote assessment, and up to 6 extended brief interventions, usually delivered on a one to one basis, however this could also be delivered in small groups. There were 25 people accessing the service at the time of the assessment.
• The outreach team also provided hub days, where colleagues from different agencies; housing, mental health service and the police attended to support people dropping into the service in a comprehensive holistic approach.
• For clients with literacy difficulties we saw the service develop resources that were accessible, including a drinks diary with images rather than words. Clients could also access the service without the barrier of forms that they could not easily complete.
• Staff told us of a client who was fasting for Ramadan, and they moved the daily collection of medicines to late evening they could collect it safely.

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 service commissioned a third sector organisation to support clients into work. The eligibility for the service was that clients needed to be in structured treatment. The service offered one-to-one support with searching, applying, and interviewing for jobs, up to 9 months support to find a job and up to 4 months of in-work training. They also provided access to resources, training and funding, help to keep or change jobs if clients were already working and support to produce a CV.
• For clients in recovery, they had access to SHINE (Sobriety, Hope, Inspiration, New Beginnings, Empowerment) community groups. The activities were based at one of the bases where structured treatment was not delivered, to promote people’s ongoing recovery. Groups included soba music, mums in recovery, men’s groups, an allotment and a recovery choir. Stakeholders told us how much people valued the activities to support their wellbeing and recovery.
• The service had a criminal justice team which worked with clients in approved premises, under probation and in police stations. The team worked with people on release from prison to support them in their treatment in the community.
• The service had a young people’s service for young people under the age of 25. There were resilience workers who included a vaping lead and exploitation lead. Recovery coordinators and Children and Family workers were based in the team, support included advice and guidance for young people affected by a family member’s substance use.
• The service has undertaken work to understand local demographics and the diverse needs of the local community. This included the outreach team working alongside a third sector organisation for street health, providing treatment for female sex workers, via their outreach on a van every 2 weeks, support included offering a needle exchange to the women.
• The service developed strong partnerships with other services and third sector organisations to help meet clients’ needs. This included the delivery of training by CGL staff to partner agencies, and staff were responsive to emerging concerns or trends in substance misuse and shared this knowledge with others working with people who use drugs or alcohol.
• Strong partnership working with other agencies was a shared view by stakeholders. They told us that staff demonstrated knowledge and experience in supporting people with complex needs. Stakeholders spoke positively about the service’s visible and proactive presence through outreach work, including visiting people in temporary accommodation.
• The outreach team conducted joint outreach with the rough sleepers team and attended weekly multi-disciplinary team meetings with the rough sleepers team, where cases were raised to identify coordinated actions for individuals sleeping rough. The outreach team also held drop in sessions at temporary accommodation locations, day centres and a specialist GP practice to enable ease of access to the service and supported colleagues in working with people to access structured treatment.

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

• Staff made notifications to external bodies as needed. This included CQC notifications which we reviewed, and they were detailed and timely in submission.
• Information governance systems included confidentiality of client records. Clients were referred to as their ID in meeting minutes to protect their confidentiality.
• Staff ensured that clients could obtain information on treatments, local services, clients’ rights, how to complain and so on. There were notice boards in all bases with information about treatments, groups and giving feedback.
• The information provided was in a form accessible to the particular client group. We saw adjustments in place for clients with literacy difficulties including a visual drinks diary.
• Staff made information leaflets available in languages spoken by clients. We saw treatment leaflets in Farsi, Polish and Romanian. The website included timetables of groups and activities, and this could be translated to any chosen language. There was a link on the website for people to do this.

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 service received 29 complaints in the 12 months preceding the assessment. These related to communication, quality of service, prescriptions and medicines, staffing and responsiveness. Four of the complaints were upheld and 6 partially upheld.
• The service received 45 compliments in the 12 months preceding the assessment. These related to the quality of the service, staffing and staff attitudes.
• Clients knew how to complain or raise concerns. Clients were encouraged to give feedback via feedback forms following the groups, also the pulse survey which could be accessed digitally via a QR code or in paper format. Feedback from the pulse survey was collated into a ‘you said, we did’ document, this showed action being taken, for example in the increased offer of counselling for clients.
• When clients complained or raised concerns, they received feedback. We saw in care records the action taken by managers to resolve complaints, for example by changing an allocated worker and the communication with the client regarding this.
• Staff knew how to handle complaints appropriately. We saw in care records that staff had followed the complaints procedure including sending acknowledgement letters and outcome letters.
• Carers were encouraged to give feedback via the Family Support Impact Feedback Survey. Results showed positive feedback including improved emotional resilience, better self-care, and a sense of empowerment.
• We reviewed the team meeting minutes and found that staff did not always receive feedback on the outcome of investigation of complaints - there was no standard agenda across the teams and complaints were not discussed in the meetings. However complaints, learning and findings were a standard agenda item at the leadership IGTM (Integrated Governance Team Meetings).

