The Sussex Beacon

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

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last assessment we rated this key question good. At this assessment the rating remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We assessed all quality statements in this key question.

The service had a shared vision, strategy and culture. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for people who work for them.

However, the service did not always have clear responsibilities, roles, systems of accountability or good governance. Staff did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The service was in breach of regulation in relation to governance processes. However due to the service becoming dormant during the period after the inspection, we did not issue an action plan in relation to this breach.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The Sussex Beacon vision was “Making a difference for people living with HIV”. Staff and leaders we spoke with were dedicated and passionate about achieving this vision.

At the time of the assessment, leaders were honest and open about the future of the service. They acknowledged that the inpatient unit was under utilised and not financially sustainable in its current format. Leaders had been working with the Integrated Care Board (ICB) to explore plans for the service, including options to open the service to other patients including those who did not have HIV. They recognised that the inpatient service may have to close unless a sustainable way forward could be found that worked for both patients and commissioners.

Because of this uncertainty, the service did not have a formal strategy at the time of the assessment. Instead, leaders had devised a ‘12-month roadmap’ which focused on aspects such as financial sustainability, quality and compliance, inclusive culture and amplifying the voices of people living with HIV. However, shortly after our assessment, the service was made dormant, and the inpatient unit was closed.

The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders understood and managed the priorities and challenges the service faced. However, prior to their appointment the service had operated without a registered manager for a significant amount of time. This meant that the new leadership team inherited a service that had lacked effective management oversight and financial direction.

Staff and leaders fostered a positive, compassionate, and listening culture that promoted trust and understanding.

Although new to their roles in the organisation, the CEO and registered manager were experienced professionals. The registered manager had extensive experience in HIV care and demonstrated a clear commitment and passion for supporting people with HIV to live their best life. The CEO, who was also the nominated individual had extensive experience of the charity sector. Both leaders acknowledged the challenges of taking responsibility during a period of instability and were committed to restoring financial stability of the service going forward and ensuring staff and patients were well supported.

The service had recently strengthened its governance arrangements by appointing 4 new trustees. Trustees were all from professional backgrounds with experience in either finance, healthcare, civil service or clinical practice, providing a breadth of expertise to support strategic oversight.

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff had access to the freedom to speak up policy which provided information on how to speak up and what to expect to happen after speaking up. Leaders and staff understood the importance of being able to raise concerns without fear of retribution.

Openness and honesty were encouraged at all levels within the organisation. Leaders told us about encouraging professional curiosity and reflection. A Freedom to Speak Up Guardian had recently been introduced to provide an independent and confidential route for staff to raise concerns or share ideas for improvement. Leaders explained this initiative was introduced to ensure all staff felt safe and supported to speak up, reinforcing a transparent and learning-focused culture.

The evidence showed a good standard. The service valued diversity in their workforce. Leaders worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service promoted equality, diversity and inclusion. It welcomed and celebrated people of all faiths, recognising that people’s cultural backgrounds and values differed and needed to be respected to provide a service for people from all backgrounds and walks of life.Leaders told us that the workforce included staff with lived experience and close connection to the communities served, which they felt was responsive to the needs of people who experience health inequalities and barriers to accessing mainstream services

Leaders told us they were committed to maintaining a culture that supported staff wellbeing, professional reflection, and psychological safety. They explained that a range of structured and proactive measures had been put in place to promote resilience, open communication, and staff engagement. These included facilitated clinical reflection sessions provided by a clinical psychologist from the local NHS trust. Leaders told us that these sessions offered a confidential and supportive space for staff to discuss complex cases and their emotional impact, with the aim of fostering reflective practice and building emotional resilience.

The evidence showed some shortfalls. The service did not always have clear responsibilities, roles, systems of accountability or good governance. Staff did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The 4 highest rated risks on the risk register were all related to financial sustainability. These included the risk of losing the NHS contract for the inpatient unit and the inheritance of legacy debts from the service. Leaders recorded mitigating actions for all risks. However, they did not update residual risk scores following these actions. It was unclear when or how often they reviewed risks, we did not find risks being discussed in the quality and governance committee meeting or in the board meeting minutes that we reviewed. This meant that there was no oversight of risks within the service or mitigations to reduce the risks. Following the inspection, leaders told us that at the time of the inspection the organisation was operating within a challenging financial and commissioning environment, with uncertainty regarding the future of inpatient services, which directly impacted on leadership capacity and governance processes. They told us that despite these pressures, patient safety was prioritised and proportionate decisions made to avoid exposing staff and patients to unnecessary risk.

The quality and governance committee met monthly and followed a standing agenda where incidents, policies and training were discussed. Risks were not a standing agenda item. We reviewed minutes from September and October 2024 and found they contained identical content, so it was unclear if these were accurate.

The service had over 114 policies, all of which required review at the time of our assessment. This meant that staff could be using policies that did not reference the most up to date standards or best practice. The service had recently employed a consultant to project-manage the review process and bring all policies up to date, however this was ongoing at the time of our assessment.

We found that several appliances were overdue or missing their electrical safety test. Staff told us that these tests were completed by third party contractors and that they were not aware of when they were next due to be tested.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. Staff shared information and learning with partners and collaborated for improvement.

The service collaborated and worked in partnership with external organisations to support people’s health and wellbeing.It worked with commissioners, local care providers, NHS trusts, charities and other health and social care professionals to coordinate and provide the best possible care. We saw examples of where patients’ care was planned to ensure that the right professionals such as psychiatrists and allied healthcare professionals from neighbouring organisations were available during a patient’s admission.

The service held a weekly multidisciplinary team (MDT) meeting with the HIV service based at a local NHS trust and was proactive in supporting patients to engage with other healthcare, social and charity providers.

The service was an active member of the local community and was actively involved in supporting a variety of charitable events.

The evidence showed a good standard. Leaders focused on innovation and improvement across the organisation and local system.

The service had previously introduced a self-referral pathway which was now embedded within the service. Electronic patient records had also been implemented since our previous inspection.

At the time of the inspection the future of the service was uncertain. Leaders at the service were in discussions with relevant stakeholders about the best way to future proof the inpatient unit and the wider organisation. Part of this planning was to redesign and adapt the service model to remain sustainable, equitable and clinically relevant in response to changing population need, commissioning priorities and financial realities. Following our assessment the service went into dormancy, and has since been re-opened with an updated statement of purpose.