Elements Medical

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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

Key question commentary We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment, we rated this key question as inadequate. At this assessment, the rating remains the same.

This service scored 32 (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.

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.

The service did not always have clear systems of accountability or good governance. Managers were beginning to complete appraisals and performance reviews. The provider had begun to establish some governance processes that were appropriate for their service, but these were newly introduced and not yet embedded. Staff could access some policies and operating procedures via a shared drive, but these were limited in scope and number and not yet tailored to the service’s specific needs. Some described the responsibilities of the hospital trust and provided a hyperlink to a hospital trust intranet site which staff at this service would not have access to. The Freedom to Speak Up Guardian named in the service policy was the owner and provider of the service, meaning that staff may have felt conflicted and therefore reluctant to raise concerns. Since our inspection an alternative guardian has been named. Staff had recently completed whistleblowing training. Managers had begun to introduce service meetings with staff. A system to identify significant events had been introduced but was not yet fully embedded. A new training platform had been introduced which gave the provider oversight of any training which was overdue or outstanding. Not all relevant training had been assigned to all relevant staff, by the manager. At this inspection we were not able to ascertain if there had been any improvements in the quality, effectiveness and assessments of clinical records or whether improvements in obtaining consent to share information between healthcare professionals had improved. This was because we had imposed a suspension onto the provider meaning they were unable to legally carry out regulated activities, and therefore there were no records to support this. We will follow up on this at a future inspection.

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.