We rated Referral, Utilisation and Intensive Case Management as outstanding because:

• The morale among all staff we spoke with at the service was excellent. Senior staff and leaders within the organisation were described as visible and accessible, driving improvements and leading by example, demonstrating commitment, enthusiasm and innovation in their roles.Staff and managers demonstrated an open and transparent culture that ensured learning from complaints and incidents was embedded in practice. Staff were encouraged to share concerns and enable change. Staff were supportive of each other.
• Care records reflected holistic and recovery focussed interventions. Staff completed person-centred assessments with young people to ensure they would receive the right referral pathway that was the least restrictive for them. Staff had built good working relationships with partners and external agencies and were embedded in the multidisciplinary teams on inpatient wards where young people they supported were receiving treatment.
• Staff were qualified, skilled and experienced and ensured young people were safe. They provided a high quality service that was accessible to everyone in need of the service. The service did not use bank or agency staff, to ensure consistency of service delivery.
• There was a person-centred culture within the service at every level from senior managers to front-line staff. Staff showed commitment to working in partnership with people who used their service, and their families and carers. Feedback from young people and their families was positive.
• The service had reduced the average length of stay for young people on inpatient wards and developed new, accessible pathways for young people to access services to support engagement of vulnerable young people into services that might have otherwise been missed. The service had a ‘no wrong door’ policy. This meant that anyone who contacted the service would receive referral onwards to a suitable support service.
• The service had low numbers of incidents and complaints. There was an imbedded culture of learning lessons and improving safety following incidents that had affected the service and those that had occurred outside the service. Governance structures were clear and provided assurance that the service was safe and effective and achieving a high standard of care.
• Staff were aware of their responsibilities in relation to the Mental Health Act and Mental Capacity Act and their guiding principles, including Gillick competence. Staff ensured children and young people made informed choices following assessment and routinely sought their consent to access treatment.
• Staff looked outside their own organisation for quality improvement and research methodologies. The service and managers sought innovative ways to project a continuous cycle of improvement. The service was involved in multiple projects and worked in innovative ways to inform future practice. They routinely shared learning with partner agencies to improve outcomes for young people.