St Andrews Healthcare Northampton

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

Governance processes did not always operate effectively. Managers did not ensure that staff were up to date with supervision or training. Numerous items on the risk register were not assigned to anyone to action or follow up on. There were not clear audit timetables in place to improve the quality of care. There were no clinical governance meeting minutes in place for Hawkins ward. There were not clear team meetings taking place for staff. Therefore we issued an action plan request to the provider under regulation 17 Good governance. However the provider had a clear quality strategy in place and had introduced a culture strategy with the emphasis on listening to people’s voices. Leaders were aware of the risks and concerns on both wards and had acted on these concerns in relation to staffing. Staff and leaders understood their role and felt confident in carrying out their duties.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff said that they were aware of the organisations vision and values, they said that management did listen to them if they had concerns or feedback. Staff said they liked working for the organisation and were passionate about the patients they cared for and supported. Staff said they attempted to provide good quality care and support at all times. Staff told us that morale had improved on Sycamore ward, specifically since changes to leadership, staff dynamics had changed and extra resources had been put in place. Leaders spoke passionately about the charity’s vision and their role in achieving it. Leaders increased support to staff by facilitating listening sessions for staff and arranged them during night shifts to ensure that voices of all staff were heard.

The charity launched their new five year quality strategy in 2023 with an aim of becoming a national and international leader in helping people with mental health needs transform their lives. The quality strategy includes their vision of high quality, personalised care. The strategy includes clearly defined priorities for each of the five years until 2028 and measured by quality improvement plans and ward action logs. A new culture strategy was introduced alongside their quality strategy with particular emphasis on listening to people’s voices, social impact and high quality care. Staff survey results from June 2023 showed that 56% of staff from Hawkins and Sycamore wards took part. Out of those, 57% of staff felt motivated to help the provider achieve its goals and 43% recommended St Andrews as a place to work. These compared to charity-wide scores of 85% and 62% respectively. We reviewed their risk register following our assessment, there were no actions to improve survey outcomes for these wards, or others across the charity.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

Staff said that they knew the executive leadership team and they did visit the ward. Staff demonstrated that they knew their roles and responsibilities within the nursing team and said they felt confident in carrying out their duties. Staff were open and honest regarding the increase in safeguarding incidents in relation to particular patients. Both wards had been identified as ‘wards of concern’ which meant the provider had put in extra leadership and resources to make quick improvements and reduce incidents. Leaders spoke of a wide range of data sources to assess the quality of care, including incidents and supervision and regularly review to investigate concerns. Leaders were aware of staffing concerns and reported that bank staff were being block-booked to avoid mis-communication and repeat incidents. The service introduced quality matron and general manager roles to support ward managers and increase level of managerial support to staff. Leaders spoke of collaboration with different local authorities to create therapeutic placements for service users within their hospital grounds and planning to replicate this in future. Leaders were able to articulate their roles in submitting statutory notifications and were open to improvement ideas from staff. The charity used an electronic system that had a contingency for cyber attacks and could also facilitate tracking of service users social media activity if required for an investigation. Leaders participated in weekly divisional risk meetings and safety huddles to discuss a wide range of safety aspects, however the notes did not include evidence to show that lessons were learnt from incidents. Other concerns such as repeated non compliance with seclusion audits and completion of patient physical observations were identified but no actions were recorded to improve or identify the root cause.

We reviewed 2 audits of Hawkins ward handovers. Nineteen out of 28 staff members were recorded as having not worked on the ward in previous 48 hours with no specific actions noted to address this. This highlighted a concern with the effectiveness of handovers alongside repeated incidents of a similar nature. We reviewed the risk register for the division. We found 1 high inherent risk item (low residual risk) relating to service users not receiving the correct access to occupational therapy, psychology and social work. This risk item was due for review on 29 March 2024 and was overdue for review. Twelve out of 21 items on the risk register across the division were not assigned to anyone for follow-up. Three were categorised as major risks and 4 were labelled as high risk. We requested audit timetables for both wards, we received a blank template which was not specific to either ward. We reviewed the provider-wide business continuity plan which had clearly defined processes for managers to follow as a result of different kinds of adverse events. We requested the last 3 months of clinical governance meetings for both wards but only received minutes from 2 clinical governance meetings for Sycamore and no information was received for Hawkins ward. The minutes for Sycamore ward were detailed and included elements such as quality improvement but there was no section to record actions to be taken forward to the next meeting or effective learning from incidents. Similarly, we requested staff meeting minutes from both wards to cover the last 3 months. We reviewed monthly staff meeting minutes for Hawkins ward between January to April 2024. There was no record of who attended or discussion around learning from incidents. The only staff meeting notes that we received for Sycamore took place after our assessment. Examples of good news stories were received and shared.

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.

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.