We are With You Wigan and Leigh

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff considered and could access support for clients beyond just their specific substance misuse needs.

Staff developed a comprehensive care plan for each client that met their mental and physical health needs. Staff were generally reviewing and updating care plans when clients' needs changed. Care plans were generally personalised, holistic and recovery-orientated and identified the client’s keyworker.

However, staff appraisal completion figures for the previous 12 months at the Wigan location were low.

The service did not have appropriate oversight of staff supervision compliance as of the time of the assessment.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 13 client records during the assessment. Staff completed a comprehensive assessment of need including history of substance misuse.

Staff made sure that clients had a physical health assessment and knew about any physical health problems.

Staff developed a comprehensive care plan for each client that met their mental and physical health needs. Staff were generally reviewing and updating care plans when clients' needs changed. Care plans were generally personalised, holistic and recovery-orientated and identified the client’s keyworker.

Staff responded promptly to any sudden deterioration in a client's health, for example management and response to relapse. Staff could give examples of how they monitored this and how they would escalate when they had concerns about a client.

The compliance rates for staff appraisals were low at the Wigan service and managers did not have appropriate oversight of staff supervision at the time of the assessment. However, the service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence.

Staff participated in clinical audit, benchmarking and quality improvement initiatives.

The team included or had access to the full range of specialists required to meet the needs of clients in the service.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the client group.

We requested data in relation to staff appraisals for the 12 months prior to the assessment. The service confirmed that, for Wigan, 21% of staff had an appraisal, 33% of staff had not had an appraisal, 40% of staff were either new or in their probation period, so would not be expected to have an appraisal, with a further 6% of staff identified as not applicable due to being agency staff. The Leigh data was more positive, with 44% of staff having had an appraisal, 50% of staff being either new or in their probation period and the remaining 6% being not applicable due to being agency staff. The Head of Service Delivery acknowledged that the appraisal data for Wigan was not at their expected level and had identified actions to address this, including providing some additional training, coaching and support to managers to provide quality appraisals, along with undertaking additional audits in relation to this.

The service did not have appropriate oversight of staff supervision at the time of the assessment. The service had a supervision tracking spreadsheet although this was not being used or monitored. The service provided an updated tracker following the on-site assessment which, although there were some gaps, indicated that supervision was generally taking place. Staff that we spoke to gave mixed feedback about supervision, although most staff generally felt supported by managers. The provider confirmed that the supervision tracker would continue to be updated following the on-site assessment and that they would be undertaking regular audits of this.

Managers were in the process of amending the structure and format of team meetings. Managers had identified that the previous format was not effective and had decided to replace this with quarterly face-to-face meetings for all staff. The first of these meetings was due to take place in August 2025 with the management team creating the agenda for the meeting at the time of the on-site assessment.

Managers dealt with poor staff performance promptly and effectively. Managers could give examples of how they monitored and managed staff performance.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings. We observed a multidisciplinary meeting during the assessment where individual clients were discussed as identified by staff. Staff spoke respectfully about clients and were considerate about the client’s individual needs and requirements. Staff all had a voice within the meeting.

The service had multiple teams that worked within a specific remit. Each team had oversight from a specific operations manager. Managers described how the individual teams worked and were confident that each team had effective working relationships with each other.

The teams had effective working relationships with teams outside the organisation. Staff described and gave examples of how they worked with and alongside external agencies to support clients. We received mostly positive feedback from external agencies and stakeholders about the service and the care and treatment that they provided.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service had implemented Hepatitis C tests for all clients attending the service. Managers noted that there were only 107 clients still to be tested out of the total clients for the service and were aiming to have these completed by September.

The service had a health and wellbeing team.

The service had access to or utilised external services to support clients in having additional tests, such as ECGs and fibroscans, which is a type of ultrasound to measure inflammation in the liver.

The service had plans to recruit to a new mental health practitioner post which they planned to implement. Managers noted that, as part of this role, the practitioner would also provide support and advice to clients around areas such as sleep hygiene.

The service could signpost clients and had access to food banks and packs.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service had processes and procedures in place to monitor the work being done by the service and how it was performing. Data and service performance was reviewed and discussed as part of the monthly clinical governance meetings. These meetings also identified areas where the service needed to improve to better support patients and ensure they were receiving all appropriate aspects of their care and treatment.

Client outcomes were monitored through a process called the Treatment Outcome Profile (TOPs). The TOPs form is a national monitoring outcome tool developed by the National Treatment Agency to monitor clients at various stages in their treatment journey; the data is reported through the National Drug Treatment Monitoring System (NDTMS).

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable clients to make their own decisions. For clients who might have impaired mental capacity, staff were aware of what they may need to consider in relation to this and how they could access support and advice if needed.

Staff ensured clients had agreed and gave consent where required and appropriate.

We observed that client consent and capacity was considered within the client records that we reviewed.

Managers noted that training on the Mental Capacity Act was included as part of the service’s mandatory learning sessions.

Managers gave an example of a complex case where capacity and decision making had been had to be considered closely and sensitively. Managers advised that progress had been made for the client as a result of the work that had been undertaken.