Essex Partnership University 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 rated Well Led as good because: Staff said they felt respected, valued, and safe. Staff and patients felt safe from potential sexual behaviour. Staff worked well together and supported each other as a team. Staff knew about the NHS sexual safety charter and that the trust had signed up to it. The service valued a diverse workforce and worked towards an inclusive and fair culture by improving equality for staff. Staff reported that they could speak up and that their voice would be heard. The trust set up a tackling racism group to help support staff to speak up about potential incidents of racist abuse. This was done in response to a culture review. The service worked well with their partners across the local system. The service had good governance and the ward managers used these to good effect. Concerns about safety were listened to by senior leaders and safety events were investigated and reported thoroughly.

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.

Staff said they felt respected, valued, and safe. Staff we spoke with reported that they felt sexually safe at work and that they would be confident to raise sexual safety concerns using the reporting routes provided by leaders. Staff worked well together and supported each other as a team. Staff knew about the NHS sexual safety charter and that the trust had signed up to it. Staff spoke about the importance of team working to provide the best outcomes for the patients. Staff had the opportunity to contribute to discussions about the strategy for the service.

The trust had worked hard to improve sexual safety culture within the service. Senior leaders set up workshops for staff about how to identify and report potential incidents of sexual abuse that could be experienced by both staff and patients. Line managers had received specific training around how to manage reports of potential sexual abuse. All staff discussed whether they felt sexually safe at work during one to one conversations with their line manager. The trust provided sexual safety training for staff and a trust wide sexual safety group to raise awareness of sexual safety with frontline staff. This was incorporated into the service's bi-annual away days. The service displayed posters on the wards and in staff offices around culture.

The service had inclusive leaders who understood the care and treatment needs of people in secure settings. Leaders embodied the culture and values of the staff and trust. Staff knew who the most senior managers in the organisation were and said they were approachable and visible. Leaders said they had an open-door policy. The director of specialist services was based at Brockfield House and had extensive experience working in a forensic setting. Staff praised the director of specialist services and felt able to raise concerns with them. Patients knew who the senior staff were and could approach them.

The ward manager of Aurora covered shifts at weekends, so they had oversight of weekends and could speak to the staff that work weekends.

The trust fostered a positive culture where people felt that they could speak up and that their voice would be heard. Staff felt confident to speak up if something wasn’t right. Staff said they had access to a hotline they could ring to share concerns confidentially.

The service had a dedicated Freedom to Speak Up Guardian (FTSUG) that staff could talk to if they wanted to raise concerns and speak up. The local FTSUG co-produced things with staff to support them to speak up. This included a dedicated telephone line for people to report any concerns like sexual safety. Once a call was received a swarm huddle was commenced, to ensure they had the appropriate people involved to deal with any concerns. The local FTSUG had created a video on sexual safety, about how reports to the police are made and investigated.

Staff told us that they felt the trust promoted a fair culture. Staff reported that the service promoted equality and diversity in the workplace and provided opportunities for career progression. Development opportunities were available for staff. Managers created the RISE programme to support BAME staff with their career development.

The service carried out a culture review. The results of this showed that staff did not feel adequately supported against racist abuse whilst at work. The trust set up a ‘tackling racism’ group which improved reporting of racial abuse, effective de-briefs and additional support to staff. The trust had 6 weekly Equality and Inclusion meetings, supported by employee relations. The trust celebrated black history month.

Staff knew the procedures to manage different situations and the reporting processes. Staff said that information was shared well, and they received feedback. Leaders said they had access to a dashboard so they could have oversight of what was happening across the service and use this to improve performance and outcomes. Ward managers accessed the dashboard, so they had oversight of issues such as incidents, mandatory training, supervision, and complaints.

The service had a clear framework for what must be discussed at trust and ward level. For example, monthly Quality and Safety meetings followed a structure where pertinent issues such as incidents, complaints, staffing and performance data were discussed. This information was cascaded down into the monthly staff meetings. The service maintained a risk register to ensure staff had oversight of the risks within the service. Audits included care planning, risk assessments, seclusion records and long-term segregation. Themes, trends and learning were collated and communicated back to staff to drive improvements. The service had also been working on reducing restrictive interventions, these were kept under constant review via daily huddles. Senior leaders carried out night visits to support staff and ensure patients were safe.

Patients and carers told us that plans for patients to be transferred to other services were discussed with staff in collaboration with commissioners. Prospective step-down accommodation was discussed with staff and the patient’s social worker.

Staff shared information and learning with partners. Staff worked with commissioners and other stakeholders to share information and learning from serious incidents.

Commissioners told us that they had an open and honest relationship with the service and were kept updated on pertinent information. This included information on serious incidents, seclusion and long-term segregation, equality and diversity and repatriation.

Brockfield House was part of the East of England Specialist Mental Health provider collaborative. Senior leaders attended referrals and allocations meetings with the provider collaborative to ensure a smooth transition pathway for patients.

Staff described opportunities to give feedback on the running of forensic services and input into service development. Staff had created a carers pack that they gave to patients when they were admitted. Staff felt lessons were learned well following incidents. After a serious incident on Forest ward, leaders said they had a good response from staff on the support that was offered, which included debrief sessions with psychology. They discussed processes with staff but also checked on people’s welfare. Leaders said they were in the process of getting a Point of care testing machine and training staff to be able to monitor patients prescribed clozapine. This meant they could do the blood tests on site.

Senior leaders had introduced a managers development programme to support with career development.