Crossley Place

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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.

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 and analysed data about outcomes and performance. They used this to identify improvements.

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 we spoke with knew and understood the provider’s values and how they were applied in the work of their team. The provider had stated organisational values: kindness, integrity, teamwork and excellence. The senior leadership team had successfully communicated the provider’s values to the frontline staff in this service. This included in staff meetings, daily handovers and multidisciplinary team meetings.

Staff were positive about the service and felt they were part of a team that worked well together and were supported by managers. Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. This included in staff meetings, daily handovers and multidisciplinary team meetings.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. The service had an established registered manager. Managers completed a year-long management training course to support them to carry out their roles.

Managers felt supported in their role. They attended a daily call with other managers from Elysium Healthcare hospitals across the North West, where they shared updates and information. They routinely accessed information, advice and support from the provider’s human resources, finance and estates departments.

The registered manager was supported by a multidisciplinary senior leadership team. Managers had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

Managers were visible in the service and approachable for patients and staff. Staff felt supported by managers, who they could go to for support and felt listened to. Patients felt able to raise concerns or complaints and felt that they were listened to. Staff and patients were familiar with managers within the local service, but less so with senior managers in the wider organisation.

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 had access to information about how to raise concerns and access the provider’s Freedom to Speak Up Guardians (FTSUG). Information was on display within the service and on the provider’s intranet. Staff had regular meetings where information was shared and received provider-wide emails from the FTSUG. The service had recently nominated a local FTSU representative.

Managers promoted an open and honest culture. Staff told us they felt able to raise any concerns they had and knew how to contact the FTSUG. The findings of the most recent provider’s staff survey were made available in November 2025. Out of 58 staff, 64% responded that they could ‘speak up’ without fear of negative consequences, but 16% felt they could not. Managers had taken action to address this, which included promoting two-way communication through various methods. There had been 1 whistleblowing or freedom to speak up concern raised over the 12 months prior to our inspection. Managers had discussed the concerns raised with the staff team. They had initiated a ‘Culture Web’ analysis, which was a process for assessing the culture within an organisation. The findings were positive about teamwork, prioritising patient safety, and having high clinical standards. There were recommendations for the senior management team which broadly suggested improvements to their communication and visibility, and more general recommendations around staff recognition and facilities. An action plan was developed which had mostly been completed at the time of our inspection. All staff had completed closed cultures awareness training.

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

At provider level there were groups to represent the interests of people with a disability, women, LGBTQ+, race and ethnicity, and working families and carers. Inclusivity and diversity was a standing agenda item in the local governance meetings. The provider had carried out a recruitment drive for nursing staff from overseas, and several had been employed at the hospital. There had been some difficulties due to different cultures and expectations, but the provider had supported staff through induction, and local managers had worked with staff and patients to address the problems.

Managers put reasonable adjustments in place for staff members to help them carry out their role. This included for people returning to work from sickness absence and pregnant women. Staff could apply for flexible working and told us that managers allowed short or longer term flexible working to take account of personal circumstances, such as caring responsibilities and health issues, provided it could be accommodated within the service.

The provider undertook equality monitoring of staff within the service. This was not necessarily reflective of the patient group, which came from countries across the United Kingdom and the Republic of Ireland.

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

The provider had a clear governance process that ensured information was shared from the service, to regional governance meeting, and up to the provider’s board. Meetings took place at set time periods so they could feed into one another. Managers held a comprehensive governance meeting each month, that had a set agenda. The set agenda included safety, training and education, clinical effectiveness, patient and carer experience, leadership and lessons learned. Staff collected and analysed information that was routinely monitored through an online dashboard and was collated and summarised for review in the monthly governance meetings.

Managers held a daily multidisciplinary management meeting where each patient was discussed, any significant incidents or events were discussed, and relevant information shared. Broader management issues were also discussed which included potential admissions, staffing levels and training. Medicines records and physical health monitoring records were reviewed at the end of each meeting, so that any required actions or errors could be quickly identified and addressed.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level. Managers carried out a detailed review of all incidents at the monthly governance meeting, and shared learning from this and other services. Staff had made changes following incidents, which included how staff observed patients, and improvements to practice drills for medical emergencies. Managers attended a daily meeting with managers from the other 7 hospitals owned by the provider across the North West. They shared key information, which included incidents.

