Calderdale and Huddersfield 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

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 as good. At this assessment, the rating remains the same.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff described the Trust’s vision as centred on four core pillars of values and behaviours: demonstrating kindness, fostering a welcoming approach, and committing to continuous improvement. They also emphasised treating others with respect, promoting diversity and inclusion, acting as positive role models, and consistently meeting mandatory responsibilities to ensure people remain safe and well. Most staff described the culture as open and supportive.

Managers had a good understanding of the services they managed. They could explain clearly how their teams were working to provide high quality care.

The trust staff survey for 2025 had an increased staff response rate to 50.6% from 36% in 2024. The community division scored above the NHS national staff survey average for all areas. This found staff stated they had a voice that counted, felt their role made a difference to patients and would feel secure in raising concerns about anything that concerns them in the organisation. The staff we spoke with also endorsed this.

During the inspection, the leaders demonstrated the skills, knowledge and, experience to lead effectively. Staff told us the leaders at all levels were supportive, available, approachable, and responsive to concerns. The division had a risk register, and the leaders were aware of the risk priorities and the responses to them.

The trust staff survey for 2025 had an increased staff response rate to 50.6% from 36% in 2024. The community division scored above the NHS national staff survey average for all areas, including compassionate and inclusive leadership. The community division scored 5% higher than the trust average for feeling valued and colleagues being understanding, kind, respectful and appreciative of each other.

The trust had a freedom to speak up policy, freedom to speak up arrangement were in place and the trust board had received an annual report from the freedom to speak up guardian.

We found adult community health services promoted a positive culture where staff told us they felt safe to speak up and confident their concerns would be heard. Staff knew about the role of the Freedom to Speak Up Guardian (FTSUG). Staff were able to tell us how to access the trust’s FTSUG. Any concerns raised were reviewed by the patient quality and safety divisional board.

Policies supporting equality, diversity and inclusion were in place.

We also reviewed the Workforce Disability Equality Standard (WDES) data from the NHS Staff Survey 2025. This showed a reductionin the percentage of staff with a long-term condition or illness who reported experiencing harassment, bullying or abuse frommanagers or other colleagues in the last 12 months. There was also a reduction in the percentage of staff with a long-term condition or illness who felt pressure to come to work despite not feeling well enough. The data showed an increase in the percentage of staffwith a long-term condition or illness who felt satisfied with the extent to which their organisation valued their work. There was also anincrease in the percentage of staff who said their employer had made reasonable adjustments to enable them to carry out their work.​

We reviewed the Workforce Race Equality Standard (WRES) from the NHS Staff Survey 2025. The results were trust-wide and were not broken down by individual departments.​ The data showed a decrease, compared with previous years, in the percentage of staff from black and minority ethnic groups who reported experiencing harassment, bullying or abuse from other staff. This figure was below the national average.​The percentage of staff from black and minority ethnic groups who believed the organisation provided equal opportunities for career progression was above the national average.​The percentage of staff from black and minority ethnic groups who reported experiencing discrimination at work from a manager, team leader or other colleagues in the last 12 months had decreased by 5.23% compared with the previous year and was now below the national average.​

​The community health service for adult’s leaders explained that they provided flexible working arrangements and time for staff to follow their religious and cultural beliefs. Staff had access to continual professional development, support, and mentorship and occupational health.

In January 2026, it was identified that only 78% of annual leave had been taken in the last twelve months. Not taking leave can contribute to short- and long-term sickness. In response, annual leave was monitored from both a staff well-being and patient safety perspective to ensure staff were following the annual leave management protocol.

The trust staff survey for 2025 had an increased staff response rate to 50.6% from 36%, in 2024. The community division scored above the NHS national staff survey average for all areas and found improvements in being a compassionate and inclusive leaders, we are always learning and we are a team.

In response to the survey results, the divisional leaders had worked with the divisional human resource business partner to analyse the staff survey and to develop an action plan against the findings. Following staff engagement each action was worked through and promoted through team and individual meetings and further enhanced with “you said, we did…” promotions. Areas for improvement were staff feeling safer at work, support for the appraisal process, and improving health and wellbeing.

In 2023, in response to significant workforce challenges, including more than 6 vacant district nurse posts and national difficulties in recruitment, the leaders carried out a review of district nursing training. A Band 6 nurse development role was introduced which was designed to provide structured preparation ahead of university study for the MSc in District Nursing. The trust continued to support an average of 2 colleagues per year through this development pathway.

