Reset Treatment and Recovery Support Service - Tower Hamlets

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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

People consistently described staff as kind, respectful and supportive. We observed warm interactions and practices that upheld dignity, such as knocking before entering rooms and using private spaces for conversations. Staff had completed training on cultural safety and confidentiality, and people said these behaviours helped them feel safe and valued.

Care and treatment were tailored to individual needs. People described flexible appointments and adapted groups, and staff made reasonable adjustments such as longer sessions for interpreters and tailored resources for transgender people. Leaders promoted inclusivity through cultural competence training and partnerships with translation services. These actions helped ensure people felt understood and respected.

People said they were involved in decisions and supported to make choices. Activities and spaces encouraged independence, and staff used motivational interviewing to build confidence. People told us staff responded quickly to concerns, and we saw evidence of clear processes for urgent situations, including accessible panic alarms and regular testing. Staff described managers as approachable and supportive, and wellbeing initiatives such as reflective practice and decompression spaces helped maintain a positive culture.

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.

People told us staff were kind, understanding and respectful, with one person describing them as “always having a smile” and “amazing.” We observed staff interacting warmly with people throughout the service. These behaviours helped people feel valued and supported.

People told us their care and treatment were tailored to their individual needs. They described flexible appointment times and said groups were adapted to meet specific needs, with one person commenting that the women’s group was “great.” Others described the service as “beyond 5-star” and “a life saver,” and said staff had “put me on the right road to recovery.” This matters because when care reflects what is important to people, they are more likely to feel valued and engage fully with their treatment.

Staff explained they asked people what they wanted and supported goal setting during one-to-one sessions. They described adapting care for diverse communities, including a large Bengali population, and said they worked to remove barriers by offering home visits and providing printed materials in different languages. We saw evidence of reasonable adjustments being made, such as booking longer appointments for people who needed interpreters, supporting a transgender person with tailored resources and community links, and arranging home visits for people with mobility difficulties. These actions are important because they enable people to access care in ways that meet their needs and reduce the risk of exclusion.

Leaders told us they had introduced initiatives to improve cultural competence and inclusivity. This included training for staff, partnerships with translation services, and adapting practice for people who were blind or hard of hearing. The service had a diverse team and had taken steps to address gaps, such as creating a job description for a Somali-speaking worker and delivering khat-specific psychoeducation sessions for Somali women. Staff also described work to engage LGBTQ+ communities, including offering a SMART group that was well attended. We observed that the service provided timetables in both Bengali and Somali, and Somali-specific newsletters, alongside groups delivered in Somali.

People told us they felt supported to make choices and had control over their care. They said they were involved in decisions about their treatment and recovery, and no one reported any concerns in this area. This matters because when people are actively involved in decisions, they are more likely to engage with treatment and achieve sustainable recovery. One person told us they would like more funding so they could attend courses, which showed that while people felt empowered, some external factors limited opportunities for further independence.

Staff described how they worked with people to identify and achieve their goals, even when those goals differed from their own clinical perspective. They explained that psychosocial support was prioritised alongside prescribing, as this addressed the underlying reasons for substance use. Staff gave examples of using motivational interviewing and positive risk-taking to help people learn from experience and build confidence in managing their own recovery. They emphasised that people were the experts in their own lives, and their role was to support and guide rather than direct. This approach is important because it promotes autonomy and helps people develop skills to maintain progress beyond treatment.

We saw evidence that the service offered a range of activities and spaces that encouraged choice and independence. There were computers available for people to use, and noticeboards displayed timetables for sessions such as budget cooking, co-production spaces, and education, training and employment drop-ins. Posters created by people, including motivational messages, were displayed in communal areas, reinforcing a sense of ownership and involvement. The service also hosted events such as coffee mornings, talent shows and poetry performances, which gave people opportunities to connect socially and express themselves.

Care records showed that staff adapted support to meet individual circumstances. For example, one person who had returned to full-time work was able to attend evening sessions, ensuring they could continue their recovery while maintaining employment. This flexibility is important because it reduces barriers to engagement and supports people to balance treatment with other responsibilities.

Staff and leaders described additional initiatives that promoted choice and control, such as women-only spaces, acupuncture sessions, and clinics for people who sex work. Mutual aid groups were available most evenings, and staff told us these provided safe environments for people to share experiences and support each other. These options gave people the ability to choose what worked best for them, which is essential for personalised care.

