Berkshire Healthcare 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 assessment we rated this key question outstanding. At this assessment the rating has changed to good.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. The provider had a ‘plan on a page’ for the coming year, which was displayed on the ward. The ward had then used this to create their own local plan on a page. Staff were aware of this and told us their appraisal objectives would be linked to it to ensure that goals were aligned. All staff had received an appraisal within the last 12 months.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. The most recent staff survey results showed that 91% of respondents from the ward felt able to make suggestions to improve the work of their team.

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 had the skills, knowledge and experience to perform their roles. Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

Leaders were visible in the service and approachable for patients and staff. All staff and patients we spoke with told us that leaders were visible and approachable. During our inspection we observed a patient confidently approaching the ward manager to make a request. Staff told us that senior leaders, including the Chief Executive Officer (CEO), also frequently visited the ward and that they wouldn’t hesitate to raise concerns with them if needed.

Leaders were inclusive and involved staff in decision making. The 2025 NHS staff survey results showed that 82.6% of respondents from Campion unit said their immediate manager asked for their opinion before making decisions that affected their work.

Leadership development opportunities were available, including opportunities for staff. There were a range of leadership roles on the ward, including a clinical nurse lead post and 4 deputy ward manager posts.

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.

The organisation had a Freedom to Speak Up Guardian. Information about how to speak up was available on the staff intranet.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Managers and staff had access to the feedback from patients, carers and staff and used it to make improvements. For example, feedback about the food had been passed to the catering team and resulted in greater menu choice being available for patients.

Staff had opportunities to give feedback on the service and contribute to service development. Staff held daily huddle board meetings where they discussed any ideas for improvement they had. Anyone could suggest items for this and staff displayed a notice board on the ward displaying the suggestions made. All staff we spoke with told us they were confident that any feedback they gave to managers would be listened to and acted on.

Staff we spoke with were aware of the provider’s whistleblowing process. A staff member had recently raised some anonymous concerns and these had been fully investigated, including interviews with a large proportion of the staff team. The investigator had then arranged a feedback session with staff to ensure they were kept updated with the outcome of the investigation.

The results from the 2025 NHS staff survey showed that 81.8% of respondents on Campion unit felt safe to speak up about anything that concerned them within the organisation, and that 77.3% of respondents felt the organisation would address any concerns they raised.

We scored the service as 4. The evidence showed an exceptional 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 service employed a diverse team of staff from international backgrounds. Employment practices promoted equality of opportunity. Staff did not raise any concerns about discrimination. The trust provided 5 staff networks which reflected the diversity of the organisation: Armed forces, pride, purple (including staff with disabilities, physical and mental health issues, our neurodivergent workforce and/or staff with caring responsibilities), race equality and women's. The networks offered supportive and compassionate spaces for staff to connect with other people, share information and ideas and receive support. Each network had clear aims and objectives as well as an executive sponsor.

Staff displayed information about celebrations from different cultures in the patient lounge. We observed information about Easter and Ramadan on display during the inspection.

Staff were able to apply to work flexibly e.g. flexible working agreements to account for personal circumstances such as caring responsibilities and health issues. The organisation encouraged staff to use inclusion passports to support managers and staff to have meaningful discussions around support needs for staff. The results from the 2025 NHS staff survey showed that 95.7% of respondents from Campion unit felt they could approach their immediate manager to talk openly about flexible working.

The trust had achieved level 3 'Disability confident leader' status. This is a government initiative that encourages employers to recruit and retain disabled people and those with health conditions. Achieving this status meant the trust were recognised for their commitment to workplace inclusion and accessibility. It also meant they supported other employers in their journey to becoming Disability Confident. 

