Via - New Beginnings - Brent

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question good.

At this inspection the rating has remained the same.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety based on openness and honesty, in which concerns about safety were listened to, safety events were investigated and reported, and lessons learned to continually identify and embed good practices.

In the 6 months, between 1 March 2025 and 1 September 2025, the service recorded 4 deaths of clients using the service, and 2 incidents of self-harm. At our last inspection there was a breach of regulations in this area, as the provider had not reported all relevant incidents to the Care Quality Commission. During this inspection, we saw that all notifiable incidents had been reported to the Care Quality Commission.

Staff shared learning from incidents in meetings and this was evident in their team meeting and governance meeting minutes. We also observed that, where appropriate, incidents were discussed at staff supervision meetings. Staff we interviewed were able to give us several examples of incidents that had occurred and learning from these. These included raising awareness of driving under the influence following an incident of this type involving a client. Another example of learning was how to better share critical information across all services involved in clients’ care.

Staff we spoke with knew what incidents to report and how to report them. Managers told us that every incident went through a lessons learnt process which formed an action to be completed.

Staff understood the duty of candour. They were open and transparent and gave people using the service and families (if appropriate) a full explanation if and when something went wrong. Duty of candour is a legal requirement, which means providers must be open and transparent with clients about their care and treatment. This includes a duty to be honest with clients when something goes wrong.

The service referral and admission process ensured that all essential information about the client was received to determine if their needs could safely be met.

Staff involved all the necessary healthcare and social care services to ensure clients had continuity of safe care, both within the service and post-discharge.

Staff provided assessments as soon as patients came into the service. In practice, if anyone self-referred, staff tried to provide an immediate assessment as they recognised that it could be challenging for people to make a first contact.

Allocated practitioners followed up client non-attendance pro-actively, and where necessary would refer clients to the outreach team to follow up with a home visit.

Staff from different disciplines worked together as a team to benefit clients. They supported each other to make sure clients had no gaps in their care.

Staff carefully planned clients’ discharge and worked well with external services to make sure this went well. There was a regular multidisciplinary meeting to review discharges.

The service worked with people to understand what being safe meant to them, as well as with partners, on the best way to achieve this. The service shared concerns quickly and appropriately. There was one area for improvement, which was that the service needed to keep their safeguarding referral tracker up-to-date, to accurately reflect the actions staff had taken.

Staff had training on how to recognise and report abuse, and they knew how to apply it. Staff had completed adult and child safeguarding up to level 3. Staff knew how to identify adults and children at risk of, or suffering, significant harm. This included working in partnership with other agencies. Staff told us that they referred any safeguarding concerns to the local authority safeguarding team where the person lived. Staff we spoke with were able to demonstrate a good understanding of safeguarding and gave examples of recent safeguarding and the process of referrals to the local authority.

Staff attended formal safeguarding meetings monthly. Safeguarding was also reviewed daily at check in meetings and at the weekly multi-disciplinary team meeting. Urgent cases could be discussed at either site. Records showed staff recognised safeguarding concerns and involved the local authority appropriately.

Staff used a safeguarding tracker to record safeguarding referrals that had been made to the local authority. We saw that this tracker was not always up to date and reflective of the actions staff had taken. This was an area for improvement at the last inspection, and the service should continue to monitor this. Since the inspection, the service have outlined how this has been addressed.

The service had made 27 safeguarding referrals in the previous 12 months. 17 were adult referrals and 7 child referrals. Staff also contacted local social services team for clients with children to check if they were known to social services after initial assessment.

Staff had access to a safeguarding lead, who had received level 5 safeguarding training for this role. This meant that staff had a person they could go to for advice and guidance if they had a concern about a client’s safety.

We spoke to 10 clients who all reported that they felt safe when using the service.

The service worked with people to understand and manage risks by thinking holistically so that care met their needs in a way that was safe and supportive.

Each client had a named recovery worker. Staff actively involved clients in care planning and risk assessment and sought their feedback on the quality of care provided. Discussions were held with staff and information leaflets had been developed about their treatment for dependence on alcohol or an opioid based substance.

Each client who used the service had a recovery plan and risk management plan in place. These had been reviewed and updated on a regular basis and all included clients’ views.

Staff communicated sensitively with clients and ensured that they understood their care and treatment. Clients had access to a range of information leaflets about the service and other relevant local services.

Staff engaged with clients, and their friends and families (where appropriate) to develop support plans that met their needs and ensured they had the relevant information needed to make informed decisions about their care.

Staff met clients on the premises, or if there were concerns about clients’ welfare joint home visits were considered. If clients failed to attend an appointment staff made every effort to contact them either by telephone, text messages or by contacting their next of kin and in some cases the client’s GP.

The service displayed suggestion boxes and a digital feedback kiosk in the reception area as another way for clients or carers and family to provide feedback on the service they had received. The service also displayed what they had learnt from suggestions and what they had done about it as a form of feedback. Clients also stated that they would like text message reminders about appointments. Following this, if a patient opted in, the services client management system automatically sends the client a text message reminding them 24 hours before their appointment.

