Ashgate Hospice

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

The senior leadership team had action plans, strategies, policies, and procedures in place which maintained excellent governance, oversight, and overall management of the service. Leaders celebrated having a culturally diverse workforce as it better represented the patient group and the wider community. The service had clear vision and values around the patient experience and the quality of care and support they constantly strived to provide. The service provided various innovative initiatives for its staff to maximise their skill set and practice which enhanced the care, support, and treatment they were able to provide to the patient and their loved ones. The service had a culture of openness, honesty, and inclusion which encouraged and supported staff in all areas to provide feedback. Where appropriate lessons had been learnt, and this drove consistent improvement for the service.

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

Leaders were inclusive of all staff and were open and honest. Engagement with staff was considered to be key, with meetings being face to face when possible. The service encouraged staff at all grades to attend governance meetings, where strategies and values were promoted, knowledge shared, and feedback encouraged. The service had a “One Ashgate” strategy with 4 ambitions which incorporated 12 strategic objectives, around care, people, voice, and future. The strategy addressed social impact and sought to resolve any potential barriers to people wishing to access the service and was the foundation for the culture, values and direction of the service.

There were comprehensive and successful leadership strategies in place to ensure and sustain service delivery, and to develop the desired culture. There were processes in place to ensure the vision, direction, and culture of the organisation were embedded, through a comprehensive organisational induction, mandatory training, and ongoing individual and team support.

Leaders were compassionate, inclusive and effective at all levels. Leaders demonstrated high levels of experience, capacity and the capability needed to deliver excellent and sustainable care. There was an embedded system of leadership development and succession planning, to ensure that the leadership represents the diversity of the workforce. Leaders were open, and supportive of all staff, and volunteers, encouraging and supporting them through training opportunities to develop their skill set, and to develop others. The service supported all its staff as individuals and learnt as much as possible about their workforce. They had regular supervision and meetings with staff and volunteers, leaders were open and transparent. They provided a comprehensive induction and training program that educated and empowered all staff to be part of the shared direction and open culture of the organisation. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.

Comprehensive and successful leadership strategies were in place to ensure and sustain delivery and to develop the desired culture. Leaders were visible and communicated with nursing teams regularly. Sharing information and values helped them all to understand the vision of the organisation. They gave direction and encouragement to their staff and were inclusive and supportive, staff were listened to. Leaders supported and encouraged them to deliver excellence every day.

Leaders had an open culture, free from reproach and actively encouraged staff to raise any issues or concerns with the Freedom To Speak Up service. Staff were aware how to raise concerns and knew who the freedom to speak up guardians were. Leaders felt raising issues or concerns enabled the organisation to learn lessons which drove improvement. For example, several concerns were raised and investigated, the outcome was a policy review and amendment which gave staff and volunteers clear direction on processes, and enhanced role responsibility. Leaders said they all engaged with and referenced the cycle of change where all voices were important. The service promoted an open culture around feedback from staff through a comprehensive survey, were themes were identified, addressed, and actions were put in place.

Whistleblowing policies and procedures were in place to enable people to raise concerns or complaints confidently, knowing they would be supported throughout and informed of outcomes and any actions taken. The freedom to speak up guardian was able to raise concerns or give feedback at governance meetings, this ensured the governance process could monitor the information and where needed, take action to improve. Meeting notes reviewed showed leaders had taken appropriate actions after feedback had been received from the freedom to speak up guardian.

The service was proud of its culturally diverse workforce and supported them individually and as a team to thrive. Leaders were supported by the HR department, Freedom To Speak Up guardians, and the Equality, Diversity and Inclusion (EDI) lead. This ensured all staff had a voice, they were always heard and supported. Leaders made reasonable adjustments for staff with new or pre-existing issues/conditions where possible as it was important that all staff felt safe and supported to work. Leaders facilitated flexible working patterns for staff where possible and always consulted the occupational health team for added support. The service made adjustments for staff to enable them to have quality time for themselves away from the workplace, striking a good work life balance in the process.

