Francis House

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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 changed to requires improvement .

There was no structured way for managers to measure and track service performance. There were insufficient systems to ensure medicines policies around transport were being followed and insufficient systems to ensure all volunteers were checked by the disclosure and barring service. The service was not using any quality improvement methodologies and was not actively part of any research.

However,

Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued.

This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of regulation for governance at the service.

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.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in this service.

Staff could explain how they were working to deliver high quality care within the budgets available.

Leaders had the skills, knowledge and experience to perform their roles.

Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

Leaders were visible in the service and approachable for clients and staff.

Leadership development opportunities were available, including opportunities for staff

Clients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs.

Managers and staff had access to the feedback from clients, carers and staff and used it to make improvements.

Staff are able to apply to work flexibly e.g. flexible working agreements to account for personal circumstances such as caring responsibilities and health issues.

Managers put reasonable adjustments in place for staff members to help them carry out their role.

There was no clear framework to measure key performance indicators at the service. This meant that the service could not easily measure its performance and improve. There were also insufficient systems to ensure that all staff were acting in line with policy on the transport of medicines, and insufficient systems to ensure that all staff (including all volunteers) had been checked by the disclosure barring service.

However, Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the clients.

Staff maintained and had access to the risk register at local level. Staff at local level could escalate concerns when required.

Staff concerns matched those on the risk register.

The service had plans for emergencies – for example, adverse weather or a flu outbreak.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care.

Information governance systems included confidentiality of patient records.

Team managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

Leaders engaged with external stakeholders – such as care managers.

Clients and staff could meet with members of the provider’s senior leadership team and commissioners to give feedback.

There was no current research taking place at the service.

Staff did not use quality improvement methods to improve the service.

The service participated in national audits.