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 well led good. At this assessment the rating remains as 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. 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 and analysed data about outcomes and performance. They used this to identify improvements.
 

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 wards followed the trust visions, strategy and culture. The 2 wards local values aligned with the wider organisational values. The Trust vison of “a great place to get care, a great place to give care” was evident on both wards with positive feedback from relatives. Staff told us that there appears a good team culture on both wards and there has been significant work by leadership to improve the culture and sickness levels, specifically supervision on Orchid ward.
Both ward managers and the service manager displayed a compassionate style of leadership with positive feedback from relatives and staff. .
 

Quality Statement Score:

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 and 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. Leadership development opportunities were available, including opportunities for staff. Management training opportunities were available through the trust. Both managers had been in post for a period of time, allowing stability and structure to grow with confidence in leadership. For example, there was a well-being trolley on the wards and the teams had away days to promote team awareness and cohesion. Staff also had bring and share days which allowed the staff to promote their different cultural foods.

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 wards had access to the trust freedom to speak up guardians and there were champions within the wards to support staff.
A key theme was culture of care, a national initiative adopted by the trust, and focussed on reducing a perceived blaming culture. This reinforced that the trust and wards are a safe space for honesty and constructive feedback.
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. Some patients felt food choices could be improved.
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. Staff described how they feel able to raise concerns and they have had various options to speak up including access to a trust freedom to speak up guardian. The organisation had a Freedom to Speak Up Guardian. Information about how to speak up was available on the staff intranet. Staff could report concerns anonymously, or via one to one or group sessions. Staff were encouraged to raise concerns directly with colleagues or the nurse in charge with focus to the correct platform if local resolution cannot be provided.

Good work was recognised by a thank you day scheme. Leaders reported no current concerns relating to the wards and felt any concerns or identifying any emerging concerns or indicators of closed cultures could be managed by current good practice such as team meetings, supervision, away days and an open leadership culture. There was an anonymous staff suggestion box in place which was reviewed every two weeks and then discussed as a team and ways to offer support. Family members reported feeling able to raise concerns and were confident that their views would be listened to and acted upon. Staff told us that there was no formal peer support for nurses and thought this would be beneficial.
 

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 wards were supported by the wider trust equality and diversity initiatives.
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 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 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 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.

The trust had achieved leader status in Stonewall's Proud Employer's Accreditation. This meant that the trust were among the organisations recognised as setting the benchmark for LGBTQIA+ inclusion. The trust had an armed forces strategy for 2025 to 2030 and offered to deliver specialist mental health care through services and have been nationally recognised for their armed forces-friendly employment practices.. This allows access and support to both ex forces personal and families supporting them into new communities when leaving military service.

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.
Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well. The service operated within the Trusts governance and service framework. This structure was embedded into the ward provision around governance and good practice. 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.
We attended Safety Huddles and a Quality Improvement Huddle. We observed good governance processes to support these discussions and cascading of information.

Audits, medicines reviews and care plans were documented in line with established governance processes.

Patient identifiable information was supported and held in confidence as part of the wider trust systems.
 

Quality Statement Score:
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 shared information and learning with partners and collaborate for improvement.
We attended a patient flow meeting, where the Ward Manager and Consultant were answerable to senior colleagues about the discharge progress. Senior leaders had established relationships with system partners to offer support in unblocking any barriers. There were good relationships with community teams and police. For example, managers ensured correct procedures are followed to provide video evidence to police and have a structure in place to document this.

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

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. Summarise your findings here using the topics below:
Wards participated in accreditation schemes relevant to the service and learned from them. Rowan ward was fully accredited by the Royal College of Psychiatrists’ Quality Network for Older Adult Mental Health services. Orchid Ward was working towards this status.
The trust's quality improvement processes and quality management information system (QMIS) were well embedded on the wards. The wards had a plan in place to reduce the length of inpatient stay and the patient flow through the wards. This meant improvement in the beds available allowing better access to care and support for patients. For example, action plans around improving attendance of community teams at meetings to improve discharge planning. This allowed for accountabilities of actions. In addition, wards had identifiable benchmark of targets planning with a focus of the NHS England 80-day national target. On Rowan ward staff were encouraged to submit continuing improvement ideas. Managers told us Rowan ward had achieved their target and work on this project will continue.
There was an established learning culture on the wards achieved through handover meetings and safety huddles, Culture of care support under NHS culture of care standards was being embedded into the wards which allowed better, safer and more equitable care.

In 2025 the trust worked with the Health innovation Network to become the first mental health trust to implement Martha’s Rule. This meant that staff, patients or family members could request a review from a different team if they felt a patient's condition was deteriorating and they were not being responded to.