There were processes in place that worked extremely well, ensuring equality, diversity and inclusion were promoted. Reasonable working adjustments were made for staff, where practicable and considering the needs of both the person and the demands of the organisation. The Equality, Diversity and Inclusion lead completed training and education internally and externally with partners, with the service being part of the Anti-Racism programme and initiative. The service had been awarded the Rainbow Accreditation by Derbyshire LGBTQ+, and were also accredited with being a Mindful employer, Disability confident employer, Age friendly employer, and the employers’ initiative on domestic abuse.

Leaders had clear responsibilities, roles and systems of accountability which ensured excellent overall governance, and risk oversight. Leaders used these to manage and deliver excellent quality and sustainable care for people using the service. Leaders encouraged staff to attend monthly governance meetings to maintain transparency. Staff attended sustainability steering groups, and were involved in plans and strategies designed to improve the sustainability of the service and what it provided, any actions recommended were taken, audited, with any learning shared with staff electronically, and in team meetings. Leaders had clear expectations of what conduct, care, treatment, and support the organisation should be providing, and were also aware of the potential impact on care and support if they did not meet their own standards. Governance, and processes were driven by best practice which was measurable and monitored for outcomes. Where appropriate lessons were learnt, which enabled the service to continually improve and strive for excellence. There were robust procedures in place to safely manage sensitive data which allowed them to maintain people’s privacy, dignity and confidentiality. Governance meeting minutes reviewed showed staff from different areas of the service attended and were involved in discussion about the service and how improvements could be made.

One Ashgate ensured quantifiable and measurable outcomes supported strategic objectives, through robust service delivery plans, team and individual work planning, and patient, family and commissioner feedback which was effectively shared throughout the organisation. The challenges to achieving the strategy, including relevant local health economy factors, were understood and where required appropriate actions were put in place. Staff in all areas knew, understood and supported the vision, values and strategic goals and how their role helped in achieving them. The service adhered to statutory and regulatory requirements and where required worked closely with the regulator of the service. Managers undertook quality improvement projects throughout the service, these were measurable, and impactful.

Nursing teams worked with and were inclusive of external partners and care providers who were involved in care delivery. Patients were encouraged and supported to maintain their connections with the local community, and the people and places important to them, with patients and their family members taking part in fund raising events within the local area.

The service had constructive engagement with staff and the people who used services, including all equality groups. Rigorous and constructive challenge from the patients and stakeholders was welcomed and seen as a vital way of improving the service. Leaders had excellent relationships with all partners of the service. The service had good working relationships with the local authority safeguarding team, integrated care board (ICB), and the wider local community. Leaders had collaborative meetings with partners and the wider community, which enabled them to share good practice and learn lessons together.

The service actively involved commissioners, specialist services, and partners from prospective future placements, they were encouraged and supported to be actively involved in planning and contributing to the continued care of the patient. The service welcomed and utilised the knowledge, and expertise of partners, understanding the importance of joined up collaborative working, and the positive impact this would have on outcomes for the patient. Partners felt the service was open, honest, and very responsive to patient needs, keeping patient care at the centre of care delivery.

There were processes in place to ensure services were developed with the full participation of patients, staff and external care providers were seen as equal partners. Innovative approaches were used to gather feedback from patients, the public, and included people in different equality groups, either by completing feedback forms in writing or digitally by scanning a Quick Response code (QR). Feedback forms were available in different formats and languages upon request. The service demonstrated a commitment to acting on all feedback.

Leaders promoted hot topic discussions around advanced technology for enhanced care and security, and making provider retail outlets more accessible. The service monitored themes and trends that were relevant to them, the patients they supported, and the service they provided. Action plans were formulated through the inpatient unit improvement plan (IPU) to address any issues or concerns, this drove improvement, promoted innovation, and enhanced knowledge and learning. The service completed audits and clinical audits, which were evidence based and measurable. The service learned lessons from the sharing of information, this helped them to drive improvement and to strive for excellence. Leaders always celebrated good practice and used this to maintain the drive to succeed further. Managers attended regular meetings with all staff where innovation, ideas, and learning were shared.

There were processes in place that worked well and demonstrated a clear, systematic and proactive approach to seeking out and embedding new and more sustainable models of care. There is a strong record of sharing work locally and nationally, with the service working in partnership with other service providers in numerous benchmarking schemes and clinical audits. For example, financial benchmarking, end of life care strategic groups, and Last Days matter. Learning is shared, promoted and encouraged, and safe innovation is celebrated.