St Andrews Healthcare Northampton

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, 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.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers told us they promoted a positive work culture and a diverse workforce. They were open and inclusive and very often mixed the staff skill set to help develop staff skills and help promote good practice in other wards. Leaders had regular meetings with staff and through being open, transparent, offered the correct training and support to empower staff to be part of the shared direction and open culture of the organisation.

Managers completed colleague engagement surveys to gather feedback from staff and implemented action plans which clearly showed areas they were going to prioritise as an organisation. Staff knew, understood and shared the provider’s vision and values and how they were applied to the service and the people they support.

Managers and leaders had the skills, knowledge and experience to provide safe care and treatment. They knew their service well and had a good understanding of the wards they managed including patients, staff and operations. Leadership opportunities and associated training were available for staff including the Aspire nurse apprenticeship. This allowed staff members to complete the qualification within the St Andrews Healthcare organisation and university while being supported financially and through pastoral care.

Staff felt supported and suitably supervised by their managers. Staff were very proud and happy to share the support they received from their managers including mentoring, gaining professional qualifications and reasonable adjustments made to support work life balance and cultural and religious needs such as observing Ramadan. Staff told us managers promoted a positive and diverse culture within the team.

The ward managers were supported by an overall general manager who oversaw the 3 wards alongside the Child and Adolescent Mental Health Services (CAMHS) unit within St Andrews Healthcare Northampton. A joint meeting was held once a week where all managers would share good practice and reflect upon actions across all wards. Leaders and managers in the service had access to leadership and development training. Senior managers were supported by the wider organisation, such as by finance, human resources and facilities.

The service had a whistleblowing policy and procedure in place. The policy guided staff on how to raise concerns and encouraged staff to feel confident in raising concerns and to question and act upon concerns about practice. It gave staff information on who they could raise concerns to including senior leaders and relevant bodies including the Care Quality Commission.

Ward managers said they had an open culture with an open-door policy, free from blame and actively encouraged and supported staff to give feedback on the service, through themselves, the Freedom to Speak Up Guardian and an anonymous telephone reporting system set up by the provider. Managers told us raising issues or concerns enabled the organisation to drive for consistent improvement and wanted staff to feel comfortable and confident with the organisations vision, to take ownership and feel involved. Staff said they were very comfortable in sharing concerns with their managers and there was a clear process in place which allowed the Freedom to Speak Up Guardian to escalate concerns to management at a board level.

Management was proud to have a diverse staff team and were inclusive regardless of opinion, ethnicity, and culture.

The service had staff networks for equality, inclusion and diversity. These groups included, PRIDE, a LGBTQ+ network, DAWN, a Disability and Wellness Network, WiSH Network, a Women in St Andrew's Healthcare network and a UNITY Network that was open to colleagues from across the charity from all ethnic backgrounds. These were accessible to all staff and were included in the corporate induction workbook.

Staff had shared examples of when they had faced racism from patients while on the ward. Staff did not feel targeted and said that believed it had occurred due to the patient's poor mental health. Staff felt supported and comfortable to raise and report incidents and were encouraged by their managers and the organisation to promote safety and wellbeing. Staff were aware of their rights to report the matter to the police and had support from managers and the service.

Managers and staff attended governance meetings held monthly to maintain transparency. Key performance indicators and monthly audit processes were in place to help give oversight of the service to managers. Managers we spoke with were able to describe the governance and reporting structure at ward and hospital level, as well as the quality and assurance processes in place with commissioning bodies. Managers had clear expectations of what care and support the service aimed to provide. They told us of processes in place to ensure they had oversight of the service. Robust processes were in place to safely manage sensitive data which allowed them to maintain people's privacy, dignity and confidentiality.

Staff we spoke with knew how to raise concerns and reported that they received feedback when they submitted incidents. Staff had access to of policies, procedures and operational guidance to support them in the delivery of care. Staff could access further support from mangers, provider level teams and specialists where required.

The service had a risk register in place with mitigations in place to help reduce the risk. These risks were discussed within governance meetings alongside other issues including complaints, incidents, meaningful activity, staffing, staff training and safeguarding. Each area was discussed in detail and where required appropriate actions were put in place, which were then reviewed at the next meeting. Staff completed audits to provide assurance and made improvements where required.

Managers understood the importance of positive working relationships with external partners, The service had processes including CPA meetings, discharge meetings and ward rounds to ensure all relevant partners were involved in patient care. They worked closely with the local NHS trust including the crisis team. Managers told us it was extremely important to maintain these relationships as it enhanced the service provision and maintained continuity for the patient. Managers and staff told us they had good working relationships with the police, local authority, integrated care board (ICB), local safeguarding team, community mental health services and the wider local community. They had collaborative meetings with partners and the wider community. The meetings enabled the provider, partners, and the wider community to share good practice and learn lessons together.

Managers told us they had recently experienced a positive change in culture, following the last CQC inspection report due to the efforts of the leadership team and the staff teams at the service. Managers told us they completed feedback to all staff on the progress made following the last CQC report and welcomed feedback from all staff to help with continuous improvement. Managers referenced the internal service quality improvement auditing programme in place. Regular staff meetings and de-briefs were in place to discuss incidents, and the lessons learnt. Managers acknowledged the importance of celebrating good practice. There were ward champions in place who were had oversight over certain aspects within the ward such as infection control and safeguarding. The organisation provided individuals with support, additional training and valued both their input and opinion.

The organisation held their first quality improvement conference in order to share the charities improvement journey and progress so far. This was attended by staff and leaders in person and remotely across Microsoft Teams.