Humber Teaching 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 key question has been rated good. We looked for evidence that service leadership, management and governance created high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. The service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. There were strong links between partners such as social services, education and specialist professionals. Leaders had the skills, knowledge, and experience to perform their roles to a high standard. They had a good understanding and oversight of the service, the needs of young people, families and staff. Staff told us they were approachable, supportive, and visible.

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 found that staff were positive and felt empowered by leaders within the service. Leaders told us that they worked closely with partners and engaged in regular meetings to share updates about the service or feedback about young people. Leaders told us that the day-to-day running of the ward was done by collaborating with the young people and there were weekly community meetings where young people gave feedback and raised any concerns they had. We spoke to 5 relatives who told us family members were encouraged to be part of multidisciplinary meetings. Leaders told us they ensured all staff understood the shared direction by gathering feedback through team meetings, staff awards, supervision and clinical support. Staff told us the diversity of the team had a positive impact on the ward and patient care. Staff gave examples of the trust safety team and police working together. The psychology team offered debriefs and extra supervision for staff and young people. The Trust’s quality and diversity lead completed projects with the staff team to improve the ward in terms of environment, activity and restrictions.

Leaders had the skills, knowledge, and experience to perform their roles to a high standard. They had a good understanding and oversight of the service, the needs of young people, families and staff. Staff told us they were approachable, supportive, and visible. Staff were positive about managers and senior leaders, feeling supported, encouraged and able to use their voice. There was clear leadership at both local and senior level. Managers were visible on the ward and available for staff. Leaders were up to date with best practice and guidance and ensured that knowledge was shared across the whole team through a range of meetings and learning sessions. Leaders ensured staff felt valued and supported. Leaders told us they felt supported to recruit additional staff where needed to ensure staffing was safe and effective. Staff we spoke with said they were encouraged by leaders to develop skills within their role. The ward provided support to student nurses and preceptorship nurses and ensured these were not included in shift numbers. Staff told us they felt the reflective practice at the end of each shift was helpful and that managers addressed any issues identified. There is a clear supervision structure in place as per the Trust Policy. in addition to this, the ward manager meets with all ward staff individually on a three month basis to ensure staff wellbeing and communication was maintained. The ward also implemented annual away days where staff completed team building exercises. Young people told us that the staff were consistent and familiar. The ward utilised regular bank staff to ensure young people had ongoing and consistent support from people they trusted.

Staff knew how to raise concerns and told us they felt confident to do so. They said leaders were supportive and approachable, and they felt reassured that managers dealt with issues appropriately. Managers regularly shared learning with staff during meetings and handovers. Incidents and investigations were managed well and the outcomes shared with the board of commissioners and regulators where appropriate. Staff were aware of the whistle blowing policy and procedure in place. Staff had access to a freedom to speak up guardian and staff we spoke with knew how to contact them. There were posters on the ward which detailed how to make a complaint. Staff were able to raise concerns through a variety of feedback methods. Young people and relatives had opportunities to give feedback on the service and were involved in decision making about changes to the service. Young people and staff could meet with the senior leadership team to give feedback. Young people told us they felt safe in speaking up.

Staff told us that managers were supportive of cultural diversity and felt assured that any incidents of abuse were thoroughly investigated. As part of our inspection, we reviewed staff meeting minutes which reflected feedback from staff and leaders. Staff told us that the ward was a good place to work, that the staff team and managers were supportive, and that managers adjusted where necessary. Staff had the appropriate training in equality and diversity. The service recently recruited an involvement and engagement manager, with young people sitting on the interview panel.

We found that staff had access to the equipment and information technology they needed for their roles. At the time of inspection, 97% of staff had completed information governance training. The leadership team of manager and band 6 clinical nurses are responsible for oversight of all audits, monitoring training and compliance and staff supervisions. The target for compliance of audits is 90% with the ward reaching 96%. The audits we looked at included environmental, discharges, infection prevention and control and appraisal and supervision. Staff and leaders could describe what they discussed in meetings such as learning from incidents, complaints, and safeguarding concerns.



Meetings included handovers, MDT meetings and risk reviews. Leaders ensured that incidents and reflections from ‘sunrise and sunset’ meetings were routinely reviewed by the clinical lead/ward manager and themes and trends were identified, such as staffing levels, positive interactions and challenges through shifts. The service had good oversight of clinical and environmental risks. The ward had a risk register and business continuity plans for emergencies which were in date. Young people had individualised plans for emergencies (PEEPS) and the equipment on the ward had been tested and was within date. 6 monthly reports were completed and presented to the trust board which covered innovating quality and patient safety, enhancing prevention, well-being and recovery, fostering integration, partnership and alliances, developing an effective and empowered workforce, maximising an efficient and sustainable organisation and promoting people, communities and social values. For each of these area’s positive assurances were provided to the board and key actions which were underway.

Young people told us that relatives and external teams were involved in their care and treatment when they had consented to this. Young people were also involved in providing feedback to senior leaders and to external partners during quality reviews of the service. Staff told us they had good relationships with wider partners including commissioners, NHS England and the police. They met with partners to share good practice and learning lessons and fed back findings to staff during team meetings. Multidisciplinary team meetings ensured all relevant partners were involved in young people’s care. The social care team helped plan discharges and ensure these were safe. The youth action group working with the nursing team around autism needs provided input around training.

Staff told us they were supported to develop their skills. All staff spoke positively about their mandatory training opportunities to develop their knowledge and skills and to reflect on their practice. Staff completed Oliver McGowan training in order to support their understanding of young people with a learning disability and/or autistic people. There are plans to review the acute CAMHS pathway with the aim to reduce inpatient admissions. Patient safety analyses and Patient And Carer (PACE) reports were used to inform improvements with the last annual report being from 2023-2024. Improvements included young people who used the service being invited as part of interview panels for potential staff. This developed a collaborative approach to the recruitment process. The report also highlighted improvements in communication between services evidenced by feedback from young people, carers and professionals. There was involvement of a newly launched Youth Recovery and Wellbeing College. (YRWC) which is a person-centred community for those aged eleven to eighteen living in the Hull and East Riding. The college is led by young people and explores creative and empowering ways to improve wellbeing through engaging virtual and face-to-face experiences, workshops, sessions, and activities. We spoke to a member of staff from the YRWC who told us that they link in with occupational

therapists to deliver meaningful one-to-one engagement based on the young person’s interests.