Royal Preston 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 assessed 1 quality statement under the well-led key question. The service had established governance and accountability arrangements, supported by a positive incident reporting culture and effective team communication. While the small substantive workforce affected resilience and increased pressures, the trust was aware of these challenges. An established audit programme demonstrated improvements in service delivery, although SARC-specific audits were still developing to better evidence outcomes and support UKAS accreditation. Patient and stakeholder feedback was highly positive, and staff described strong teamwork and supportive leadership.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The judgement for Capable, compassionate and inclusive leaders is based on the latest evidence we assessed for the Well-led key question.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

There were clear lines of responsibility and accountability within the service. Until the week before the inspection, a dedicated SARC manager had overall responsibility for the day-to-day operation of the service and for ensuring compliance with operational policies and procedures. The manager was supported by the clinical director, quality manager, matron and divisional management team, who provided both clinical and managerial oversight. However, in the absence of the SARC manager, there was a risk that some day-to-day responsibilities could be overlooked. Senior leaders had sought to mitigate this by allocating additional duties to substantive staff. However, the small size of the team meant this arrangement increased existing workforce pressures and highlighted the service's limited resilience.

The service was actively working towards United Kingdom Accreditation Service (UKAS) accreditation. Staff were in the process of implementing the quality management systems and governance arrangements required to meet accreditation standards, and progress had already been made.

A comprehensive suite of policies and procedures was in place to support the delivery of safe and effective care. These had been adapted to reflect the specific requirements of the SARC, and staff could readily access organisational policies through the trust's intranet.

Staff understood how to report incidents and were confident in using trust procedures. Records demonstrated a positive reporting culture, with a range of incidents being identified and reported. Learning from incidents was shared through governance processes, including incident learning bulletins and team meetings. Daily safety huddles also enabled staff to discuss emerging issues and agree any necessary actions.

Some staff had received training in undertaking audits, and the service had implemented a programme of audit activity. Trust-led audits demonstrated progress and improvements in service performance and delivery. While SARC-specific audit reports provided detailed findings, they were less clear in identifying outcomes and measuring improvement over time, which may limit the service's ability to effectively monitor progress and drive continuous improvement. However, we recognised that the provider was at an early stage in developing its audit programme to support UKAS assessment and accreditation.

Staff actively sought feedback from patients about their experience of the service, and comments were acted upon where possible. For example, changes had been made to improve the range of snacks available and the ambient temperature of the forensic examination room. Feedback consistently demonstrated high levels of patient satisfaction.

External stakeholders spoke positively about the service. NHSE representatives told us the service consistently met its key performance indicators and submitted required performance data in a timely manner. Police representatives also described highly positive working relationships with SARC staff.

Communication within the service was effective. Daily safety huddles and regular team meetings enabled staff to share information, discuss operational matters and maintain oversight of patient care and service delivery.

Staff spoke positively about teamwork within the service and the support they received from managers and colleagues. The team held a monthly ‘glimpses of brilliance’ initiative to recognise staff achievements and the trust provided staff with wider access to support and wellbeing activities; including a dedicated health and wellbeing team and a programme of mindfulness.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.