Governance processes operated effectively at community health services for adults, and performance and risk were mostly managed well and all risks were mitigated.For example: -

• Incidents were presented and reviewed by the divisional patient safety panel. The panel included the associate director of nursing, head of nursing, matrons, pharmacists, safeguarding representatives, tissue viability nurse, team leaders and clinical educators for community.
• As part of the quality governance reporting structure the division provided a quarterly report to the Quality Committee which summaries the activity undertaken within the divisional Patient Safety Quality Board.
• These reporting mechanisms are outlined in the Quality Governance meeting structure.
• There were structures, processes, and systems of accountability in place to monitor the performance of the services.
• Staff at all levels were clear about their roles and accountabilities and felt supported.
• There was a framework of what should be reviewed at team and service level to ensure essential information was shared and discussed. Staff attended daily handovers and staff meetings where incidents and complaints were discussed. However, we found there was an inconsistent approach at team level to how often team meetings occurred
• Staff told us they felt fully supported and supervised and team leaders described an open-door policy, daily handovers, accompanying staff on visits or following staff into visits to check compliance. However, we found there was an inconsistency and lack of formality to the approach to one-to-one line management and operational supervision. The community health services for adult’s leaders had recently reviewed supervision guidance, to improve consistency, which was then approved at the February 2026 patient safety and quality board.
• The leaders monitored staff training compliance through the monthly divisional board.
• The service leaders reported to patient safety and quality board, quality assurance groups, clinical outcome groups and other clinical governance meetings and senior management meetings which fed into the trust board meetings. Information was fed from these meetings back to their staff
• The division held monthly risk review meetings to review all current risks on the risk register, ensuring that they were up to date and still relevant and to consider any emerging risks that needed to be added to the risk register. We reviewed the risk register; at the time of the inspection there were only low-level risks regarding the district nursing services.

Staff collaborated with other agencies and shared information and learning to help ensure seamless care. The staff worked with hospital staff to ensure the safe discharge of patients and liaised with people’s GPs to enable patients to be treated at home.

Specialist nurses supported the district nurses to provide specialist care.

The district nurses described effective multidisciplinary and integrated team working between GPs, tissue viability nurses, diabetic services and other specialist teams.

A divisional experience of care group had been recently formed to work in partnership with people to strengthen improvement of their experience of care. This aligned with and supported the national drive to amplify the voices of people and communities (NHS England, 2025). The services which were involved with this were cardiac rehabilitation, long covid, Quest multidisciplinary team and pulmonary rehabilitation. The group looked at areas where the patient feedback had suggested improvements

To improve partnership working feedback was requested from system partners regarding the Quest team matrons. The feedback helped to reduce duplication of visits and reinforced the importance of empowering staff to spend appropriate time with each individual patient.

The pulmonary rehabilitation team undertook a discharge satisfaction survey which confirmed that individuals were achieving their personal goals in addition to receiving information and education required.

Where the community services had been relocated to different premises the leaders provided information to demonstrate both staff and patients were involved through Healthwatch.

The community health service for adults had learned from incidents, made improvements and carried out some innovative works. Examples included:

• Urgent community response (URC) provided patients with holistic short term and urgent home-based assessment and support within 2 hours of referral. The team recognised there was a greater opportunity for admission avoidance, by increasing staffs’ awareness of what UCR offered and scoping whether a pathway within 4 hours would be beneficial. The outcomes were increased staff awareness, and implementation of a pathway within 4 hours.
• Use of an individual care of dying document to ensure the best care was delivered to meet the needs of a dying person and their family in the last hours or days of their lives. The outcome of the project was still to be collated at the time of the inspection.
• The chief nurse hosted a weekly leadership meeting every Friday, which brought together nursing, midwifery, and allied health professional leaders. The forum provided a space for shared learning, collaborative decision‑making, and collective leadership across professional groups.
• The community division had contributed to improve patient experience to the trust’s digital patient story program which supported organisational learning and improvements across the division.
• During Carers Week 2025, senior leaders visited community and outpatient settings, speaking directly with unpaid carers, patients and staff to understand their experiences of caring.
• A divisional experience of care group had been recently formed to work in partnership with people and to strengthen improvements of their experience of care.