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

• Staff ensured the needs of clients with mobility issues were met. All buildings were accessible, with ground floor interview rooms or lifts to upper floors.
• Staff made reasonable adjustments for clients. Joint working took place with staff from the LGBT Foundation to facilitate groups. There was also a veterans group that the service facilitated. Information was translated into other languages when needed, we saw treatment leaflets in Farsi, Polish and Romanian. The website included timetables of groups and activities and could be translated to any chosen language via a link on the website.
• There was adequate medical cover, and the service could access support from mental health services. The outreach service held a weekly street engagement hub where professionals were based at the service and clients dropped in, could be reviewed and support was provided from a variety of organisations. The outreach team had a non-medical prescriber employed full time in the team to be responsive to the needs of the homeless community.
• Staff ensured clients had access to post-discharge care – for example, mutual aid groups. The service commissioned third sector organisations to deliver groups for people progressing through their recovery, including Foundations to Connect, Grow and Thrive with a 6 week Here and Now and Move On group to help people plan to exit towards community-based support. Information was displayed in the bases and given out to clients about mutual aid support including Alcoholics Anonymous, Narcotics Anonymous and Cocaine Anonymous.
• The service was easy to access. People could self-refer into the service.
• The service had assessed the needs of the local community to ensure the service was able to treat the community it served.
• The service undertook outreach programmes to groups that were difficult to engage or underrepresented in treatment. The outreach team worked across the city into day centres and temporary accommodation for people who were homeless in addition to outreach in the city centre. The outreach team also supported the third sector organisation for street health, providing treatment for female sex workers, via their outreach van every 2 weeks, support included a needle exchange for the women.
• The service had flexible opening times to support access from those in full time employment, the service was open until 7pm on Tuesday, Wednesday and Thursday across 3 of the bases.
• The service was part of Thriving Families, a multi-agency partnership, led by Manchester City Council for families at risk of having their children removed. CGL staff worked alongside the social worker, domestic abuse workers and mental health workers to support the family, with CGL workers focusing on substance misuse. The service could visit families at home. Stakeholders told us the service was very responsive, the pathway enabled parents to be seen as a priority and the communication between CGL, and other specialists involved with the family was excellent. Parents were encouraged to join recovery groups and volunteering opportunities.

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.

• Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. All clients we spoke with told us they felt able to share their views and opinions.
• 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.
• Staff were trained in equality, diversity, inclusion and human rights and compliance rates were 100%.
• The service considered and addressed barriers to access for specific communities and those with protected characteristics. The outreach team worked into the local community at venues where people who were homeless were, this included day centres, temporary accommodation and on the streets. The outreach team were based at a community resource centre for people who were homeless, and people could drop into the service. The service had managed to support 7 clients who were homeless into detox in 2025, this had been as a result of gradually building professional relationships with clients and working alongside other agencies including housing to plan for clients’ future.
• The outreach team worked on the street health outreach van every 2 weeks, providing treatment for female sex workers on the streets, support included a needle exchange for the women.
• The criminal justice team provided sessions at approved premises, police stations, probation, drop in centres for people who were homeless and liaised with prisons to try to coordinate treatment for clients upon release. The team were achieving above the national target for prison release appointments, with the national target being 65% and the team achieving 66%.
• The service reviewed client outcomes in line with protected characteristics and took actions to address inequitable outcomes. Treatment outcome profiles (TOPS) were completed with clients and reviewed every 3 months. The TOPS included how much clients were using and if this was reducing, and clients rated themselves as well. Joint work took place with the LGBT Foundation to provide support and groups to the LGBTQ+ Community.
• Client feedback was analysed including where the feedback was received from, what the service did well and what could be improved, the pulse survey analysed the gender, age and disability status of people responding. The service developed action plans in the format of ‘you spoke, we heard’ and ‘together we will’.

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.

• Staff supported clients to make decisions about their care and treatment and their future. Future support options included detoxification, rehabilitation, mutual aid groups, support with employment, recovery and wellbeing groups.
• Staff created personalised care plans to account for the client’s needs, wishes and feelings. These had to be reviewed with the client prior to discharge from the service.
• Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. A risk review and service user plan review had to be completed prior to discharge from the service. Potential discharges were discussed at weekly multidisciplinary meetings. Discharge was discussed with the client. The process of discharge went from recovery worker to team leader to project manager to ensure there was oversight of the process and decision making.
• Staff supported clients to consider relapse and relapse prevention. This was via groups that were delivered by sub-contracted third sector organisations and one to one with recovery coordinators.