Northern Healthcare Head Office

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• 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

The organisation was well structured, with a good skill mix amongst senior leaders. Governance is at the heart of the organisation to try and drive improvements so that people supported are given opportunities to achieve positive outcomes. Senior managers regularly completed quality site audit visits. Responsibility and accountability had been designated to senior staff, with leads, champions and mentor roles in place for existing staff, to support with new employees. The service had a range of audit tools in place, used by the Registered Manager, Quality and Clinical Governance and Service Managers to aid oversight and management of the service. Monthly governance meetings took place and ‘safety huddles’ were held daily with service managers and staff on site. The ‘safety huddles’ were used to communicate any concerns and actions needed. On a monthly basis, management completed lessons learned, in relation to medication, incident reporting and post incident reviews. Staff we spoke with felt listened to. They considered the service achieved good outcomes for people they supported and was a good place to work. Staff were aware of mechanisms in place for speaking up. The service had a Freedom to Speak Up advocate in post. Management demonstrated their awareness of informing CQC of notifiable incidents and accidents for people receiving a regulated activity. Referrals had been made to host authority safeguarding teams regarding potential abuse. On 2 occasions, it had been identified that the service had not notified CQC of safeguarding issues. However, this was addressed on site and rectified immediately. The service had established good relationships with outside partners, including local authorities, mental health commissioners. CQC received limited feedback from partners, but all feedback received was positive.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The Operations Director as the Registered manager had daily support from the CEO, quality leads, HR leads, regional and service manager level staff. There was a good skill mix amongst senior leaders, with access to clinical expertise when needed. The company worked hard to ensure staff felt involved and rewarded. Staff felt invested in due to senior leaders taking the time to listen and engage. Staff were able to offer thoughts, ideas and opinions in meeting forums and felt comfortable in doing so. There was a strong sense of trust between leadership and staff and morale was high. One staff member told us, “I definitely received the right support. The management team are amazing, I can’t fault them. We’ve had some tough moments and the management provide support right away, check if I’m alright, carry out debriefs with me and ask what extra support is needed to help me.” Staff considered the service achieved good outcomes for people they supported and was a good place to work. Career opportunities for staff enabled them to progress with the company. Staff felt valued and invested in. Responsibility and accountability was designated to existing support staff in the form of ‘champion’ roles and mentor roles with new employees.

The company had a set of values in place; these PROUD values were likened to a ‘golden thread’ running through the heart of the organisation, were well known to staff and aligned with work practices. Tools and strategies were in place to facilitate the involvement of everyone in the service, with people and staff surveys. Mechanisms were in place to recognise staff who had gone over and above and performed well. PROUD cards could be completed by both and staff; they were able to nominate anyone who demonstrated the company values. Receiving a nomination was a great morale booster for staff one support worker told us, and gave people receiving support a great sense of pride.

There was an open, honest and transparent culture within the service. Staff were aware of mechanisms in place for speaking up; for example via the whistleblowing policy, in supervisions, staff meetings or by approaching the service manager. Staff were confident they would be listened to. A Freedom to Speak Up advocate had recently been appointed and had sent an introductory email to staff outlining their role. A staff member we spoke with told us, “I feel comfortable in speaking up; I feel listened to.”

There were mechanisms in place for staff to speak up and a culture in place to encourage them to do so. Good communication was in place through the on-call system, team meetings and formal supervision sessions, all of which were documented; staff were given numerous opportunities to engage with senior leaders. This was also supported by policies and information that enabled staff to raise concerns externally if required.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There were clear and effective governance, management and accountability arrangements. We spoke to various senior staff, including the CEO, the Operations Director (Registered Manager), Quality & Governance Clinical Lead, the People Director, the Regional Operations Director and 2 Service Managers as well as 7 senior / support workers; all understood their roles and responsibilities and the company vision. The Operations Director as registered manager held regular meetings with service managers and visited on site with other senior support if needed, such as regional managers and clinical support. The service managers and staff we spoke with told us the support from the provider was extremely good and appreciated. One staff member considered management had much improved, and that the values of the company were better communicated and promoted. All the support workers we spoke with confirmed senior leaders encouraged staff to speak up with ideas for improvement and innovation. A staff member told us, “I’ve been given the opportunity to give input into care planning reviews and share my knowledge.”

The organisation was well structured, and governance was at the heart of the organisation to try and drive improvements, so that the people supported were given opportunities to achieve positive outcomes. Audit schedules, policies, procedures and systems ensured effective governance was in place and supported compliance. Service managers submitted data and reported key information at regular intervals into head office. This information fed into the governance systems and became a focus for discussions at monthly meetings to help drive continual improvement of the business. Lessons learned audits were completed on a monthly basis regarding medication, incident reporting and post incident reviews and were shared with staff. We identified 2 occasions where referrals had been made for people in receipt of a regulated activity; management had failed to inform CQC of potential abuse on the appropriate statutory notification. Retrospective notifications were submitted, both were closed with no further actions identified. Mechanisms were put in place to ensure any future safeguarding referrals were submitted to CQC where warranted.

People benefitted from the relationships and partnerships that the provider continued to forge with stakeholders and community groups. The provider continued to work with external agencies and professionals so that people were appropriately supported.

Quality site audit visits were undertaken by senior managers and the quality team. The service was open and transparent, sharing information with partners and stakeholders via various channels.

The provider had forged good networks and partnerships with a range of stakeholders, including local authorities, mental health commissioners, health and socials care professionals and landlords. Feedback we received from commissioners was positive. A commissioner we contacted stated communication with the service was excellent. They described how staff had helped residents achieve positive goals, for example with volunteering, returning to previous tenancies or moving on to live more independently.

Referrals where made to other agencies when necessary. The service produced a quarterly bulletin for commissioners, keeping them updated with events within the service. A recent bulletin had informed commissioners of the new Chief Executive Officer appointment. The bulletin also contained details of any new services opening, examples of people’s successful journeys and details of staff achievements.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.