Nelson House

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

At our last assessment we rated well-led as required improvement. At this assessment the rating has changed to good. 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. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected analyzed data about outcomes and performance. They used this to identify improvements.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 through regular communication and in-person visits. Staff at all levels had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. Staff could explain how they were working to deliver high quality care within the budgets available and were in discussions with commissioners to provide intensive reablement courses.

Leaders had the skills, knowledge and experience to perform their roles and 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 patients and staff. Leadership development opportunities have been utilised by staff at all grades including support working, nurses and senior leaders.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Patients and carers were involved in decision-making about changes to the service. Recent ‘You said, we did’ community meeting results were displayed on community noticeboards. Patients and staff could meet with members of the provider’s senior leadership team and governors to give feedback. Patients said they saw the hospital director every day and staff were visible on the wards.

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. Staff were positive about working at the service. They felt they were treated well and equally. Several staff stated the service supported flexible working agreements to account for personal circumstances such as caring responsibilities and health issues.

There was a clear framework of what must be discussed at a ward, team or directorate level in team meetings to ensure that essential information, from incidents and complaints, was shared and discussed. Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the patients.

Staff undertook local clinical audits on a monthly, quarterly and annual period with additional oversight from corporate quality improvement leads. The audits were sufficient to provide assurance and staff acted on the results when needed. The senior leadership team had good oversight of the quality of care being delivered across the hospital and actions needed to improve care.

Staff maintained a risk register at ward and hospital level. Concerns were escalated when required and acted upon. New cabling for improved WiFi was being installed to better support the digitization of EMAR prescription records, care records and service user needs. 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 were password protected, and access limited to protect the 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.

Patients and staff could meet with members of the provider’s senior leadership team and commissioners to give feedback. Information was in an accessible format, and was timely, accurate and identified areas for improvement. Service leaders engaged with external stakeholders describing good relations with ICB colleagues, commissioners, patient advocacy organisations, and providers of onward placements after discharge like the Society of St James.

Staff like the consultant psychiatrist and occupational therapist were given the time and support to participate in research with Queens University (Ontario) concerning overmedication and undiagnosed autism. Innovation is happening around sensory controls for irritability and establishing biomarkers and sensory profiles for patients, which is standard in the field of autism but new in rehabilitation environments (outside of learning difficulties). The hospital director is an accredited quality improvement coach and is providing bitesize training opportunities and supporting several staff to pursuing formal accreditation in this field, using quality improvement methods on service issues like ward rounds and carers meetings.