Lincolnshire Community Health Services NHS 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

Well Led Commentary

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

Senior managers we spoke with knew and understood the provider’s vision and values and how they were applied in the work of their team. However, ward staff were unsure about the purpose and values of the group model, they said it had not been fully embedded or communicated well to them. They said there had been a lack of clarity around the management structure, unrealistic deadlines and lack of professional support which impacted on staff wellbeing.

Staff described how they were working to deliver high quality care within the budgets available.

Leaders had the skills, knowledge and experience to perform their roles and had a good understanding of the services they managed. They could explain 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.

Patients and carers had opportunities to give feedback on the service they received, and managers and staff used it to make improvements for example providing basic supplies for relative staying overnight on the ward with their loved one.

Staff we spoke with said they were aware of the providers freedom to speak up process, and they were confident they would use if required.

The provider had a equality and diversity matters policy, this focussed on eliminating discrimination against any individual, employees, patients, services users and carers on the grounds of gender, gender reassignment, disability, age, race, ethnicity, sexual orientation, socio-economic status, language, religion or beliefs, marriage or civil partnerships, pregnancy and maternity, appearance, nationality or culture.

There were equality and diversity champions within the service.

Staff were able to apply for flexible working agreements to account for personal circumstances such as caring responsibilities and health issues along with reasonable adjustments to help them carry out their role.

The provider completes equality monitoring of staff within the service by Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) submissions, to ensure it is diverse in its make-up and representative of the patient group.

There was a lack of management oversight and robust governance processes.

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

Managers failed to have oversight of the effectiveness of people’s care, treatment and support in relation to nutrition, hydration and pressure care. We saw staff used a variety of assessment and patient monitoring forms. On one ward we saw gaps in recording which showed there was insufficient assurance that care was delivered safely, and this put patients a risk of avoidable harm.

Managers did not ensure that patients’ privacy and dignity was respected at all times.

Managers did not ensure that staff accurately recorded the temperature of clinic rooms of medicine fridges and that abnormal results were escalated appropriately.

Managers did not ensure that out of date medical supplies were disposed of.

Staff maintained and had access to the risk register at ward level and could escalate concerns when required.

The service had plans for emergencies, for example, adverse weather or a flu outbreak.

Managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

Managers we spoke with told us of the good relationships with community and partner organisations, for example volunteers and local nursing homes.

We were told of several joint fundraising initiatives intended to improve facilities for patients and carers.

We found that the community hospitals focussed on continuous learning, innovation and improvement across their organisation and the local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

We saw staff on one ward had implemented a range of initiatives which improved the levels of hydration of patients’ and achieved positive outcomes in relation to physical health and wellbeing.