People told us staff responded quickly when they raised worries or problems. They described the service as responsive and said they could contact staff easily by text message or telephone. People also told us they were given contact numbers for urgent or out-of-hours help, which helped them feel reassured that support was available when needed. This is important because timely responses reduce the risk of harm and help people feel safe and supported during periods of crisis.

Staff explained how they managed urgent situations. They told us they would speak with people who were upset, offer reassurance, and provide practical support such as a drink or fresh air. Staff described using de-escalation techniques and maintaining neutral body language to prevent situations from escalating. They said they worked as a team to keep the environment safe and would involve other professionals if they believed someone was at high risk. This matters because effective de-escalation and teamwork can prevent harm and maintain a calm environment for everyone using the service.

We observed visible and accessible panic alarms in all rooms. Staff told us these alarms were tested weekly and records confirmed this. Staff were aware of the procedure for responding to alarms, and the provider had a document listing emergency response teams. However, some staff expressed uncertainty about how quickly help would arrive if an alarm was activated. One staff member told us they were confident in their own ability to manage situations, but not confident others would know what to do. Another staff member described a previous incident where a colleague was locked in a room by a person using the service. Records showed this incident was investigated and managed by the provider, and learning from this had led to improvements, including ensuring alarms were accessible and procedures clarified. This is important because clear processes and staff confidence in emergency response reduce risks to both people and staff.

Staff gave examples of responding to immediate risks. One staff member described how they identified a person at risk of suicide and escalated concerns to the duty manager. They told us they updated the risk section on the system immediately and changed the risk status to current. They also said the wider team was informed at the morning briefing and the person was given crisis contact details and advised to call emergency services if needed. The provider also submitted a statutory notification to CQC following a serious safeguarding incident. Records showed the service escalated concerns internally, informed relevant agencies, and arranged an emergency safeguarding meeting to plan safety measures. This demonstrates that staff acted promptly and followed safeguarding processes to protect people from harm.

People told us the service provided good support for families, which helped them feel involved and reassured. Staff said they worked together to share information and support colleagues when urgent situations arose. Leaders told us they had a duty system in place and allocated first responders each day. They confirmed panic alarms were called “support signals” and were tested regularly. They also told us learning from incidents had led to improvements in response times and staff awareness of procedures. This is important because a coordinated approach ensures people receive timely help and reduces the risk of harm during emergencies.

Staff told us they felt safe and confident to raise concerns and said managers were approachable and worked collaboratively to find solutions. They described leaders as supportive and said they could approach team leaders or colleagues when times became overwhelming. Staff confidence in raising issues helps maintain a safe and effective service because concerns can be addressed promptly before they impact care.

Leaders told us they had implemented changes to support staff wellbeing, including reflective practice sessions, one-to-one meetings with a psychologist, and immediate debriefs following incidents. They also introduced decompression spaces, trauma groups, and workshops such as ‘Being with Dying’ to help staff manage the emotional impact of their work. Leaders explained decompression spaces were introduced following staff feedback and were intended to help staff manage stress before leaving work. Minutes from strategic leadership meetings showed workforce decompression spaces were discussed on several occasions. Leaders also told us they acted quickly on staff feedback, saying they used electronic surveys and task and finish groups to implement changes within a month following feedback at IGTM meetings. Structured wellbeing support reduces stress and helps staff remain resilient, which is essential for sustaining safe and compassionate care in a high-pressure environment.

Staff described feeling proud to work in a team that prioritised wellbeing and said there was always someone available with a solution. They told us they could request protected time and use work-from-home days to catch up on administrative tasks. Observations during the inspection showed leaders actively checking in with staff and engaging in light, positive interactions, which staff said helped them feel valued. A positive culture and practical support reduce the risk of burnout and improve the quality of care provided to people using the service.

However, some staff told us they consistently raised concerns about safety and behaviour from a small group of people using the service but felt management responses were limited to policy explanations. They said they would like clearer boundaries, such as behaviour contracts or short bans, to reduce stress caused by repeated incidents of abuse.

Leaders told us they had introduced a principal psychologist and reflective practice groups, including sessions for staff working with rough sleepers. They said they reviewed supervision quality through dip sampling and held meetings to discuss incidents, sickness, and reasonable adjustments. Staff confirmed reflective practice was available monthly, although some said they used the time for other work. Leaders also told us they recognised staff achievements through monthly Spotlight Awards, which staff confirmed and said helped them feel valued. Minutes from internal governance meetings showed staff awards were a standing agenda item. Recognition and structured support contribute to staff morale and retention, which helps maintain continuity of care for people using the service.