Reset Treatment and Recovery Support Service - Tower Hamlets

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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.

Leaders and staff shared a clear understanding of the service’s goals and values, and there was evidence of a culture that promoted learning and inclusivity. Staff told us they felt encouraged to speak up and share ideas, and governance records showed wellbeing was a standing agenda item.

Almost all staff described leaders as knowledgeable, approachable and compassionate. They said managers were supportive and responsive, and people using the service spoke positively about staff acting quickly when they had worries. Governance arrangements were robust. There had been improvements to the services culture, which would benefit from a continued focus to ensure these are embedded.

Leaders worked collaboratively with partners and community organisations, enabling people to access practical and emotional support in familiar settings. Staff had access to professional development opportunities, and leaders participated in external forums to share learning and maintain current practice.

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.

Leaders and staff demonstrated a shared understanding of the service’s goals and values, and there was evidence of a culture that promoted learning and inclusivity. Senior staff described clear plans for achieving service objectives and processes for addressing shortfalls. For example, leaders told us they were using the Integrated Governance Team Meeting (IGTM) approach to monitor the quality of delivery and had introduced a stigma pilot to address discriminatory practice. This was supported by evidence of the staff survey being discussed at a strategic leadership meeting and the provider’s involvement in the national Changing Stigma Indicators project. These initiatives reflected a commitment to embedding equality and reducing stigma, helping to create an environment where people using the service experience care that is respectful and free from discrimination.

Staff and leaders described an open approach to learning. Equality training was mandatory for all staff, and neurodiversity training was available. Death reviews were held every two weeks to identify learning without apportioning blame, and staff were invited to share challenges and request support. This was consistent with feedback that staff were encouraged to speak up and challenge decisions during meetings and that weekly clinical discussions and Continuing Professional Development (CPD) sessions were used to share learning. These processes help ensure staff have the confidence and knowledge to deliver safe and effective care, and that learning is shared across the team.

Staff told us that in the past, decisions were mainly made by senior leaders, but they now feel the culture is becoming more open and collaborative. One staff member told us they felt the service was “getting a lot better” and moving towards “good treatment,” although they were not always confident about approaching managers without fear of confrontation. They said leaders could sometimes be empathetic and that relationships had improved over time. This was balanced by comments that leaders had provided clear guidance and direction and had done a “fantastic job” in meeting service goals. These differing views suggest progress in developing an open culture that would benefit from further embedding.

Policies and procedures supported the service’s commitment to equality and inclusion. We saw evidence that the Equality, Diversity and Inclusion policy was included in the staff induction handbook, with links to relevant procedures. The provider’s Pulse survey of people using the service recommended celebrating recovery stories and sharing lived experiences to inspire others and reduce stigma. This demonstrates that the provider was seeking feedback and using it to inform cultural initiatives, ensuring that the service reflects the needs and experiences of the people it supports.

Almost all staff we spoke with told us leaders had the knowledge and compassion to lead effectively. They said managers were approachable and friendly, and staff felt able to be open and honest when raising issues. This created a culture where staff felt supported and confident to seek guidance, which helps ensure that concerns are addressed promptly and care for people using the service remains safe and responsive.

Staff told us leaders were generally aware of what was happening in the service. A few staff said their own line managers were supportive, but they felt the wider focus was mainly on clients, with less attention to staff wellbeing. They said trauma-informed approaches were used for people but not always for staff, which they felt could affect resilience. Some staff also said repeated inappropriate behaviour by people using the service was not always addressed effectively and that the usual response was to reallocate the person to another worker. This left some staff feeling unsafe and unsupported. Leaders acknowledged these concerns and explained that the service does not operate a blanket ban policy, which they felt could limit options for managing behaviour. They told us they aim to address issues through engagement and modelling positive behaviours.

The registered manager had been in post since 2021 and described their leadership style as inclusive and fair, aiming to create an open and supportive culture. They had recently completed a 360-degree feedback process, which included comments that they were informative and approachable. Staff told us they valued the manager’s experience in the sector and felt confident in their knowledge. We saw examples of positive feedback from staff, including an email from a nurse who expressed satisfaction with working at the service.

