Humber Teaching NHS Foundation Trust

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

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 inspection we rated this key question good. At this inspection the rating has remained good.

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. 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.

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 knew and understood the trust’s vision and values, and the senior leadership team had successfully communicated them across the service. The trust vision, values and strategy were incorporated in the trust corporate induction, and the trust values were displayed across the service.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. Managers told us they had received a lot of support for the Mental Health Front Door project which planned to align all patient access routes to a single point. Staff we spoke with told us they had been involved in discussions and could describe the plans to the inspection team.

Managers told us they felt the culture had improved across the team. In the 12 months prior to our inspection, managers had made changes to the service such as increasing the amount multidisciplinary meetings and reviewing risk and providing formulation meetings with the psychologist. Managers said this helped bring staff together and there has been less sickness and turnover. Staff we spoke with said they worked well together, enjoyed working within the team and looked after each other, ensuring they felt safe.

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. They told us they felt supported to do their job well, they had a good understanding of the services they managed and could explain clearly how the teams were working to provide high quality care. Managers told us they worked closely together and had good oversight of the service.

Staff told us leaders were visible and approachable. We observed shift coordinators providing advice, support and guidance to staff throughout the day. Staff said they knew how to contact senior managers when required.

Leadership development opportunities were available, including opportunities for staff. Staff told us of band 7 leadership training to enhance their skills and development. Managers we spoke with had developed their careers with the trust. They told us they had been supported to complete training and professional qualifications that enabled them to progress their careers.

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

Staff knew how to Speak Up if they needed to. At the time of our inspection, 96% had received Freedom to Speak Up (FTSU) training. In the 12 months prior to our inspection, there was 1 FTSU concern raised by a staff member about their experiences working with the crisis team, which had been reviewed by senior staff and no further action was taken or required.

There was a culture of speaking up where staff actively raised concerns and those who did (including external whistleblowers) were supported, without fear of detriment. When concerns were raised, leaders investigated them sensitively and confidentially, and lessons were shared and acted on. Staff told us they would speak up when needed and they felt able to raise concerns and felt comfortable doing so. Staff were confident that their voices would be heard. We saw information displayed that promoted the FTSU service. Managers told us they encouraged staff to raise concerns and promoted the value of doing so.

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.

Managers put reasonable adjustments in place for staff members to help them carry out their role. Staff gave us examples of adjustments that had helped them to do their job more easily. Staff were able to apply to work flexibly and had flexible working agreements to account for personal circumstances such as caring responsibilities or health issues. Managers told us each request was reviewed individually, and they were supported by trust policies and procedures and staff within human resources to make fair and just decisions.

The trust had an equality, diversity and inclusion lead in place to help ensure staff did not discriminate and instead embraced an inclusive approach to their work. Staff were trained in equality, diversity, inclusion and human rights. At the time of our inspection, 96% of staff were compliant.

The trust undertook equality monitoring of staff within the service to ensure it was diverse in its make-up and representative of the people who used services. The trust produced an annual Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) report. WRES and WDES data were only available at trust-wide level. We reviewed the 2025 report which gave a snapshot of the trust as of 31 March 2025 and included findings from the NHS staff survey which took place in Autumn 2024. The WRES data saw improvements in all 9 indicators and 7 surpassed national comparison figures. However, identified actions included improving the experience for ethnically diverse staff so they did not face bullying and harassment or discrimination from people who used services, carers or colleagues. The WDES data saw the trust had improved in 7 out of the 10 indicators and had also surpassed national comparison figures. Actions from the WDES were similar to the WRES; to improve the experience of bullying and harassment from colleagues and managers.

In December 2024 the trust launched the No Excuse for Abuse Framework toolkit to support managers and staff when subjected to abuse by people who used services.

The trust had 3 staff networks associated with equality and diversity: anti racism network, disability staff network and rainbow alliance staff network. They provided a safe space for staff and helped drive an inclusive culture within the trust by delivering cultural initiatives and supporting events, schemes, frameworks and standards related to diversity and inclusivity. The disability staff network had focused on ensuring staff had access to accessible equipment.

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

Managers and leaders attended a range of clinical governance meetings based upon quality, patient safety, performance, business delivery and information sharing.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level. The clinical risk management group reviewed, identified and facilitated any necessary investigation or analysis from deaths, incidents, complaints, restrictive interventions and other items of risk in line with the national Patient Safety Incident Response Framework (PSIRF). Recommendations and learning was shared with senior staff who had oversight and monitored subsequent action plans.

