Head Office

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 assessed a total of 7 quality statements from this key question. Our rating for this key question is good. We found the service had a clear set of values that staff were aware of and acted upon. There was a freedom to speak up guardian in post; staff told us they felt comfortable raising concerns. Most staff told us they felt supported and that leaders were approachable, however some staff told us they found it difficult to access support from leaders in the service. The provider acknowledged the difficulties faced by staff due to the nature of the service. Leaders were based at a different location to the practices where services were delivered. Some staff raised concerns about high turnover of staff in certain management positions, however we saw the provider had already taken steps to improve recruitment processes, which they anticipated would lead to a more stable workforce.

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 at the service detailed clear vision and values for the service. This was shared with staff who they told us had input into the direction of the service. Staff told us that they felt engaged by leaders at the service. They told us that they were listened to, and they were aware of and understood the vision, values and strategy and their role in achieving them.

There was a clear vision and set of values, which we saw the service acted on. The service had a realistic strategy and supporting business plans to achieve priorities. The strategy was in line with health and social priorities across the region. The provider planned the service to meet the needs of the local population. The provider monitored progress against delivery of the strategy.

Most staff told us that leaders at all levels were visible and approachable. They told us that they worked closely with staff and others to make sure they prioritised compassionate and inclusive leadership. However, some of the staff to whom we spoke told us that leaders were not always supportive, and there had been occasions where individuals were not spoken to with respect in front of other colleagues. We shared this information with leaders at the service who acknowledged that there had been times where actions that had not been completed by individuals had been discussed during team meetings. Leaders told us this was a rare occurrence and did not happen routinely.

There were clear lines of responsibility to support capable and inclusive leadership. The service had put in place clear job descriptions and parameters for all staff and had ensured staff were aware of their roles and responsibilities.

Leaders at the service told us that the organisation considered it important that the voice of staff could be heard. They told us that there was a freedom to speak up guardian in place at the service. Staff told us that they felt comfortable raising concerns and were confident that the leadership of the organisation would act on them.

There was freedom to speak up policy in place at the service. There were formal mechanisms by which feedback from all staff groups could be shared with the managers of the service. Staff knew who the freedom to speak up guardian was and felt comfortable raising concerns.

Staff had received equality and diversity training. Leaders provided an environment free from discrimination and harassment, where people’s contribution was valued, and they were protected from abuse.

Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control. Leaders detailed and demonstrated that they had established proper policies, procedures and activities to ensure safety and assured themselves that they were operating as intended. Whilst feedback from staff was mostly positive about the service, some staff members raised concerns about the high turnover of staff in some management roles. In particular, the Service Manager role (recently restructured to a more senior Head of Operations role). Staff felt people in management roles could be offered greater support and training. The provider was aware of the issues around recruitment for a number of management roles. Leaders at the service had already taken action to improve recruitment processes. For example, a stakeholder panel had been introduced to interviews, where staff who would report to these positions were given the opportunity to ask questions of potential new hires. Following our assessment, the provider told us they had appointed to the Head of Operations role.

Leaders had developed a governance structure that provided oversight by leads at the service. This was supported by policies, procedures, and clear lines of accountability. Structures, processes and systems to support good governance and management were clearly set out, understood and effective. The governance and management joint working arrangements and shared services promoted interactive and co-ordinated person-centred care.

The provider took steps to engage with people using the service.

Leaders told us they collaborated with stakeholders and had active care meetings engaging with GP practices in Bexley, plus other services with whom they worked. They told us that while the service itself did not have its own list of patients, and therefore did not have a patient participation group, they would where possible engage with other bodies to develop the service.

We had no concerns regarding partnership and communities.

The service had formalised engagement mechanisms with both their commissioners, and partner organisations in the area.

There was a focus on continuous learning and improvement at all levels within the service. Staff knew about improvement methods and had the skills to use them. Leaders and managers encouraged staff to take time out to review individual and team objectives, processes, and performance.