Longfield

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 6 areas of the well led key question. We found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was rated as good. We found managers had the skills to support staff, review how well the service was being provided and engage with people who were involved in commissioning the service. Managers used information from all aspects of the service to plan future services and identify where improvements could be made.

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.

Leaders of the service had reviewed the strategy and vision for the service in collaboration with staff, people who use the service, external partners and local communities. The strategy was in the process of being developed to the next stage. Managers understood the challenges and needs of people in the community. Staff expressed their pride in working for the service.

Leaders used processes effectively to review the future service provision. The strategic plan was due for renewal in 2024 and was in the process of completion following consultation with stakeholders. The consultation had provided the leadership team with information about what matters to the community who use the service, staff, and partners in the wider community. Strategy aims were clearly articulated with patients and staff.

Staff were positive about changes made within the service and felt supported by their managers. Leaders had listened to concerns raised by staff and used compassion in managing any issues. Leaders had involved staff in forming the new strategic plan. Decisions were made that were sensitive to the needs of the service, its staff and people who use the service. The leadership team had made changes which staff felt positive about and felt they improved the culture within the service.

Managers used process to review and provide communication to staff and people who use the service. There had been a recent management restructure which gave staff clear support systems and line management. Policies were regularly reviewed and updated to reflect changes in practice or national guidelines. Skills of trustees were being reviewed to identify the areas of the service they could support effectively. There were close and organised links with external partners such as the local integrated care board and NHS trusts. These had prompted discussions about the type of support staff could offer, which would free up NHS community nursing time and provide more effective patient care.

Senior leaders had an open door policy and staff fed back this was effective. Staff described they were happy to access and raise concerns with managers and senior leaders. Staff had raised concerns with managers and senior leaders and their anonymity had been maintained. A person was allocated to the role of Freedom to Speak Up Ambassador although they had not received any training specific to the role. However, managers were reviewing available training.

Processes were followed by staff and leaders to promote an open culture. There were policies for how staff could raise concerns or speak up about concerns, harassment or bullying. An annual staff survey was held and actions were reviewed at board meetings. The most recent survey was under review. A staff forum met for the first time in April 2024 called Culture Club. Staff comments were collected at exit interviews when they left the service and we saw these had contributed to actions taken.

Staff were consulted and felt informed of strategic plans. Leaders encouraged an inclusive culture within the workplace. The Chief Executive officer attended staff meetings and staff felt leaders understood issues they raised and took action in response. Work was underway to assess how diversity in the trustee membership could be matched to the community and incorporated to strategic aims.

The service considered equality, diversity and inclusion when it drafted, published and reviewed all of its policies. We saw equality impact assessments had been carried out to ensure no group, or groups of staff were adversely affected. Improving and expanding people’s access was discussed by managers to provide greater equity for all people who would benefit from using the service.

Staff were aware of changes to the management structure and were clear about their own and others’ responsibilities. Managers reviewed risks and took action to reduce these risks. Patient stories were shared to provide a fuller understanding of their experiences to inform staff, managers and trustees. Staff and leaders looked beyond their own service for potential improvement actions by linking with other services or specialist roles.

Processes gave a good overview of the service and how effective it was for people who used the service. A range of committees were set up for different aspects of the service and reported into the senior management team. Board meetings reviewed the reports and identified potential improvement actions and risk reduction. There was regular and planned engagement with other health partners and commissioners in the local area which helped leaders to understand needs in the community and plan services. Discussions with the local commissioners had prompted improved access to the service especially for those who needed faster access. Information about patient care was shared securely across the hospice and NHS services. Managers submitted notifications to external bodies as required. Matters affecting finance of the service were reviewed by senior management and we saw meeting notes of actions taken to maintain sustainability.

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

Managers used opportunities to improve the service. Managers attended meetings with a range of hospice services across the region, commissioning services and specialist national services. Staff described initiatives which were being explored as a result of some of these engagements. Plans were being developed to use specialist nursing staff from the hospice to provide a more streamlined service in collaboration with NHS community nursing teams. Staff were aware of any changes and knew how to share their comments or ideas.

Processes had been developed to identify improvement opportunities. Hospice staff had been involved with nationally run research projects in cancer care with a view to improving care for cancer patients. Existing processes for governance were reviewed and improvements identified. Processes were improved to gain input from all stakeholders. The process for recruiting trustees clearly defined the role and responsibility to challenge and improve governance processes. Systems for how staff engaged with managers and leaders had improved. This would potentially promote further improvement as staff contribute to identifying, planning and implementing improvement activities. Processes to gather patient experience had improved and would also provide better information about how to meet people’s needs and where improvements were needed.