Staff undertook or participated in local clinical audits such as the care records audit. At the time of our inspection, managers were focused on planning and implementing the Mental Health Front Door transformation, which would improve ease of access to services.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of people who used the service.

Managers monitored most risks, issues and performance in clinical governance meetings. The service had identified the following risks in January 2026: delays in 4 hour and 24 hour assessments due to service model, clinical activity and staffing shortfalls; NHS 111 option 2 data showed increased missed calls; recruitment and retention and a partial AMHP service for Hull City. Managers told us plans were in place to make improvements although the AMHP service was managed by Hull City Council and therefore they did not have any authority to make changes.

We spoke with senior staff about the environment for the health-based places of safety. They told us there were limits within the building and recognised improvements were required. They planned to review the environment and make any practical changes.

Staff maintained and had access to the risk register at service level. Staff could escalate concerns when required. There was 1 concern for the crisis resolution and home treatment team recorded on the risk register regarding processes and practices which would impact on patient safety incidents and workforce issues. This had been on the register since 2024. The register included the mitigations in place to reduce the risk, such as strengthening leadership, implementation of the Front Door project, flexible working arrangements reviewed, daily MDT and safety huddles, increased supervision including formulations and reflective practice, and structures in place to support decision making. All of these actions had been implemented. Concerns about staffing levels, increased demand for referrals through the NHS 111 option 2 line and missed calls were identified as ongoing risks. The risks were rated as high.

The service had plans for emergencies and a business continuity plan had been developed that addressed potential issues such as adverse weather, loss of staff, premises or IT.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure worked well and helped to improve the quality of care. However, people were unable to leave a message and ask for a call back on the current NHS 111 option 2 telephone line. The introduction of the Front Door later in the year intended to ensure that new systems were in place to make it easier for people to get in contact with mental health services. At the time of our inspection, the new system was due to be operational by August 2026.

Information governance systems included confidentiality of patient records and appropriate policies were in place to support staff and managers.

The service used systems to collect data that were not over-burdensome for frontline staff. Staff used electronic systems for the majority of tasks although they still completed some paper records. Some staff told us of changes required for certain tasks to the electronic record system but told us that any IT changes took time.

Managers had access to information to support them with their management role. This included information on the performance of the service such as electronic dashboards, staffing rotas, electronic care records and incident reporting systems. Information was in an accessible format, and was timely, accurate and identified areas for improvement.

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.

Directorate leaders engaged with external stakeholders. The trust were the lead partner within the Humber North Yorkshire Specialised Mental Health, Learning Disability and Autism Provider Collaborative. The trust was part of the Humber and North Yorkshire Integrated Care System (ICB). The ICB was a core member of the Humber and North Yorkshire Health and Care Partnership, alongside NHS providers, local councils, other health and care providers and voluntary services. The trust worked closely with the ICB who were responsible for planning, organising and funding health services.

The trust liaised closely with partners such as the local police, local acute and community trusts, the ambulance service and local authorities and produced joint agency protocol with regard to Right Care, Right Person, Mental Health Act 1983 and the Mental Capacity Act 2005 to ensure they worked effectively together for tasks. This included mental health assessments in the community, Section 135 and 136 detentions and procedures in the health-based places of safety. Right Care, Right Person is a national approach to make sure people who have mental health needs get help from the correct service and is an agreement between police, health and other relevant partners.

The trust had service level agreements with other providers such as the local acute and community trusts regarding the administration of the Mental Health Act 1983.

Trust staff attended monthly multiagency meetings with the police and ambulance service to discuss joint working arrangements, review specific cases and any challenges relevant to the HBPoS. An issue about the police not liaising with the crisis team prior to bringing a patient to the HBPoS had been raised and discussed. The trust also had links with a police liaison officer although managers felt the overall relationship with the police could be stronger.

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.

The trust encouraged teams to participate in quality improvement and had developed the trust quality improvement strategy for 2021 to 2026.

Staff used quality improvement methods and knew how to apply them. At the time of our inspection, staff were involved in 5 quality improvement projects. These included increasing the knowledge of medications for nursing and allied health staff, gaining more carer and family feedback, delivery of Cognitive Behavioural Therapy (CBT) for insomnia training to staff, improving the MDT process and clinical pathway and implementation of a supportive engagement tool within the health-based places of safety.

Staff participated in national audits relevant to the service and learned from them. These were related to medicines and were still in progress at the time of our inspection.