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

There was a shared direction and culture managed by capable, compassionate and inclusive leaders. Staff felt safe to speak up. There was good governance and close working with partners and the community.

This is the first assessment for this service since the trust was formed in 2018. Well-led is rated as good. This meant children and young people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a developing strategy for the children’s service. The trust strategy had been published, and the Good Hope Hospital strategy to link with this had been consulted on and was being finalised. Once this had been approved, the children and young people’s service would produce its strategy in line with the others. The strategy currently used for children and young people reflected that of the local authority’s Children and Young Persons’ Partnership Board.

There was an overview of services provided for children and young people for all sites including at Good Hope Hospital. This described how the trust planned to further reduce inequalities, hear from children and young people, prepare young people for adulthood, and support safeguarding and mental health.

The service had a shared vision and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding the challenges and needs of people and their communities. The senior leadership of the service had a strong ambition to reconfigure and redevelop children’s services in accordance with the changing needs of patients and their families.

There was a strong patient-focused culture. Staff told us they felt supported by ward managers and matrons, and they felt there was good team working within the service. However, staff did say their morale was low at times when they were short of staff.

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.

There was a clear management structure with no vacancies at senior level. Staff were given the opportunity to develop leadership qualities and develop their roles. All matrons, managers and all staff knew their job roles and understood the accountability requirements.

Leaders were visible and approachable, led by example and modelled inclusive behaviours. Staff told us ward managers and matrons were supportive, and they could speak to them regarding any concerns they had. Note from staff meetings, where managers would raise any concerns they had in relation to staff practices, showed how they could bring improvement.

Leaders were knowledgeable about issues and priorities for the quality of the service and were able to access support for their own roles. They were alert to any examples of poor culture that might affect the quality of care for children and young people or have a detrimental impact on staff.

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

Staff were encouraged to speak up and to raise concerns. Leaders promoted the value of speaking up. The hospital had a dedicated Freedom to Speak Up Guardian. This was a role introduced to health and social care organisations after the events and a failure to speak up at another NHS trust and the report from Sir Robert Francis KC. The Guardian's role was to support workers to speak up when they felt they were unable to in other ways. Information about speaking up was easily accessible on the trust's intranet. The staff had a good understanding of what the Guardian's role was. Staff told us they would approach them if they felt it was needed but would generally approach their line manager in the first instance for support and guidance.

There was a good culture of speaking up where staff felt safe to raise concerns without fear of detriment. Concerns were handled sensitively and confidentially and mindful of people's rights and responsibilities.

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 leaders had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment, and support. Staff acted on the best information about risk, performance, and outcomes, and shared this securely with others when appropriate.

Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss, and learn from the performance of the service.

There was a range of audits used to understand care and treatment and the quality and safety of how it was provided. These audits were well documented and discussed with in governance meetings, this identified what had worked well and what improvements needed to address to improve the service. However, the service did not complete audits for the monitoring of sepsis.

The managers operated effective governance processes throughout the service and with partner organisations. They had structures and systems of accountability, so all levels of the management knew and understood their roles and responsibilities.

The trust had a risk management system with 2 risk registers, 1 for children's services and 1 for the neonatal service. The risks were dated from when they had been identified, showed if they had been approved or waiting approval, and how the service was mitigating the risks.

There were a range of meetings to cover governance, quality and safety for both children's and neonatal services. Minutes recorded what was on the agenda and covered a range of key topics. This included, for example, staff vacancies, infection control, health and safety, and mandatory training compliance. It also covered patients' experience and feedback. There was an education update in which any incidents were discussed to determine how learning and changes were to be implemented. In the children's ward meeting, the team discussed pharmacy concerns, audits, risks, and culture concerns on the ward. The team discussed how they were going to address arising risks and issues.

Action plans were assessed for their progress. They showed the issue raised, the assurance received, the action and timescale of when this was to be met.

The service reviewed hospital data for learning from deaths, and a review was undertaken every 3 months. The service had a process for escalating reviews of deaths and were involved with the morbidity and mortality reviews.

The service understood the duty to collaborate and work in partnership, so services worked seamlessly for people. Staff shared information and learning with partners and collaborated for improvement.

The service worked well with outside agencies. These included key relationships with the local authority, police, and mental health services. This was to provide care which was joined up and supported people to be safe and live well in their community. There were good relationships with the rest of the trust sites where services overlapped or were co-dependent. The service worked well with other local NHS trusts, community services, local schools, and local charities.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcomes, and quality of life for people.

The service used feedback from the children, young people and families to know when there needed to be changes and improvement. An example was the children and young people’s feedback about the hospital food not being always enjoyed. Staff went to a local school to discuss food with the children and ask what type of food they might want if they were to stay in hospital. The hospital then adapted the menus.

Investigations were used to improve. For example, the report into learning from deaths clearly identified the trust’s ‘Listen, Learn and Share’ approach around learning and action.

There were education sessions for staff to attend medication rapid improvement programme. To educate and supporting registered nurses to improve patient safety. This had been identified due to the number of medicines incidents which had occurred. A post- training survey had been completed, which showed there had been an increase in incident reporting which the service stated “this is due to the increased awareness of the need to report actual and near miss events. Staff were asked “Do you feel confident with medicines preparation and administration,” with 95% of staff feeling confident to prepare and administer medicines.

There were opportunities for staff to ask questions and have a prompt response to clear up any issues. The service introduced ‘Myth Buster’ posters. These enabled a member of staff to ask a question and get a response. For example, there was a question asked about wristbands which was “Is the single red bordered patient identification band just for when a patient has an allergy?” The response came back with: “The single red bordered patient identification band is to alert staff to all situations or conditions, where the patient has a risk, i.e. allergy.”

The service produced a new leaflet to share advice about viral induced wheeze and asthma. This had specific information for children and young people and covered what was considered regular treatment. It described “how to know if your child’s asthma is under control”, actions in certain situations, discharge and escalation advice, useful contacts and QR codes for videos and information to be able to find additional support.