We are With You North Lincolnshire

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.

Good: Staff assessed the physical and mental health of all clients. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for clients based on national guidance and best practice. The team included or had access to the full range of specialists required to meet the needs of clients using the service. Staff from different disciplines worked together as a team to benefit clients.

We have not awarded this service a score for Effective.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive assessment of need including history of substance misuse and any mental and physical health needs. Assessments identified client’s internal and external resources and support networks. During inspection we observed assessments that were undertaken in a client-centered and holistic way, allowing the client to be involved in decision making about their treatment plan.

We also reviewed 5 care records which included care plans developed to meet the clients’ mental and physical health needs including history of substance misuse and these included clients’ views. They all included a comprehensive assessment of a person’s physical health needs and clear evidence of tools being used to assess severity of substance use and symptoms.

We saw evidence that staff regularly reviewed and updated care plans when clients' needs changed. Staff responded promptly to any sudden deterioration in a client's health, for example management and response to relapse.

We scored the service as 3. The evidence showed a good standard. 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.

We saw evidence that 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 and the Orange Book, which identifies drug products approved based on safety and effectiveness. Staff ensured that clients had good access to physical healthcare, including access to specialists when needed. The service had audits in place to ensure staff provided evidence-based care and treatment.

Staff routinely offered blood borne virus testing to clients and supported them to access treatment for any viruses detected.

Staff were experienced and qualified and staff told us they were given opportunities to develop their skills and knowledge to meet the needs of the client group. Managers provided new staff with appropriate induction. Managers ensured that staff had access to regular team meetings and reflective practice, and staff told us these were always collaborative, included learning and were productive.

Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and at the time of inspection all staff had received regular supervision. In the last 12 months 96.7% of staff had received an appraisal of their work performance.

We scored the service as 3. The evidence showed a good standard. 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 told us that meetings were held regularly and effective for sharing information internally. Staff shared information about clients at morning handover meetings. We reviewed 3 records from these meetings, which showed that topics such as staff roles for the day and duty tasks were confirmed, any prescription, risk and safeguarding concerns discussed, any clients in hospital and any other relevant information such as alerts regarding contaminated drugs.

We received feedback from the commissioners of the service and 5 external partners who all confirmed effective working relationships and told us that individual staff members work very collaboratively and in partnership.

We scored the service as 3. The evidence showed a good standard. 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.

Staff we spoke with understood the importance of ensuring people’s needs were met, including their physical health. We reviewed 5 care records and saw evidence that clients were supported to live healthier lives using recognised rating scales such as general anxiety disorder and patient health questionnaires.

We spoke with service users who confirmed they were supported to deal with issues relating to substance misuse and their physical and mental health.

The service engaged with a smoking cessation scheme and attended regular meetings with the Healthy Lifestyles team at North Lincolnshire Council. The service reported quarterly on providing interventions, issuing vapes and signposting clients to the postal scheme to support smoking cessation.

We scored the service as 3. The evidence showed a good standard. 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 used several methods to monitor and improve outcomes such as regular audits, meetings, surveys and feedback.

The service also undertook a mystery shop at local pharmacies to understand the client experience. This included the number of clients that attend, availability of the required equipment, information and overall service provision. It was noted if any additional training was required by the service and actioned. The service also held a pharmacy engagement event To gain a better understanding of how the service can work collaboratively with pharmacies to provide high quality services.

The service used recognised rating scales to assess and record severity and outcomes, for example, Severity of Alcohol Dependence Questionnaire (SADQ) and cognition screening with clients and these were reviewed. Staff submitted reports about care and treatment outcomes to the National Drug Treatment Monitoring System (NDTMS).

The service produced a quarterly contract monitoring report, which we reviewed during our assessment and we received feedback from commissioners which confirmed the service were meeting their contractual obligations.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

We reviewed 5 care records and found evidence of the assessment of mental capacity on admission and on an ongoing basis to acknowledge the fluctuation of capacity.

All staff completed mandatory training in safeguarding, which included the Mental Capacity Act and at the time of our inspection this had 95% compliance. The staff we spoke with had a good understanding of mental capacity and were confident about how to assess it. Staff told us they took all practical steps to enable clients to make their own decisions and provided good examples regarding raising safeguarding concerns.

Staff ensured clients had agreed and signed confidentiality agreements in relation to which parties’ staff could share their personal information with.