Northamptonshire Healthcare NHS Foundation Trust

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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.

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

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.

We have a shared vision, strategy and culture that is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

Quality Statement Score: 3

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.

The service had a clear vision aligned with the trust strategy, “Together we Thrive.” Staff at all levels understood the organisation’s values and reported feeling part of a shared purpose. Carers told us, “Willows is so welcoming… staff work together in a person-centred way, and care is tailored to the individual.” Staff described the workplace culture as inclusive and compassionate. They felt respected and valued, reporting that stress was well managed, with no evidence of bullying or harassment. The freedom to speak up process was well understood and had been used appropriately in the past.

However, some staff said the ward could feel isolated as a stand-alone unit and would benefit from greater recognition and visibility from the wider trust.

The trust’s senior leadership team had successfully communicated the organisation’s vision and priorities to frontline staff. Team members said they felt informed about wider strategies and could see how their work aligned with the trust’s long-term goals. This gave staff confidence that their efforts contributed to a bigger picture.

Staff told us they had opportunities to contribute to discussions about the future of the service, particularly during times of change. They described forums and team meetings where their views were sought and acted upon. One staff member said “they were involved in the ongoing extension project and were asked for their input by the Ward Manager.”

Managers engaged staff in discussions about how resources could be best used, creating a sense of shared responsibility.

The manager told us they used the trust’s key performance indicators (KPIs) to monitor compliance with mandatory training. Staff were aware of the KPIs and understood how their performance was measured against them. This provided oversight and assurance that training compliance was being monitored consistently and that staff maintained the skills needed to deliver safe and effective care. The use of KPIs supported the service in identifying areas where additional training or support might be required, ensuring that staff development remained a priority.

We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively and do so with integrity, openness and honesty.

Quality Statement Score: 3

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 at all levels demonstrated the skills, knowledge and experience required to perform their roles effectively. They had a good understanding of the service, the people using it, and the wider context in which care was delivered. Leaders were able to clearly explain how their teams worked to provide high-quality, person-centred care, and staff confirmed that leadership expectations were communicated consistently. The service manager and ward manager worked closely together, holding regular meetings to monitor staffing, budgets, and operational issues. Staff consistently described both managers as approachable, supportive, and hands-on and felt supported and confident to raise concerns directly with managers. Families also noted that leaders were accessible and approachable.

Leaders embodied the values of openness, compassion and integrity. They promoted a culture where honesty and transparency were prioritised, and families said they trusted the leadership team. One family member explained, “the manager goes above and beyond her role supporting carers and training staff to a high standard.”

Leadership development opportunities were available, and staff were supported to progress in their careers. For example, healthcare assistants were encouraged to complete the Care Certificate, and some were supported to move into nurse training via apprenticeship routes. Staff described this as motivating and said it helped them feel valued. One staff member commented, “the manager believed in them and supported their professional career journey.”

However, staff reported limited visibility of senior leaders. Of the 6 staff we interviewed, 4 said executives above the service‑manager level were rarely seen on the ward, with 1 staff stating they had never seen directors during their shift. All staff confirmed that the service manager was consistently present.

We create a positive culture where people feel that they can speak up and that their voice will be heard.

Quality Statement Score: 3

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 knew how to raise concerns and felt safe to do so without fear of victimisation. They reported positive experiences of using the whistleblowing process and awareness of the Freedom to Speak Up Guardian. Carers and families also felt able to give feedback, with adjustments made to respite letters and communication following concerns raised.

The service fostered a positive culture where people felt able to speak up and confident that their voice would be heard. Families of people who use service were encouraged to give feedback in ways that reflected their needs. Feedback was gathered through regular conversations with staff, surveys such as the Friends and Family Test, and carers’ interviews. Families told us they valued this openness.

Managers and staff had access to feedback and used it to inform service improvements. For example, families had raised concerns about communication during discharge planning, and in response, the service introduced clearer written updates and earlier involvement of families in planning meetings. Staff confirmed that feedback was discussed in team meetings and used to guide changes.

Patients and carers were involved in decisions about service development.

Staff also felt confident to raise concerns. They told us they knew how to contact the Freedom to Speak Up Guardian and felt assured that issues raised would be taken seriously without fear of repercussions. One staff member said, “we do have the opportunity to feedback on services and input into service development.” Another staff stated that they have used the freedom to speak up opportunity in the past.

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

Quality Statement Score: 3

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.

The trust had a clear equality, diversity and inclusion (EDI) strategy, supported by staff networks and national benchmarking standards. Locally, staff and carers reported that care was person-centred and inclusive, with individual preferences respected, for example in relation to gender choice for personal care.