Clients reported that they felt supported, informed and involved with their treatment decisions and care planning. All clients we spoke with reported they had discussed their plan of care with the team and were happy with it.

The service detected and controlled potential risks in the care environment and made sure that the equipment, facilities and technology supported the delivery of safe care.

The premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose. They were accessible to clients with mobility difficulties. Staff undertook monthly risk assessments of the care environment. Staff recorded and reported on any areas which required attention. However, we saw a disparity in the upkeep of Cobbold Road in comparison to the Willesden centre. Cobbold Road was very modern and had client input in decoration in comparison, whereas the Willesden site was not easy to locate within the service site.

Staff had the option of carrying personal panic alarms and some of the rooms where staff saw clients had an alarm button to use in an emergency. Staff at the service had landline and mobile telephones to call emergency services. Staff completed all off-site work in pairs or one Via staff with an external organisation practitioner. The provider did have a lone working policy that staff were aware of.

Staff completed daily and weekly environmental checks including CCTV, fire alarm, fire panel, fridge testing, panic alarm test emergency lights check, fire door, first aid. A fire risk assessment had been carried out for the service and the risk assessment identified the key risks of fire and how these should be mitigated, including the training of fire wardens and first responders on each day. The service completed emergency evacuations drills twice a year. We saw that a fire drill had taken place within the previous 12 months, and all staff, clients and visitors had been evacuated safely. The allocated fire warden for the day was discussed in every morning meeting so that staff were aware.

Clients and carers told us that they felt safe in the service. They described the environment as clean, safe and welcoming.

The service had enough qualified, skilled and experienced people, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

Via Brent New Beginnings is one treatment system operating from two sites, Cobbold Road, and the Willesden Centre for Health. Most staff at the Willesden Centre for Health were employed by the NHS partner trust. Seven Via staff worked alongside 22 NHS staff. There were enough staff to meet the needs of clients accessing New Beginnings and the service could manage any unforeseen shortages in staff. Via staff received relevant training to keep clients safe from avoidable harm, for example, in safeguarding and assessing risk. The service had a morning meeting to discuss staffing and cover arrangements.

At the time of our inspection all the staff were in permanent positions. The service at the time of inspection had 4 vacancies however these positions had been recruited to, and the onboarding process was ongoing.

There was a team of 7 outreach practitioners. They worked off site and in the community, to ensure people who could not attend the site could still receive care. This was completed in line with their lone working policy.

Staff had an average of 22 clients on their caseloads and reported that this was manageable. Staff were responsible for booking appointments for clients, being involved in assessments, maintaining regular contact with them, and ensured that client records were kept up to date. Staff from the NHS partner delivered clinical interventions and medicines management was outsourced.

The sickness rate for Via staff was 3.85%. Most of the staff had worked at this service for several years.

The service had arrangements in place for annual leave and sickness absence. For example, staff covered each other during periods of absence.

The medical establishment and medical cover, both in and out of hours, was provided by the partner NHS trust and was easily accessible to the team.

The service ensured robust recruitment processes were followed in line with provider policies. This included current criminal record checks, a minimum of two references and evidence of suitable experience for the role to ensure staff were safe to work with vulnerable adults. Some staff previously worked as volunteers for the service.

The service had arrangements in place to ensure staff had received vaccinations recommended by the Centres for Disease, Control and Prevention, for example, hepatitis B or chickenpox. Healthcare workers are at risk of exposure to Hepatitis B Virus (HBV) from infected clients and are also at risk of transmitting HBV to clients.

Staff were up to date with all their mandatory training with a compliance rate of 90%. Staff had completed training in infection prevention control, health and safety, diversity, equity and inclusion, safeguarding adults level 5 for managers, safeguarding children level 5 for managers, mental capacity act, de-escalation skills, professional boundaries, motivational interviewing, Best practice in Optimising Opioid Substitution Treatment (BOOST) programme, data security, The Oliver McGowan training on learning disability and autism, Modern Slavery and Human Trafficking and unconscious bias. Overall, there were always appropriate levels of trained staff on duty, when combined with the training of the NHS partner staff on site.

Clients reported that staff rarely cancelled appointments.

The service assessed and managed the risk of infection, detect and control the risk of it spreading.

All areas that clients had access to were visibly clean at the time of the inspection. There were regular cleaning schedules in place for the service to ensure that no areas were missed. The cleaning of the service was completed by an external service. Managers had access to cleaning records.

The service had a clinic room, which could be used to undertake physical examinations with an examination couch. It was visibly clean and clutter free. There were records to show that equipment, including scales and height measuring equipment were cleaned and calibrated regularly.

Staff completed monthly environmental audits and cleaning audits including checks on the safe storage of cleaning detergents. The provider had several policies including management of body fluids, hand hygiene, outbreak management, sharps. The partner NHS Trust also had their own Infection Control Policy.

Medicines were managed by the partner NHS trust.

Managers told us that all prescriptions and prescription forms (FP10) were stored securely and locked away on the electronic system. Staff had regular contact with community pharmacists to check if clients had been compliant with their prescribed medication.