CGL Waltham Forest Adults Substance Misuse Service

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Staff consistently treated people with kindness, compassion and respect. People described staff as supportive and non-judgemental and said they felt able to return following relapse. Observations showed staff interacted warmly with people, explained delays, offered reassurance and responded sensitively to distress.

Staff treated people as individuals and adapted care to reflect their needs, preferences and circumstances. They tailored communication approaches, supported people from diverse backgrounds and made adjustments for people with communication or accessibility needs. Staff involved people in decisions about their care and supported them to set personalised goals, including those related to recovery, independence and wider life outcomes.

Staff supported people to build confidence and structure through one-to-one work and group activities. People described positive impacts on their wellbeing and daily routines. Staff responded flexibly to people’s immediate needs, including accommodating late attendance and adapting support when circumstances changed. Observations showed staff recognised when people required support and responded promptly.

Staff worked within a supportive team environment and had access to supervision and leadership support. Records showed high levels of compliance with supervision, and performance management processes were in place. Leaders addressed previous gaps in appraisal completion, and all appraisals were completed by January 2026 following earlier recording and tracking issues. Appraisal data for the period December 2024 to November 2025 had shown reduced compliance, and leaders identified challenges with recording and tracking systems during this period, which they had resolved by the time of inspection.

We have not awarded this service a score for Caring.

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

Staff consistently treated people with kindness, empathy and respect, and people described staff as caring in their approach. One person said a staff member was “a good worker,” and another told us staff looked into their needs and supported them effectively during relapse, adding they felt able to return “without judgement.” These accounts aligned with observations during the inspection, where staff welcomed people warmly, offered refreshments, explained any delays and escorted individuals to appointments. Staff demonstrated warmth and attentiveness in their interactions and responded calmly when people appeared anxious or needed extra support.

Staff also spoke positively about the people they supported. One worker said their role had become more focused on spending meaningful time with service users, and another described this aspect of the job as their favourite part. Leaders and staff said they prioritised offering honest and sometimes difficult conversations to maintain engagement rather than excluding people, and this reflected the supportive culture described by those using the service.

The service promoted dignity in how it supported its staff. One member of staff told us managers took time to understand their health needs and agreed what information should be shared with colleagues to ensure their safety while protecting privacy. They said they felt listened to and respected as a result. This approach modelled the respectful culture described across the service.

Staff treated people as individuals and understood what mattered to them. People said staff did not judge them, and 1 person felt staff were understanding of their cultural background and how it influenced how they presented during appointments. They said their keyworker adjusted their approach to reflect this. Staff gave examples of tailoring conversations to what was meaningful for individuals, including discussing topics connected to a person’s heritage, such as culturally significant recipes. These approaches helped people feel recognised and understood.

Staff and leaders described how they tailored support for a range of individual needs. For example, 2 wheelchair users had their medication delivered by a pharmacy when travel to the service was difficult. Staff also used personalised communication approaches, such as a specific communication plan to support a Deaf person during emergency evacuations. Leaders said integrated governance meetings included open discussions about issues affecting individuals, including rising racial tensions in the community, and they described support from the provider’s inclusion team. Clinical and medical staff demonstrated relevant training and awareness, including transgender awareness training completed by the consultant, and leaders described further education provided to staff to strengthen inclusive practice.

Observations showed personalised practice in how staff responded to individual needs. A prescribing doctor carried out regular home visits for people unable to attend the service, and staff welcomed a support dog as part of a person’s care. Staff knew the local community well and ensured information was available in languages commonly spoken locally, including Polish. They also used interpreting services, and the team’s diversity meant some staff could communicate directly with people in their preferred language.

Care and treatment records review showed consistent documentation of people’s personal needs, strengths and goals. Records included personalised plans that aligned with what people told us about being treated as individuals, and what we observed during the inspection.

Staff supported people to make informed choices about their care and to retain control over their treatment. People told us they were included in planning and decision making, and this was reflected in all 5 care records reviewed. Records captured individuals’ personal goals, including ambitions related to employment, fitness and relapse prevention strategies. Staff encouraged people to set goals that were meaningful to them and reviewed these regularly.

Leaders and staff described activities that promoted independence and community involvement. Peer led gardening opportunities were available, and we observed front and rear gardens maintained jointly by people using the service and members of the community. Staff said these activities supported wellbeing and fostered choice and ownership over the service environment.

People could also access structured groups designed to promote independence. The timetable included an employability workshop, a weekend planning group and a recreational ‘fun group’ awaiting a final name. Staff explained these groups supported confidence, structure and day to day planning, which helped people build independence alongside their treatment programme.

Staff responded to people’s immediate needs in a flexible, understanding and person-centred way. People told us staff were accommodating when they arrived late to rapid prescribing sessions, and 1 person said this contrasted positively with previous services where they would have been turned away. Another person said their one-to-one appointments were well spaced and regular, and that the service was understanding over the Christmas period when they were unable to attend due to their child being unwell. This feedback reflected a flexible and responsive approach.

Leaders and staff described responding compassionately when people became distressed. They said they aimed to be patient and calm, recognising that distress could influence how people presented.

During observations, staff appeared to recognise when people were seeking help and responded promptly. We saw staff pause other tasks to support people without delay, demonstrating attentiveness and responsiveness in moments where individuals needed immediate help or reassurance. This meant people received timely reassurance and support when they were most vulnerable, which helped reduce escalation and promoted a sense of safety.

Staff told us they felt well supported in their roles, with regular access to supervision and opportunities for professional development. One worker said they received supervision, caseload management support and could approach managers whenever needed, adding that they loved their role. Another staff member, with 10 years’ experience in the organisation, said they had felt able to develop and support others over time. Staff described positive teamworking and said they knew where to seek help if needed. Leaders said they aimed to ensure staff felt comfortable and supported, which aligned with the experiences described.

During observations, staff and leaders demonstrated a clear commitment to workforce wellbeing. Caseloads were manageable, and staff did not raise concerns about workload. Posters celebrating staff achievements, such as “Tester of the Year,” were displayed across the site. End-of-day procedures were clearly outlined and accessible, which supported consistency and predictability at busy times.

Service data for the period December 2024 to November 2025 showed an appraisal completion rate of 72%, with 5 appraisals outstanding. Leaders reported that all appraisals had been completed by January 2026 following actions to address recording and tracking issues. This demonstrated that the service had addressed previous gaps and established improved oversight of appraisal processes. Leadership meeting minutes over several months recorded appraisal completion as an ongoing action and identified challenges with reporting and tracking following changes made to ‘Skills’ in July 2025. All staff except 1 had up-to-date one-to-one meetings recorded.