The trust demonstrated readiness for the Patient and Carer Race Equality Framework (PCREF) and promoted co-production with service users and families.

The service valued diversity within its workforce and demonstrated a commitment to building an inclusive and fair culture. Staff told us that equality, diversity and inclusion were actively promoted and that they felt respected and supported in their roles. One staff member said, “I like it here- it is a very supportive team, it can be stressful at times, but we pick each other up.”

There were equality and diversity champions within the organisation, including representatives for LGBT+ and BAME staff, who offered guidance and acted as points of contact for colleagues. Staff said they felt reassured that there were designated people they could approach for advice or support.

The trust monitored the diversity of its workforce and assessed whether it was representative of the community and patient group. Families also recognised the positive impact of a diverse and inclusive workforce.

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

Quality Statement Score: 3

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.

Governance structures were clear, with regular meetings, audit programmes, and escalation processes in place. The service demonstrated proactive learning from incidents, for example introducing protective protocols after a percutaneous endoscopic gastrostomy related incident. Routine audits provided assurance, and lessons learned were shared with staff.

The service had clear responsibilities, roles and systems of accountability that supported good governance and the delivery of sustainable, high-quality care. Staff were clear about their responsibilities, and managers used governance frameworks to ensure that risks, performance and outcomes were monitored consistently.

There was a structured framework for team and ward meetings, where essential information such as learning from incidents, safeguarding alerts and complaints was discussed. Staff confirmed that these meetings allowed them to reflect on practice and share improvements.

Risk management arrangements were robust. Staff had access to the ward and provider risk register and were able to escalate concerns when necessary. Staff concerns aligned with those recorded on the register, which demonstrated transparency and consistency. The service also had contingency plans for emergencies such as adverse weather and flu outbreaks, ensuring continuity of care.

Performance and risk data were collected in a way that was not burdensome for frontline staff. Team managers had access to timely and accurate data about performance, staffing and patient care, which they used to monitor quality and identify areas for improvement. Staff also had access to the equipment and IT systems they needed, including effective record-keeping systems that supported confidentiality and good information governance.

Cost improvement programmes were in place but did not compromise patient care. Staff said they understood pressures on resources but felt supported to maintain safe standards.

Governance processes were robust, and evidence showed that actions were followed up effectively. A minor observation regarding food labelling was raised with the provider during the inspection and addressed promptly. The specialised cot bed training documentation, initially unavailable on the day of inspection, was subsequently provided within the inspection timeframe, confirming that staff had received appropriate training. Senior visibility on the ward was variable, and while no breaches were identified, continued attention to leadership presence and oversight will help sustain ongoing improvements.

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service collaborated with local authorities and community partners to review respite provision and identify gaps in capacity. Leaders engaged with external stakeholders such as commissioners, Healthwatch and community services, and feedback was used to inform service planning and improvement.

Staff told us they felt supported by these partnerships, which ensured that care planning and funding arrangements were coordinated effectively.

The service also shared information and learning with external partners to support improvement. This included updates about safeguarding, feedback from complaints, and outcomes of local audits.

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Leaders encouraged continuous learning. Staff received targeted training, and service improvements included record-keeping audits, wound care competencies, and innovation in dual-role staffing models.

The service placed a strong emphasis on continuous learning, improvement and innovation, both within the trust and in collaboration with partners in the local system. Staff told us they were encouraged to identify opportunities for improvement and were given time and support to do so. One staff member explained, “When we spot something that could be done better, managers listen – and we often see changes made quickly.”

Quality improvement methods were used effectively, and staff were able to describe how these had been applied in practice. For example, learning from medication audits had led to more structured checks and refresher training, while feedback from families prompted changes in the way discharge planning was communicated. Families confirmed that these changes were visible.

Staff had opportunities to participate in national audits and benchmarking exercises, which provided assurance and helped the service learn from wider practice. Outcomes from these audits were shared with staff during meetings, and learning was embedded into day-to-day care.

Innovation was also encouraged within the service. Staff gave examples of creative approaches to supporting people with complex communication needs, including the use of visual tools and technology to help people express choices.

The service had consolidated its learning disability provision under a unified structure, which strengthened oversight and consistency. Leaders encouraged innovation, with examples including the introduction of an occupational therapist/healthcare assistant dual role and enhancements to audit processes. The service also identified system weaknesses and implemented corrective measures, such as annual health checks and record-keeping audits, to drive improvement and sustain safe, effective care.

Although the service did not undertake formal research projects on site, staff had access to trust-wide research and innovation initiatives, and leaders promoted a culture of staying up to date with national best practice.