Field House

On this page

• 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, honest, and 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. Thesenior leadership team had action plans, strategies, policies, and procedures in place which maintained good governance, oversight, and overall management of the service. Leaders celebrated having a culturally diverse workforce as it better represented the patient group and the wider community. The service had clear vision and values around the patient experience and the quality of care and support they constantly strived to provide. The service provided various innovative initiatives for its staff to maximise their skill set and practice which enhanced the care, support, and treatment they were able to provide to the patient and their loved ones. The service had a culture of openness, honesty, and inclusion which encouraged and supported staff in all areas to provide feedback. Where appropriate lessons had been learnt, and this drove improvement for the service.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff across the service knew, understood and supported the vision, values and goals of the service, and how their role helped in achieving them. There were comprehensive and successful leadership strategies in place to ensure and sustain service delivery, and to develop the desired culture. For example, PDSA cycles to measure impacts and outcomes. There were processes in place to ensure the vision, direction, and culture of the organisation were embedded, through a comprehensive organisational induction, mandatory training, and ongoing individual and team support.

Leaders were compassionate, and inclusive at all levels. They demonstrated experience, and the capability needed to deliver good and sustainable care. Leaders were visible and available, communicating with nursing teams regularly. Leaders were inclusive of all staff and were open and honest. Engagement with staff was consistent and considered a priority. Sharing information and values helped them to understand the vision of the organisation. They gave direction and encouragement to their staff and were inclusive and supportive, staff were listened to. A system of leadership development and succession planning was in place, to ensure that leadership represented the diversity of the workforce. Leaders were open, and supportive of all staff, encouraging and supporting them through training opportunities to develop their skills, and had a dedicated upskilling budget which was used to enhance the knowledge and practice of its staff. Leaders supported all its staff as individuals and learnt as much as possible about their workforce. Leaders supported and encouraged them.

Leaders had an open culture and actively encouraged staff to raise any issues or concerns with the Freedom To Speak Up service. Staff were aware how to raise concerns and knew who the freedom to speak up guardian was. Leaders felt raising issues or concerns enabled the organisation to learn lessons which ensured improvements were made. Leaders engaged with all staff because they recognised that all voices were important, and to be valued. The service promoted an open culture around feedback from staff through a comprehensive survey, where themes were identified, addressed, and actions were put in place to reach a resolution. Whistleblowing policies and procedures were in place to enable people to raise concerns or complaints confidently, knowing they would be supported and informed of outcomes and actions taken.

The service was proud of its culturally diverse workforce and supported them individually and as a team. Leaders were supported by the HR department, Freedom To Speak Up guardians, and the Equality, Diversity and Inclusion (EDI), an overseas staff ambassador, and a hate crime and anti-racism officer. This ensured all staff had a voice, they were listened to and supported. Leaders made reasonable adjustments and offered flexible working patterns for staff who needed it as it was important that all staff felt safe in the environment and supported to work. This enabled staff to have quality time for themselves away from the workplace, maintaining a good work life balance.The hate crime and anti-racism officer was available to support staff and patients and had completed training and education with all staff. The service completed LGBTQ+ training and education.

Leaders had clear responsibilities, roles and systems of accountability which ensured good overall governance, and risk oversight. However, the governance processes were not always fully effective. For example, the provider had processes for weekly reviews and audits of medicines administration records; on occasion these had failed to identify or address the gaps we found during our assessment. Following our feedback, leaders took prompt action and provided the required assurance before the assessment was concluded. The service encouraged staff at all grades to attend governance meetings, face to face where possible, where strategies and values were promoted, knowledge shared, and feedback encouraged.Leaders and staff attended daily patient safety and risk oversight meetings, and monthly governance meetings to maintain transparency and improve care. Patients had a patient representative who was invited and encouraged to attend governance meetings, and to be involved.All information, learning, and feedback was shared with staff electronically, in team meetings, and with patients through patient meetings. Leaders had clear expectations of what conduct, care, treatment, and support the organisation should be providing, and were also aware of the potential impact on care and support if they did not meet their own standards. Where appropriate lessons were learnt, which enabled the service to continually improve. There were procedures in place to safely manage sensitive data which allowed them to maintain people’s privacy, and confidentiality. Meeting minutes evidenced staff from different areas of the service attended and were involved in discussions about the service and how improvements could be made. For example, the freedom to speak up guardian attended governance meetings and was able to raise concerns or give feedback, this ensured the governance process could monitor the information and where needed, take action to address any issues, and improve. Meeting notes evidenced leaders had taken appropriate actions after feedback had been received from the freedom to speak up guardian.Processes ensured measurable outcomes supported service objectives, through service delivery plans, team and individual work planning, and patient, family and commissioner feedback which was shared throughout the service. The service adhered to statutory and regulatory requirements and where required, worked closely with the regulator of the service.

The service worked well with and were inclusive of external partners and care providers who were involved in care delivery. Staff and external care providers were seen as equal partners. Feedback from partners demonstrated the service was open, honest, and very responsive to patient needs, keeping patient care at the centre of all they did. Constructivechallenge from the patients and stakeholders was welcomed and seen as a way of improving the service. Leaders had good working relationships with the local community mental health teams, the local authority safeguarding team, the integrated care board (ICB), and the wider community. Leadershad collaborative meetings with partners and the wider community, which enabled them to share good practice and learn lessons together. The service welcomed and utilised the knowledge, and expertise of partners, understanding the importance of joined up collaborative working, and the positive impact this would have on outcomes for the patient. Innovativeapproaches were used to gather feedback from patients, the public, and included people in different equality groups, either by completing feedback forms in writing or digitally by scanning a Quick Response code (QR). Feedback forms were available in different formats and languages upon request. The service was committed to acting on all feedback.

Leaders promoted quality improvement projects (QI), there were projects that focused on service delivery, and patient experience. For example, supporting patients to write reflective accounts, healthy and sustainable food sources, and exercise initiatives, including gym membership, dance, and aqua fit. Learning is shared, promoted, and encouraged. Action plans were formulated through monitoring outcomes to address any issues or concerns, this drove improvement, promoted innovation, and enhanced knowledge and learning. Leaders celebrated good practice and used this to maintain the drive to succeed. Managers attended regular meetings with all staff where innovation, ideas, and learning was shared. Leaders shared work locally and nationally, with other rehabilitation service providers in numerous benchmarking schemes and clinical audits. For example, Clozapine medication and the links to diagnosis. The service also promoted an expert by experience research project which was done in coproduction with patients at the service.