Staff undertook and participated in local clinical audits. Audits were recorded on an online system that was accessible across the organisation. Managers had carried out audits to gain assurance of staff skills in the areas of observation, safeguarding, food and fluids, infection prevention and control, and medicines. Where gaps or issues were identified they were acted upon and the actions recorded.

Managers maintained and had access to the risk register. Staff could escalate concerns when required. The risk register included specific clinical risks, direct risks to the service, and broader risks that were not specific to this service. Each risk had a rating and the action taken to remove, reduce or mitigate the risks. The risk register was reviewed at the monthly governance meeting, and any new risks were added when necessary.

The service had plans for emergencies such as adverse weather, a flu outbreak or a major power cut. Staff had access to business continuity plans which identified the action they should take and who they should contact if these events occurred.

The service used systems to collect data that was not over-burdensome for frontline staff. 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.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure generally worked well. Information governance systems included confidentiality of patient records.

The hospital provided a specialist service, which meant patients were admitted from across England and other countries, and were often not from the local area. Patients were supported to keep in touch with relatives, even if they may be some distance away.

Patients and staff could meet with members of the provider’s senior leadership team and commissioners to give feedback. Managers and the consultant psychiatrist attended the patients’ community meetings. Commissioners visited the service and usually met with the patient whose care package they commissioned as part of their monitoring.

Managers had regular meetings and provided information to commissioners in an agreed format. Managers and staff shared information with commissioners and other representatives who were routinely involved in reviewing each patient’s care and progress. Managers shared information with host-commissioners, who had oversight of the service as it sat in their local area, even though they had not placed any patients there. Stakeholders were generally positive about their engagement with the service and the care provided and had not raised any significant concerns.

We scored the service as 4. The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff were given the time and support to have opportunities for improvements and innovation and this led to changes. Staff used quality improvement methods and knew how to apply them. Staff had opportunities to participate in research.

Innovations and improvements were taking place in the service.

Obesity was identified as a significant concern within the service, in common with many other mental health services. Staff initiated a weight-loss programme to address this. Staff considered the impact that a patient’s mental health had on obesity and vice versa, and the barriers to reducing weight from both patients and staff. Patients had their physical health routinely reviewed and monitored, and this information was analysed. Staff carried out detailed assessments of each patient’s capacity to consent to weight-loss interventions. Where patients were deemed not to have capacity best interest processes were followed. The weight-loss interventions included care plans to manage diet and promoting exercise and movement during leave, in addition to weight-loss medicines from a registered weight-loss clinic. Most patients on the programme paid for the weight-loss medicines themselves, as they were not able to access them through the NHS, and this was considered as part of their capacity assessment. After 16 weeks there had been significant weight loss for all patients who remained on the programme.

Staff were developing a trauma informed approach within the service. The model had three key stages: safety and stabilisation; skill discovery and self-development; and reconnection and transition. Psychology staff were leading on the approach with awareness sessions, a working group, pathways, environmental audit, and staff training. Trauma informed newsletters were sent out to keep people informed of the approach, the plan for its implementation, and what had been achieved so far. Implementation included an assessment of the environment, talking with staff and patients, and training. The model had been presented at a psychological trauma research and practice awards ceremony.

The service was collaborating with an artist as part of a tree-planting project within the hospital grounds. Patients had been engaged in discussions about what they wanted from the grounds, and it was expected that patients from Crossley Place and other Elysium hospitals would be involved in the planting.

Staff were in the early stages of participating in ‘The Triangle of Care’, a membership scheme that promoted standards for mental health providers to demonstrate their commitment to supporting and engaging with carers.

Patients had submitted art works to the Koestler Awards, a charitable organisation that promotes participation in the arts for people who are detained.