Via - R3 - Redbridge

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 requires improvement.

At this inspection the rating has changed to good.

This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

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

Staff knew what incidents to report and how to report them. Staff had received training on how to report incidents using the electronic reporting system. Managers investigated incidents and shared lessons learned with the whole team and the wider service. We saw that learning from incidents was discussed and learning was embedded into service practice and development.

In the last 6 months, there had been 6 serious incidents. These related to deaths, on site medical emergency and continuity of care. The service completed robust investigations of each incident as required. These investigations included learning, to ensure these incidents did not take place again.

Staff shared learning from incidents in monthly integrated governance meetings. This was evidenced in the October 2025 local integrated governance meeting minutes, where staff discussed the outcome and key learning points from an onsite medical emergency and one where an illicit substance was found onsite. During our onsite visit we saw a poster about incidents and learning from 2025 to 2026. For example, to use tags on the case management system for people with neurodiversity, to ensure their communications needs were understood and met.

In addition, Via shared alerts from other services it provided in other locations, to ensure learning across the whole organisation. The service manager attended a regular meeting with other Via service managers where key findings from serious incidents were discussed.

Staff understood the duty of candour. Duty of candour is a legal requirement. It means providers must be open and transparent with clients about their care and treatment 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 be safely met.

The service received referrals from GP surgeries, community mental health teams, social workers, homelessness centres and self-referrals.

The service offered clear pathways for new clients taken on by the service, with the goal of achieving an appropriate transfer to other services such as GP surgeries, local community mental health teams, or another support network identified during their care.

The service offered alcohol, opiate, non-opiate, medication and abstinent pathways. The service had robust alternative care pathways and referral systems in place for people whose needs could not be met by the service. For example, clients who required extra support were sometimes referred to in-patient detox or residential rehabilitation.

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 first contact.

Treatment commenced as soon as necessary medical checks had been performed. Waiting times for non-urgent referrals to assessment were three to five working days. Referrals were screened and clients were contacted by phone or letter. The service was able to see urgent referrals quickly. The service had designated time slots during the day to see urgent referrals or clients who turned up to the clinic without an appointment.

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.

Since our last inspection the service has ensured all staff received an accredited training in tackling substance misuse.

Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. The service had a safeguarding lead. Staff we spoke to knew who this was. 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, or the safety of others in contact with the client.

Staff could give examples of how to protect clients and others from abuse and neglect. This included clients with alcohol and drug issues who lived with young children and exploitation associated with substance misuse.

Staff received training on how to recognise and report abuse, and they knew how to apply it. Staff received training in level three safeguarding for children and adults. The completion rate for safeguarding level 3 was 97%. The completion rate for safeguarding level 5 was 86%.

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 they referred any safeguarding concerns to the local authority’s safeguarding team where the person lived. Records showed staff recognised safeguarding concerns and involved the local authority appropriately.

Staff were able to raise safeguarding concerns at daily morning meetings. The safeguarding lead attended external meetings with Redbridge Safeguarding Adults board. The service had engaged in a number of Safeguarding Adult Reviews, attended the Redbridge ‘One Panel’ and also contributed to safeguarding assurance exercises such as the Safeguarding Adults Self-Assessment. The Redbridge One Panel is a multi-agency group which receives referrals on cases in Redbridge that may meet statutory review criteria, and makes recommendations about what type of review should be undertaken.

The service had a monthly safeguarding meeting, where all current safeguarding concerns were discussed and actions updated. Safeguarding concerns were also reviewed daily at check in meetings and at the weekly multi-disciplinary team meeting.

Staff used a safeguarding tracker to record safeguarding referrals that had been made to the local authority. The safeguarding tracker was reviewed monthly.

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 assessments 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. The service used an electronic care record system, where assessments and treatment reviews were recorded.

At our last inspection we stated that the provider must ensure that staff create a good risk management plan that robustly assesses and manages risks to clients, and that all staff are trained in assessing and managing risk. During this inspection we saw that each client 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. In a small number, we saw these could have been more detailed. However, most detailed keywork notes and outlined clients’ needs, risks and plans.

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 educated clients about the risks of continued substance misuse and worked with them on harm minimisation to themselves and others. Clients were, for example, given naloxone, a medicine for use in the event of an overdose, with training on its use.

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

Clients had plans in place in the event of their unexpected exit from treatment. This included consent given by clients for home visits. Staff had a system in place to alert them if a client was not seen for 28 days or more, and they would attempt to contact clients in accordance with their previously agreed choices. For planned end of treatment, staff provided information to each client’s GP, and where relevant to next of kin prior to discharge.

Staff saw clients on site or conducted home visits when necessary. Where there were concerns about clients’ welfare that needed a home visit or changes in risk, this was discussed in team meetings prior to home visits being conducted.

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 premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose. At the time of inspection, the service was in the process of undergoing refurbishment and was awaiting Via decoration to be completed.

Staff could access personal panic alarms. The rooms were not fitted with alarms, but staff were able to take an alarm into rooms with them. The system allowed others to see which room an alarm was activated in. There were staff on site to respond to alarms. Staff tested the panic alarms weekly and monthly to ensure they worked. The service assigned two staff members at the start of each shift as first responders to attend to an emergency.

Access to the service and staff offices in the building was secured. There was clear information about this for staff and visitors.

