Midlands 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

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 inadequate. The service was in breach of legal regulation in relation to good governance. At this assessment the rating has changed to:

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

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 knew and understood the trust’s vision and values and they were displayed throughout the wards.

Ward managers and leaders worked together and shared experiences and good practice across sites to ensure the wards shared the same vision and strategy.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing.

Staff told us morale was good and they worked well as a team. They said they enjoyed working on the wards and their work was respected and valued. They had opportunities to progress and felt the trust invested in them as professionals and people.

Managers and leaders knew the service well and had a good understanding of the wards they managed. They had the skills, knowledge and experience to perform their roles. They could explain clearly how the teams were working to provide high quality care.

Staff said managers were approachable and open, visible and present and available when they needed them. They supported them when required and showed compassion when needed. Leadership development opportunities and associated training was available for staff who wanted to progress. Many of the managers we spoke with had worked for the trust for a number of years and had been promoted into various roles.

Senior staff had visited the wards, although staff at the Redwoods implied this was not often.

The trust had a dedicated freedom to speak up team. Staff were able to talk with one of the Speak up champions across the service if they wished. Staff said they felt comfortable raising a concern with their manager and would feel listened to.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Staff asked for feedback when patients were discharged through questionnaires.

Managers used feedback from patients, carers and staff and used it to make improvements. Feedback was discussed in managers meetings and actions put in place when required.

Patients and carers were involved in decision-making about changes to the service and staff told us of several examples of co-production, such as design of the wards. Patients and staff could meet with members of the trust’s senior leadership team to give feedback.

The trust made efforts to promote a healthy and respectful culture within teams and managers reviewed information about the service and completed quality visits to quickly identify any issues to prevent poor care.

The trust promoted equality and diversity within the service. Managers put reasonable adjustments in place for staff members to help them carry out their role.

The trust undertakes equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group.

The trust had a governance structure in place to ensure information was shared appropriately from board level to the wards. Managers had comprehensive governance arrangements and access to information to ensure the service was performing well. Information was in an accessible format and was timely, accurate and identified areas of improvement. Managers attended regular clinical governance meetings and had sufficient oversight from leaders within the organisation.

Monthly governance meetings were attended by leaders and managers of the wards and there were clear expectations of what care and support the service aimed to provide. Key performance indicators and monthly audit processes helped give oversight and identified where improvements were required. Information was cascaded to staff through team meetings, supervision and staff huddles. The service had a risk register which included mitigations to reduce the risk. Staff at ward level could escalate any concerns and risks were regularly discussed. Managers discussed risks within governance meetings alongside other issues including quality audits, themes from incidents, staffing, supervision, areas of good practice and where improvements were required. Each area was examined in detail and actions were put in place when required. Senior staff attended monthly quality meetings to oversee strategic planning, contracts, performance and updates that would have an impact on the service. Matrons attended monthly quality assurance and improvement meetings. Information reviewed included national and local audit results, guidance reviews, quality visit outcomes, local updates and feedback from patients, including complaints and compliments. The trust were compliant with the National Commissioning for Quality and Innovation (CQUIN) which was reducing the need for restrictive practice in adult and older adults settings. Issues on Brocton ward had been identified and action plans to support the ward developed.

Staff told us they had good relationships with wider partners including the local authority, housing, social care, and the Ministry of Defence.

External partners who were involved in the patients care were invited to attend and provide feedback at multi-disciplinary meetings.

The trust encouraged and supported staff to engage with quality improvement projects, they used quality improvement methods and staff knew how to apply them. Several staff gave us examples of ideas that had started as quality improvement projects and been developed and cascaded to other wards or areas. Staff had the opportunity to attend quality improvement training and learning forums. A number of projects were in progress at the time of our assessment across all the wards we visited. Norbury PICU was in the process of applying for the National Association of Psychiatric Intensive Care Units (NAPICU) accreditation scheme. Staff had opportunities to participate in research and the sensory room on Norbury PICU had been a result of a research project.