People using the service spoke positively about staff responsiveness, telling us that staff acted quickly when they had worries or problems. They described staff as “amazing,” which reflects the impact of effective leadership on the quality of care delivered. When leaders create an environment where staff feel supported and valued, it enables staff to focus on meeting people’s needs promptly and compassionately.

Staff consistently told us they felt confident to raise concerns and speak openly within the service. They described a positive team culture where they were supported by peers and leaders, and said this helped them feel safe to share issues or ideas. Leaders were described as collaborative and approachable, and staff said they worked together to find solutions and communicated these with the wider team. When staff can share concerns without hesitation, leaders are able to act quickly to resolve issues, which helps maintain continuity and safety in care for people using the service.

Staff feedback indicated that leaders had created an environment where openness was encouraged. One staff member told us they felt listened to, even if actions were not always immediate, and another said the team was caring and compassionate despite the challenges of the work. Leaders had introduced initiatives to support wellbeing, including reflective practice sessions and one-to-one meetings with a psychologist. These measures help staff manage the emotional impact of their roles, which supports consistent and high-quality care delivery for people who rely on the service.

We saw evidence in governance meeting minutes that staff wellbeing was a standing agenda item, and that a staff support working group survey had been discussed. Leaders told us they monitored supervision and appraisal completion rates through performance assurance meetings, and data showed this site exceeded the provider’s national average. Meetings were held monthly rather than quarterly, giving leaders more frequent opportunities to identify and respond to staff concerns. Regular oversight means staff receive timely support, reducing the risk of stress or burnout that could affect the quality of care.

Processes to enable staff to speak up were embedded in induction materials, which included links to the whistleblowing policy and wellbeing resources. Staff told us they could provide feedback anonymously if they wished, and leaders confirmed that morning meetings were used as a forum for staff to share what was working well and what they were unhappy with. When staff can raise issues openly or anonymously, leaders can address problems before they escalate, ensuring people using the service experience care that is safe and responsive to their needs.

Staff told us they were treated fairly and reported no concerns about their own treatment or that of colleagues. They said they felt able to raise concerns about discrimination if needed, and there had been no incidents reported to us. When staff feel confident that they will be treated equitably, it supports trust within the team and helps maintain a stable workforce, which benefits people using the service through continuity of care.

Staff also told us they could request flexible working arrangements, including working from home. This flexibility helps staff balance personal responsibilities with work demands, reducing stress and supporting retention, which in turn ensures people receive care from staff who are focused and able to deliver consistent support.

Processes to promote equality and inclusion were embedded in induction materials, which included links to the provider’s Equality, Diversity and Inclusion policy and procedure. We reviewed training records and saw that between 96% and 100% of staff had completed mandatory training on equality and diversity, including ‘Equal Opportunities and Diversity’. High compliance with this training means staff are equipped to recognise and challenge discriminatory practice, which helps ensure people experience care that is respectful and inclusive.

Meeting minutes from health and safety discussions showed leaders considered adjustments to the physical environment, such as introducing acoustic dividers at one site. This was acknowledged as a cultural change and intended to support staff who experience neurodivergence or find noise challenging. Making these adjustments helps create an inclusive workplace where staff can work effectively, which supports the quality of care delivered to people using the service.

Staff told us they believed the service was well managed. We saw evidence of governance arrangements that supported this view, including bi-weekly service performance meetings, multidisciplinary team meetings and treatment and care review panels. These forums provided oversight of clinical and operational matters, enabling leaders to monitor performance and address issues promptly, which helps prevent delays or gaps in care for people using the service.

Risk management was embedded across the service. Meeting minutes from health and safety, IGTM and strategic leadership meetings showed risks were discussed regularly. A risk register was in place with five items recorded, each with a clear direction of travel and up-to-date review dates. Two risks were stable, two improving and one worsening. Keeping risk information current allows leaders to prioritise actions and allocate resources effectively, supporting continuity and safety for people using the service.

Between August 2024 and March 2025, four statutory notifications were not submitted in a timely manner during that period. The provider explained that vacancies in key leadership roles had reduced the pool of notification authors and temporarily increased line management responsibilities. To address this, the provider increased the number of staff authorised to submit notifications, strengthened governance pathways by appointing a new quality and governance lead, and refreshed reporting timelines with the leadership team and wider service. These steps made the governance process stronger and added backup, so statutory notifications could be sent on time and legal requirements were met.

