King's Mill Hospital

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

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At the last inspection this was rated as good at this inspection it remains good. This meant there was good leadership and a culture that created high-quality care.

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.

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.

Divisional leaders told us the medical strategy interlinked with the trust strategy. Main workstreams were admission avoidance, improving patient flow and discharge and to digitise and integrate data to improve efficiency.

The Trust actively promoted a zero-tolerance stance against discrimination, championing an inclusive working environment. They had a No Place For Racism strategy. They have a multicultural workforce representing over 100 countries. Flags reflecting colleagues' countries of birth were displayed in the hospital to support inclusivity and a welcoming environment.

The trust had access to community hospitals which allowed them to increase the flow through the hospital, especially for stroke patients. There was a shared direction and services in the community had been developed to support people in their own homes, such as virtual ward, SDEC and medical day case unit.

There was a shared culture of learning and improving to enhance the patient experience. The senior leaders were passionate about getting services right for patients and gave us several examples of changes to services including the stroke pathway and links with GPs for respiratory patients to prevent admissions.

Staff told us they were proud to work at the hospital and most staff enjoyed their work and felt supported by each other and their direct leaders. They told us about working together as a team and sharing information with other departments to support the flow of patients throughout the hospital. However, some staff felt senior leaders in the organisation did not listen or support them and they were not always involved in or information was shared about decisions, working environments and changes.

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.

Most staff felt supported by all levels of their leadership team. Staff spoke positively about the immediate managers and matrons and the way they supported them. Matrons and senior leaders spoke with emotion about how proud they were of their teams, their dedication and compassion to deliver good care. Staff knew who the executive leaders were and told us they sometimes visited the ward.

The leaders were available when they were needed and led by example. They were knowledgeable about the issues and priorities in the medical service. The were keen to harness the improvement and suggestions made by staff. They focused on staff wellbeing and ensured a culture promoting good practice, good quality, and safe care and treatment.

Matrons and senior leaders told how proud they were of their teams, their dedication and compassion to deliver good care.

All staff had opportunities to develop, including for future leadership roles. There was inclusive recruitment and succession planning for the future. The trust had effective recruitment processes and ongoing checks to ensure all staff met the legal requirements to work in the trust. The service was aware of the challenges they faced in recruitment and the areas which required further support.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The hospital had a Freedom to Speak Up Guardian (FTSUG) and Freedom to Speak Up champions. A FTSUG is a named person in every trust who can provide independent support and advice to staff that want to speak up. Staff told us they were aware of the champions and would access them if required.

Managers supported an open and honest culture. Most staff we spoke with felt supported, respected, and valued. The culture encouraged openness and honesty at all levels within the organisation. Most staff told us they felt able to raise concerns and they were listened to by the leaders of the service. Staff described a ‘no-blame culture’ which empowered them to raise any concerns.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

Divisional leaders told us the medical strategy interlinked with the trust strategy. Main workstreams were admission avoidance, improving patient flow and discharge and to digitise and integrate data to improve efficiency.

Some wards had more than one extra patient in a bay. Bays that were designed for 4 or 5 beds had an additional bed to help with support the high number of patients admitted. Additional beds in bays on wards helped prevent patients having care in corridors, especially in the emergency department. There was a policy to ensure patients placed in additional beds were clinically appropriate and did not require high dependency of care. Some managers told us that staffing levels hadn’t increased to accommodate the additional beds and they often worked clinical shifts to support capacity.

The trust had access to community hospitals which allowed them to increase the flow through the hospital, especially for stroke patients. There was a shared direction and services in the community had been developed to support people in their own homes, such as virtual ward, SDEC and medical day case unit.

There was a shared culture of learning and improving to enhance the patient experience. The senior leaders were passionate about getting services right for patients and gave us several examples of changes to services including the stroke pathway and links with GPs for respiratory patients to prevent admissions.

Staff told us they were proud to work at the hospital and most staff enjoyed their work and felt supported by each other and their direct leaders. They told us about working together as a team and sharing information with other departments to support the flow of patients throughout the hospital. However, some staff felt senior leaders in the organisation did not listen or support them and they were not always involved in or information was shared about decisions, working environments and changes.

The Trust actively promoted a zero-tolerance stance against discrimination, championing an inclusive working environment. They had a No Place For Racism strategy. They have a multicultural workforce representing over 100 countries. Flags reflecting colleagues' countries of birth were displayed in the hospital to support inclusivity and a welcoming environment.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. Staff share information and learning with partners and collaborate for improvement.

There were positive and collaborative relationships with external partners to build a shared understanding of challenges within the system and the needs of the people and communities. Examples including working with the local authorities to support the homeless community and health inequalities and daily reviews with the community and ambulance services to review capacity and flow.

Feedback from external partners described the relationship with the hospital as strong, positive, and collaborative, with effective communication. They actively participate in quality improvement work and a review of any patients incidents involving both organisations. They have a good working relationship with the trust.

The Patient Experience Team launched a new Coffee and Connect initiative welcoming stakeholders to discuss shared goals, challenges and opportunities for service improvement. The aim was to strengthen relationships and enhancing engagement with stakeholders.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff actively contribute to safe, effective practice and research.

Staff told us they were committed to learning and improving. There was a strong focus on developing the skills of staff to promote their professional growth within the hospital.

A monthly divisional newsletter was available to all staff which includes, information on incidents, complaints, lessons learnt and staff celebrations.

The trust had implemented a variety of learning and improvements including implementing voice recognition for consultation and note writing. The developments of a pathway for young adults with diabetes had resulted in a reduction in hospital admissions.

The dementia team presented a patient’s story outlining changes from feedback. This was shared with the wider community for learning. A review of the stroke pathways resulted in some patients moving to the community hospital for rehabilitation and group sessions.

The trust had developed links with GPs for respiratory patients to improve the overall care and treatment to prevent admissions. They told us this had been successful and were looking at rolling out a similar project for frailty patients.