The trust was committed to being an anti-racist organisation. They had been awarded Race Equality Matters (REM) Silver Trailblazer Status to recognise their commitment to this. The trust had a clear action statement in place that focused around 5 key areas: Patient access, experience and outcomes, anti-racism, education and engagement, incidents, support and empowerment, recruitment, retention, progression and conditions and anti-racism policy and conditions. This initiative was launched in 2023 and to date 49 of 75 actions had been achieved, with 26 in progress. Examples of actions achieved so far included fairer, more transparent recruitment and progression processes and staff having clearer boundaries, support routes and expectations when racism or abuse occurs.​

Staff had been affected by racism from patients and had been awarded with funding to develop a restorative justice video. Ward staff and the consultant nurse from the IST had set up a “no excuse for abuse” working group and submitted a bid for one off funding for a project that would strengthen staff wellbeing. Patients, staff and senior leadership colleagues will be filmed for the video talking about what racism is, the impact it has and institutional response. The video will be used for induction, incident responses and ongoing education for staff and patients.

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, treatmentand support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Our findings from the other key questions demonstrated that governance processes mostly operated effectively at team level and that performance and risk were managed well. However, governance processes had not identified that not all incidents were recorded on the incident reporting system or that the care plans in patient folders were not up to date. These concerns were raised with managers following our inspection and they took prompt action to address this.

There was a clear framework of what must be discussed at a ward, team or directorate level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed.

Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. For example, the medical devices audit had highlighted that an extra piece of equipment had been left on the ward by another team. The QI unit leadership team data collection audit had showed that there was low compliance with dysphagia training due to lack of availability of sessions, so managers arranged for Speech and Language Therapists from the IST to deliver ad hoc training sessions for staff.

Staff understood the arrangements for working with other teams, both within the provider and externally, to meet the needs of the patients.

Staff maintained and had access to the risk register at ward level. The current top 3 risks were legionella, door replacement and violence/aggression towards staff. These accurately reflected what we saw during our inspection.

Staff had access to the equipment and information technology needed to do their work.

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.

Staff engaged with external stakeholders, such as commissioners and colleagues from social care. All patients had a comprehensive discharge plan and if there was a delayed discharge, the reason was documented and any actions being taken to address this, including liaison with commissioners.

Staff worked collaboratively with staff from other teams to ensure smooth transitions for patients. For example, IST staff facilitated training for placement staff to support them with working with patients once they were discharged.

The trust worked in collaboration with their local communities. For example, on their unity against racism work.

We scored the service as 4. The evidence showed an exceptional 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.

Although staff did not record all incidents in line with the Trust’s incident reporting policy, there was a strong learning culture in place.

Staff had opportunities to participate in research. During our inspection we observed staff being encouraged to participate in a research project around the experiences of people who have been involved in care and treatment reviews (CTRs).

Staff used quality improvement methods and knew how to apply them. Staff held daily board huddles where they and patients came together to consider any improvements needed. They used Plan-Do-Study-Act methodology to consider and implement improvements. The team were involved in the national Culture of Care quality improvement programme. They were working towards a goal of eradicating assaults on staff by the end of 2027.

The ward participated in accreditation schemes relevant to the service and learned from them. The ward participated in the Quality Network for Inpatient Learning Disability Services (QNLD), which is a quality improvement initiative managed by the Royal College of Psychiatrists. Services are able to achieve accreditation if they meet a certain number of standards. At the time of our inspection the service was awaiting their accreditation decision. In addition to this, 2 members of the team were peer reviewers for the programme, which meant they were trained to attend peer reviews of other services participating in the programme. This enabled learning across services.

Staff were invited to attend a ‘learning disabilities best practice’ forum which took place 3 times a year. The most recent event took place in February 2026 and had a focus on increasing confidence in working with people at risk of offending and trauma-informed care. In addition to this, there were forums for learning disability nurses and Allied Health Professionals. These forums provided opportunities for guest speakers and presentations, undertaking specific pieces of work relevant to the care pathways and learning disability nursing, as well as an opportunity for peer supervision and support. It was also an opportunity to discuss updates on what is happening nationally within learning disability nursing and practice.

The consultant nurse was also involved in work happening at a national level at the learning disability senate, United Kingdom Learning Disability Consultant Nurse Network (UKLDCNN) and the Mental Health Forum.

Nurses were encouraged to attend the NHS England Learning Disability Nurse Symposium and were supported to apply for leadership programmes with other organisations.