We also saw evidence of processes to inform relevant partners of incidents, including commissioners, in contract monitoring meeting minutes. Timely communication with external stakeholders helps maintain accountability and ensures that any impact on service delivery is managed collaboratively.

The service worked collaboratively with a range of partners and community organisations to support people’s recovery and wellbeing. People told us the service liaised with children’s services and their GP to coordinate care and treatment, which helped ensure support was consistent and addressed wider health and social needs. This was supported by evidence of GP shared care arrangements, showing that clinical information was shared appropriately to maintain continuity of treatment. Meeting minutes from the Combating Drugs Partnership confirmed the provider participated in discussions with stakeholders including the Drug Interventions Programme and Safer Communities, which enabled joint planning to address local priorities.

People said they were encouraged to attend mutual aid groups such as Alcoholics Anonymous (AA) and SMART Recovery, and one person described the SMART Recovery course as effective. Staff told us they delivered training in partnership with the local recovery college, which promoted shared learning and strengthened links with community-based recovery support. We also saw evidence that external charities held clinics onsite to provide advice on legal issues, housing and benefits, and information about local talking therapies was displayed within the service. These arrangements meant people could access practical and emotional support in a familiar environment, reducing barriers to engagement and helping address wider determinants of health.

Staff described joint working with external agencies as part of the treatment pathway, including collaboration with the local NHS trust to achieve good outcomes for people who had struggled to engage with early intervention services. The provider also worked with the hepatology department at a local hospital to deliver liver health checks through the Liver Bus, enabling early detection of liver disease for people at risk.

The provider’s risk register showed they had identified challenges in intelligence sharing about new synthetic opioids and had taken steps to mitigate these risks. Actions included internal roadshows to raise awareness of naloxone use and non-fatal overdoses, harm reduction training for staff, and monthly reviews of the local plan with senior clinical leaders. These measures were supported by evidence of positive communication channels with hostels and borough-wide forums, which helped ensure timely information exchange and coordinated harm reduction strategies. This approach strengthened partnerships and ensured staff were equipped to respond to emerging risks.

The service demonstrated a commitment to learning and continuous improvement through structured processes and active engagement with staff and partners. Staff told us they were able to share ideas in meetings and that the service regularly sought feedback from people and their relatives. This helped ensure that improvements were informed by the experiences of those using the service, supporting changes that were relevant and meaningful.

We saw evidence in the provider’s improvement plan of actions taken to strengthen family and carer support, including a promotional drive within children’s social care teams to improve uptake of the MPACT programme (Moving Parents and Children Together). This is an evidence-based, whole-family intervention designed to support families affected by parental substance misuse. It typically involves a series of structured sessions delivered in a multi-family group setting, focusing on communication, coping strategies and understanding the impact of addiction on family life. Completed actions included incorporating presentations on family services into open hour sessions, adding family-specific training to the annual training calendar, and delivering marketing outreach projects with promotional materials displayed in community settings such as GP surgeries. Numerous presentations had been conducted with partners and stakeholders, which supported wider awareness and access to family interventions. Staff confirmed these initiatives during interviews, describing how they promoted family interventions and couples counselling at networking events and in meetings with children’s social services. They also told us about monthly family service sessions held at the service, where external professionals were invited to speak and promote their services. These activities helped build partnerships and ensured families were aware of available support, which is important for sustaining recovery and reducing the impact of substance misuse on family relationships.

Staff described opportunities for professional development, including access to management training and a new team leader curriculum. Although some staff reported challenges in completing mentorship programmes due to time constraints, they told us they had applied for mentorship opportunities within the wider organisation. This supported leadership development and succession planning.

The provider’s approach to improvement was supported by active participation in external events and forums. Staff told us they attended networking events such as the London Recovery event and partnership meetings with children’s social services, where they shared information about service initiatives and discussed the impact of programmes. These opportunities enabled the service to learn from others and contribute to sector-wide developments, which helps ensure practice remains current and responsive to emerging needs.