Dorset Healthcare 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 reviewed the shared direction and culture, capable, compassionate, and inclusive leaders, freedom to speak up, governance, management and sustainability, and partnerships and community quality statements for the well-led key question.

We found Waterston Ward was well-led. The trust had systems and processes in place to ensure staff members provided safe care and treatment for patients

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.

At Waterston Ward staff members told us that they shared same vision and values as the trust. They described these values as continual improvement, trust, respect, empathy and compassion.

There were sufficient systems in place to ensure staff worked consistently towards a shared culture. This included regular team meetings and one to ones.

Staff told us there was a strong, committed and capable leadership team on the ward led by the manager. It was evident they had worked hard to make improvements.

Staff from the senior leadership team visited the wards regularly and staff told us they felt supported.



Staff felt there was a culture of continuous learning and improvement. For example, Trauma Risk Management (TRIM) Peer Support was offered to staff following the choking incidents of February 2024. Staff described opportunities for career progression on the ward.

There were action plans and risk assessments for all wards including admission to wards. This was outlined in the guiding principles and trust-wide standards for admissions onto wards.

Staff felt they would be listened to, and action would be taken to address their concerns. Staff told us they were happy and confident with raising concerns and speaking up. They would raise concerns if they had concerns about patient care and treatment.

There was a clear freedom to speak up process in place which staff were aware of, including the freedom to speak up guardians. The freedom to speak up process was promoted via a poster on the wall providing all details for staff if they wished to follow the process enabling easy access.

Staff said they enjoyed working in a team together. We saw evidence of collaborative working and sharing of ideas to improve patient care. Staff felt respected, supported and valued. They said the service promoted equality and diversity in daily work and provided opportunities for development and career progression. They could raise any concerns without fear.

We saw equality monitoring in place for staff and staff told us it was a good place to work. Staff also had access to equality networks across the trust.

Staff members spoke positively about the leadership. Staff told us leaders were visible on the ward and felt the manager had oversight on what was happening on the wards and where improvements were required. Staff told us they participated in reflective practice to enable ongoing improve in their practice to improve the ward environment.

Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well. Managers of each ward decided what items would be included in the risk register. Any member of staff could refer items to the risk register for the manager to consider.

Teams had access to the information they needed to provide safe and effective care and used that information to good effect. There were regular team meetings. The manager attended governance meetings with senior trust staff. Information was shared with staff via meetings and the trust’s internal intranet.

The service had an action plan for improvement. This was closely monitored by the senior leadership team to ensure service development. The manager ensured any complaints were investigated appropriately and learning taken to drive improvement when required.

Relatives were positive about the wards working in partnership with them about the care and treatment of patients.

Staff members spoke positively about working closely with carers, other teams within the trust like safeguarding teams and the local authority. They felt they had good working relationships with the rest of the multidisciplinary team. Managers told us they had good relationships with commissioners and were able to make recommendations about people’s future care.

We did not receive any feedback from partners.

Staff worked closely with other teams, such as the infection control teams, equality and diversity teams. We saw the staff team worked closely with other teams like the tissue viability nurses and staff worked well together, treated each other with respect and looked to learn from any incident that happened.

The staff at Waterston Ward worked closely with NHS Dorset Integrated Care Board and at the time of our inspection had attended a multi-agency discharge event to look at improvements which could be made to discharges from the ward. All teams worked closely with carers.

There was a culture of continuous learning and improvement. On Waterston Ward there was evidence of learning from incidents.

The trust provided a support programme around trauma management trauma risk management (TRiM). This was very well received by the staff team.

Staff members spoke positively about the trauma management sessions they were offered.

Following the death of a patient in February 2024, the trust implemented changes to improve the ward. Further training continued to support staff confidence and competence. This included enhanced life support training for staff. The training involved all emergency equipment within the standard emergency trollies on in-patient wards. It also included more scenario-based training (including choking), which was directly in response to staff's feedback.

Staff evidenced learning from a recent patient death in another ward. This learning was disseminated throughout the trust with urgent internal patient safety alerts issued to other services with regards to do not attempt cardio-pulmonary resuscitation (DNACPR) status and choking episodes. Staff reviewed their implementation of speech and language therapy (SALT) plans and awareness of International Dysphagia Diet Standards Initiative framework.