Bradford District Care 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 good. At this assessment the rating has remained good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

At our last assessment we rated well-led as good. At this assessment, the rating has remained good. Leaders had the skills, knowledge, and experience to perform their roles. Staff knew and understood the trust’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 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 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 trust’s vision and values and how they were applied in the work of their team. The trust’s senior leadership team had successfully communicated the vision and values to the staff in this service.

Staff had the opportunity to contribute to discussions about the strategy for the service during team meetings, daily huddles and during supervision and appraisal sessions.

Governance processes operated effectively. There was a clear framework of what must be discussed at team meetings to ensure that essential information was shared. The service had policies to guide staff in the day-to-day operation of the service. Staff collected and analysed data about outcomes and performance. They used this to identify improvements in response to our previous assessment.

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. The ward manager was new to the service but had experience in managing other wards, and the service manager had been in place for several years.

Leaders were visible in the service and approachable for patients and staff. Leadership development opportunities were available, including opportunities for staff. Leaders in the service were open and honest as well as being compassionate with patients in the service.

Staff felt respected, supported and valued. All staff we spoke with said they felt supported and valued at the service, with both management and staff saying they felt the staff team were happy. Staff told us the role could be stressful, but that they were managed and supported by colleagues and senior staff.

There were no reports of bullying or harassment at the service, and all staff we spoke with knew how to use the whistleblowing process. All staff told us that they felt they could raise concerns to management about the service without fear of retribution.

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.

Staff felt there was a positive culture at the service. No staff member we spoke to complained they had been the subject of racial discrimination or bullying.

We saw evidence that there were regular team meetings for staff to discuss any issues. All the staff we spoke with, told us that they were confident they could speak up if they had any concerns about the way they or the patients were treated. All staff we spoke to knew how to use the whistleblowing process.

All staff told us that they felt they could raise concerns to management about the service without fear of retribution.

There were daily opportunities for patients to feedback to the service any concerns or suggestions for change.

We scored the service as 3. The evidence showed a good 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.

Managers explained how staff would be supported within the workplace including through flexible working agreements to account for personal circumstances, such as caring responsibilities and health issues.

Managers advised that reasonable adjustments could be put in place for staff members to help them carry out their role, based on their individual needs.

Staff received training in equality, diversity and inclusion as part of the service’s mandatory training.

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 acted on the best information about risk, performance, and outcomes, and shared this securely with others when appropriate.

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. This was evident from meetings and minutes of meetings that we observed. Evidence showed us that governance systems had improved since the last time we carried out an inspection and the hospital was no longer in breach of any regulations. The current systems enabled effective management of risk, issues and performance.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level.

Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and staff acted on the results when needed. Actions were clearly set out and followed through where they were necessary.

Staff maintained and had access to a hospital wide risk register. It was clear that this was being used to effectively track current risks. Staff colour rated risks so higher ones could easily be seen and there was an effective system of reviewing these risks.

The service had plans for emergencies, for example, adverse weather or a flu outbreak. These were contained within an accessible contingency management plan.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care. However, a small number of staff told us that the electronic patient record was sometimes slow to access.

Team 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.

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.

Managers described how the service was engaging with external stakeholders and partners. They recognised the importance of these relationships and ensuring that they were being kept informed and involved.

We saw community care coordinators taking part in ward round meetings and there was a close relationship with community services who would support patients post discharge. We saw one patient discussing their discharge with the community staff who would be offering support via a media link, and they were arranging for them to attend the ward to meet them.

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.

Staff were given the time and support to consider opportunities for improvements and innovation during team huddles, team meetings and during appraisal and supervision sessions, and this led to changes.

Leaders told us that performance was monitored by completion of regular audits. The outcomes were recorded and discussed in management meetings. This meant leaders could monitor performance over a period to ensure continuous improvement.