Brainkind Neurological Centre York

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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 remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The service worked well with external partners also involved in people’s care. There were effective governance systems in place which identified, managed and monitored risk. Managers implemented action plans, strategies and processes which had worked well and improved the overall governance of the service.

However, some staff did not feel well supported and fed back that managers were not always available. Staff survey results showed that staff did not feel confident in managers and leaders. This included concerns about their communication and understanding of staff and the people they supported.

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.

We scored the service as 3. 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.

Staff were able to demonstrate that they 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 communicated the provider’s vision and values to the frontline staff in this service and staff and patient voice had been considered to contribute to discussions about the strategy for their service, especially where the service was changing. The service had recently undergone changes in management, but staff believed that this would effect positive change.

Staff could explain how they were working to deliver high quality care within the budgets available, although felt more staff would allow for increased activity and engagement. The service was actively recruiting at the time of inspection.

We scored the service as 2. The evidence showed some shortfalls. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support.Leaders in the service had the skills, knowledge and experience to perform their roles and held a good understanding of the services they managed although staff often felt they lacked support. Staff we spoke with told us that some leaders were visible, but not always. Some staff felt senior leaders were busy and staff sometimes lacked support at ward level. Leadership development opportunities were available, including opportunities for staff to progress and we spoke with staff that had done so. One member of staff told us, ‘You could excel within this service if there was more support’.

Since our last inspection, staff felt things had not improved, which was reflected in the October 2025 staff survey. Staff spoke to us about lack of supervisions and appraisals, which had affected their ability to develop in their roles. Staff told us there was a high turnover of staff and that lack of consistent, experienced staff contributed to burn out. However, staff expressed that when they did speak with leaders, they did feel listened to.

We scored the service as 3. 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, patients and family members felt that they were able to speak up regarding concerns and knew who to report concerns to. The service had a whistleblowing policy in place and data showed staff felt confident in using this.

Patients and staff had opportunities to give feedback on the service they received in a manner that reflected their individual needs, such as surveys. Family members we spoke with told us they often gave feedback, whether this was positive or negative. Managers and staff had access to the feedback from patients, carers and staff and identified areas for improvement from this.

Care records showed that patients were involved in decision-making about changes to the service, such as ‘You said we did’ initiatives and ideas about individual and group activities that could take place. Patients and staff could meet with members of the provider’s senior leadership team and governors to give feedback.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service was in the process of allocating new equality and diversity champions within the service including LGBT+ and BAME champions. Recent changes in staff meant currently, this role was not allocated. Staff were able to apply for flexible working either informally or formally. Flexible working arrangements were reviewed at 3 month, 6 month and then yearly intervals. Reasonable adjustments were made for staff who required them, this included staff who were pregnant and enabled them to safely carry out their roles with relevant safeguards in place. Managers told us that the organisation undertakes equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and governance structures in place. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had a risk register in place which clearly stated each risk and the mitigation in place to help reduce the risk. These risks were discussed within governance meetings and discussions also included complaints, compliments, incidents, patient experience, compliance and standards. Each area was discussed in detail and appropriate actions were put in place when required and reviewed in subsequent meetings.

We reviewed 3 months’ worth of audit monitoring, which demonstrated good oversight of clinical auditing, and governance meeting minutes which showed discussions by senior leaders around risk and mitigation. Managers had clear expectations of what care and support the service aimed to provide and robust processes were in place to safely manage sensitive data which allowed them to maintain people’s privacy, dignity and confidentiality.

There was a business continuity plan in place. The plan covered potential risks related to staffing, local emergencies, and building or maintenance issues affecting service delivery. Managers understood and had access to the annual budget. They monitored monthly expenditure reports, which enabled them to track and plan the annual budget.

Staff understood the arrangements for working with other teams, both within the provider and externally, to meet the needs of the patients, and knew when to make referrals. Staff had access to the equipment and information technology needed to do their work, including the use of electronic tablets which were easy to transport. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. The service worked alongside external stakeholders such as commissioners and the wider integrated care board to ensure patients’ care was appropriate.

Managers arranged for commissioners to attend review meetings and meet with people prior to admission. The provider was open and transparent to external stakeholders including commissioners and provided them with regular updates. There were good links with the local authority and clear safeguarding processes in place. The provider had processes including care programme approach meetings, discharge meetings and ward rounds to ensure all relevant partners were involved in people’s care.

We scored the service as 2. The evidence showed some shortfalls. The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Staff we spoke with told us that there were opportunities for additional training and progression, though this was difficult due to pressures of staffing. Staff we spoke with also told us that they had not been involved in any research within the service. We spoke with managers who told us that staff were previously involved in pilots for testing benefits of changes within the services, such as IT systems and ways of working.

Innovations that were taking place in the service were around the use of the incident reporting system and use of data within handovers, as well as improvements to the care records and ‘My plan’ system. Patients were able to update their plans when they wanted to update goals and hopes as well as being able to feedback on their own plans with oversight from the multidisciplinary team.

At the time of inspection, the service was not participating in any national audits but were looking at completing Accreditation for Inpatient Mental Health Services (AIMS) which is aimed at improving quality on mental health inpatient wards through self, peer review and feedback from both patients and family members.