Via - R3 - Redbridge

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care, supported learning and innovation, and promoted an open, fair culture.

At our last assessment we rated this key question good.

At this assessment the rating has remained good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

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

Staff knew and understood the organisation’s vision and values and how they were applied in the work of their team. The organisation had the values of: Care, Be Human and Do the Right Thing. The mission was for all staff to be able to provide a wide range of treatment and recovery provisions to service users and their families in partnership with local providers.

All staff had a clearly defined job description.

Staff had opportunities to contribute to discussions about the vision and strategy of the service through team meetings.

Staff felt respected, supported and valued by their colleagues and managers. They reported that the provider promoted equality and diversity in its day-to-day work. They felt able to raise concerns without fear of retribution.

Staff were overwhelmingly positive about working at Via Redbridge. They described the morale in the team as very good and staff supported each other. They were very positive about what the service could provide and voiced a desire to be able to provide more, if funding allowed.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Staff reported that the provider promoted equality and diversity in its day-to-day work and in providing opportunities for development. For example, volunteer staff could become substantive members of the team.

Teams worked well together and where there were difficulties, managers dealt with them appropriately.

Staff spoke positively about the service leadership, clients’ recovery and how they supported them to achieve their goals.

Staff described their managers as supportive and motivating.

Leaders could clearly explain their roles and demonstrated a clear understanding of the services they managed. Leaders were visible in the service and approachable for clients and staff. Via Redbridge is one treatment system operating from one site. There was one full time service manager.

During staff discussions we saw that staff supported one another, created spaces where people could speak up and spaces where achievements were noted and celebrated. For example, giving positive feedback to staff who had done a specific task well for the first time.

Staff told us that they would have no hesitation in whistleblowing if they had concerns about the service.

Staff said they felt able to raise concerns with management if they needed to.

Most clients stated that they felt that they were able to raise any concerns and knew how to do this.

The provider worked towards an inclusive and fair working culture. Staff we spoke to stated that they felt respected and valued.

Staff received training on equality, diversity and inclusion.

Managers put reasonable adjustments in place for staff if needed and we saw this taking place during our inspection.

The service had an integrated governance policy, which included policies for complaints, quality, record management, risk management, incident reporting and health, safety and wellbeing. Appropriate systems were in place to evaluate the safety and effectiveness of the service.

The service held integrated governance meetings monthly, during which topics discussed included learning from incidents, safeguarding, audits, policies, and the piloting of new treatments. There were also morning staff briefing meetings for staff to share information in a timely way. We saw these were well facilitated and all staff were in attendance.

The provider had a clear framework of what had to be discussed at team meetings to ensure essential information was shared amongst the staff. The service held monthly team meetings where pertinent information was discussed. Monthly clinical governance meetings included an overview of service incident reports, compliments, safeguarding concerns and complaints.

Data and notifications were submitted to external bodies as required. For example to social services, commissioners and the CQC.

Staff had implemented recommendations from incident reviews and safeguarding alerts at the service level. We saw information in staff areas that outlined learning from previous months and what was expected of staff.

Teams had access to the information they needed to provide safe and effective care and used that information to good effect.

Managers engaged with various local community providers to ensure that an integrated care system was provided to meet clients' needs. For example, probation services, homelessness services and local mental health teams.

Staff used quality improvement (QI) methods and knew how to apply them. Staff provided two examples of QI projects. Projects included creating women only spaces that included self-care activities, therapies, art and creative activities and physical health checks. Since the introduction of the women only groups, the service has seen an increase in women engaging in activities they had not previously. Another QI project had improved joint working with local mental health services and focused on understanding one another’s services, referral pathways, and effective joint working. Since the introduction of this joint working the service has done more joint care planning meetings with service users.

Staff recorded incidents, complaints and compliments on the service’s reporting system, which worked well.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well.

The service manager said they had access to information to support them in their management role. For example, supervision records, training data, sickness records, health and safety audit and annual leave requests.

The service ensured confidentiality agreements were clearly explained including in relation to the sharing of information and data.

Staff collected and analysed data about outcomes and performance. The service submitted a quarterly report to commissioners on the quality and safety of the service and used the data to improve services.

Following the piloting of Long-acting injectable Buprenorphine (Buvidal), the service monitored outcomes, noting positive results in representation for treatment. They were identified as a best practice case study published by an international pharmaceutical company.

Where the service had embedded innovative and new pathways or support, they had carried out focused case studies, to find out what worked well and any areas for continued improvement.