Change Grow Live Barnet

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 requires improvement. At this assessment the rating has remained requires improvement. This meant leadership and governance did not consistently provide assurance or support the delivery of high-quality care.

Leaders described a clear vision and values, bold, open and compassionate, which they said guided decision-making and service delivery. Staff recognised these values in practice, and leaders planned a facilitated session to refresh understanding and align objectives. A transformation plan set out strategic actions, including introducing a training and partnerships lead and a structured 12-week programme.

However, governance processes did not consistently provide assurance or ensure follow-through. Incident records showed gaps in oversight: for three of the ten incidents reviewed, actions lacked completion dates and there was no evidence checks had been carried out to confirm effectiveness. Plans for unexpected exit from treatment were not documented in care records, reducing assurance that staff could respond quickly if the key worker was unavailable. Supervision compliance for volunteers was low, and inspectors did not see emergency protocols or staff guidance for managing out-of-hours situations. Vacancies and sickness led to raised caseloads, and staff raised concerns about workload distribution and limited administrative support.

Leadership capability and culture were variable. Some staff described leaders as approachable and supportive, while others reported inconsistent visibility and perceived micromanagement during high-demand periods. Freedom to speak up processes were in place, but staff experiences were mixed, and further work was needed to embed a consistently open and safe environment for raising concerns. Workforce equality and inclusion were not fully embedded, with staff reporting limited involvement in decision-making and inconsistent approaches to adjustments.

While leaders acknowledged recurring issues such as missed reviews and delays in prescribing, they stated that sustained monitoring and follow-through were being prioritised to prevent recurrence.