Staff completed monthly health and safety audits to assess the safety of the building. The service assigned two fire wardens for each shift. This was confirmed in every morning meeting. We saw that a fire drill had taken place in October 2025, and all staff and clients had been evacuated safely.

Staff completed daily and weekly environmental checks including CCTV, fire alarm, fire panel, fridge testing, panic alarm test, emergency lights check, fire door and 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 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 service embedded personal safety protocols for staff to follow. Staff followed lone working protocols to ensure their safety on home or external agency visits. Staff used mobile phones when they visited clients' homes and always went in pairs. Staff discussed which staff were going on home and external agency visits in every morning meeting, so all were aware of the time of visit and location. Staff at the service had landline and mobile telephones to call emergency services. The provider had a lone working policy that staff were aware of.

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

There were enough staff to meet the needs of clients accessing Via Redbridge 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 where a part of the meeting was to discuss staffing and cover arrangements.

The service had calculated their staffing establishment. Roles included a full-time service manager, a clinical lead, a doctor, a clinical psychologist, nurses, health care assistants, non-medical prescribers, team leaders, and recovery practitioners. There were quality and governance leads and a data and performance lead.

There were low levels of staff vacancies. At the time of inspection, there were three recovery practitioner vacancies, one prescriber and one team lead vacancy. All vacancies were covered by locums whilst permanent staff were recruited. The service was in the process of recruiting to these posts.

In the 12 months prior to the inspection, the staff sickness rate was 8%. The service had arrangements in place for annual leave and sickness absence. The service had a designated duty manager and duty worker assigned to each shift. They ensured cover arrangement were made for staff in their absence.

In the last 12 months prior to the inspection, the staff turnover rate was 28%. Reasons given for staff leaving included career development, and a change in career.

At the time of the inspection, the service had 598 clients accessing care and treatment. This was an average caseload of 25 clients per recovery practitioner. Staff reported that this was manageable. Recovery practitioners were responsible for booking appointments for clients, being involved in assessments, maintaining regular contact with them, and ensuring client records were kept up to date. Managers reviewed caseloads with recovery practitioners during supervision.

In the last 12 months prior to the inspection the supervision compliance rate for staff was 95%.

In the last 12 months prior to the inspection the appraisal compliance rate for staff was 95%.

All medical reviews and prescribing were completed by the clinical and medical leads. The service also had one non-medical prescriber who was also responsible for re-issuing prescriptions and administering medicines if needed. Appropriate staff were involved in clinical decisions. Out of hours, clients were advised to attend the local emergency department or dial 999 in the event of an emergency.

Staff had received and were up to date with most mandatory training. Overall, compliance with mandatory training was 90%. Staff had completed training in infection prevention control, health and safety, diversity, equality and inclusion, safeguarding adults 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. Staff who were not managers had level 3 training in safeguarding.

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.

The service had arrangements in place to ensure staff had received vaccinations recommended by the Centers 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.

Clients reported that staff rarely cancelled appointments.

Staff adhered to infection control principles, including handwashing. Staff disposed of clinical waste appropriately.

We found that medicines were managed well overall.

The service had policies, procedures and training related to medicines and medicines management including prescribing and detoxification. Controlled drugs were held at this service on a named patient basis. Appropriate staff prescribed medicines. Medicines were dispensed at a pre-arranged pharmacy and convenient to the client.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff regularly reviewed the effects of medicines on each service user’s mental and physical health.

Medicines and controlled stationery were stored securely, and trackable audit records were kept. Prescriptions were either given directly to the client via appointments or at home visits.

The service had clear methods around logging prescriptions. This meant staff could account for all prescription serial numbers. The prescription management system was audited regularly. Whilst on site we saw a small delay in some prescriptions being confirmed void in line with the provider process. When we raised this to the service, this was addressed immediately.

Staff were able to administer certain medicines via Patient Group Directions (PGDs), which are written instructions allowing healthcare professionals to supply and/or administer specified medicines to defined groups of patients without a prescription in line with the recommended guidance.

Service users were provided with a lockable medicine safe to facilitate the secure storage of medicines at home. Service users had access to naloxone and were given appropriate information on how to use it.

The service stored controlled drugs (CD). This was picked up from the pharmacy prior to the appointment where it was administered. Staff worked closely with GPs, pharmacies and wider multidisciplinary team (MDT) teams to optimise medicines safety for service users.

The service had a contract with a waste management company who disposed of all their used sharps bins and any clinical waste.

Staff obtained service users’ consent to information sharing with their own GPs. Staff could access service users’ medical history, therefore were able to conduct medicines reconciliation prior to prescribing. If a service user did not have a GP, they were supported to access one, and staff took a comprehensive medicines history.

Staff told us that they reviewed the physical health of clients according to NICE guidance. Service users were offered a urine drug screen initially and during their time with the service. Service users were offered blood borne virus tests prior to treatment (hepatitis B, hepatitis C, and HIV). If a service user met the eligibility criteria for the hepatitis B vaccine, nurses were able to administer the hepatitis B vaccine via a PSD or PGD. Electrocardiograms (ECGs) were conducted by staff in the service where appropriate, for example, clients who were taking high doses of methadone.

The physical health clinical rooms were clean, spacious and equipped with handwashing facilities. Staff had access to emergency medicines, equipment, and medicines disposal facilities.