Coaching for Culture with North West Boroughs

The team

A group of clinical staff from Warrington took part in the 2018-19 cohort of the Innovation Agency’s coaching for culture programme. Led by assistant clinical director Hazel Hendriksen, the team was from Kingsley Ward, part of North West Boroughs Healthcare NHS Foundation Trust. The later life and memory service inpatient ward provides support for adults with memory problems such as dementia who require specialist inpatient care.

What we did

Hazel Hendriksen, Assistant Clinical Director:

“We had a really helpful session with the Coaching Academy facilitator. Her objectivity when looking at problems and her skill at facilitating were essential. What we were able to do was spend time with the team away from the ward, identifying what would make a difference. It cemented all the work we’d done in the other sessions, and we were able to identify what our priorities were.

“Most of the changes we’ve made lead from one single issue reported by staff - interruptions in their day. Interruptions stop the flow of care and make staff feel ineffective and inefficient.

“Some of the key actions we’ve taken include changing visiting times on the ward. That came from recognising that when the ward was disrupted by visitors, we couldn’t give the right care to the patients. We’ve hardly taken any visiting time out, but we’ve recognised that protected meal times are a priority on the ward. It gives staff the space to provide high-quality care for the patients.

“Our view is that happy teams mean happy patients. Culturally, if we can get that right, it will spill out into the care that we provide. We weren’t untypical of other groups in the coaching programme, but burnout amongst our staff was particularly high. We’ve started to see an improvement in that.”

Rachel McFadden, Falls Prevention Lead:

“The ward was quite a challenging place – it was busy, staff were overstretched and there wasn’t much organisation around visiting times. Visitors were allowed anywhere and we could have any number of visitors, even when patients were eating.

“We had four away days with the Coaching Academy team. We came back and decided the problems needed to be addressed as a team, so we had our own away day with about 20 staff from all different bands, and all different roles. It was a safe space for staff to express what they wanted.

“We’ve got protected meal times now, so visitors can’t come to the ward at those times. We’ve moved visitors from the lounge into other areas so patients who don’t have visitors can relax.

“The ward’s definitely a lot more settled now. Patients who don’t have visitors are more settled and the lounge is what it should be – a relaxing space for patients. It’s better for staff too, they can nurse patients in the lounge without visitors present. Patients eat better too.”

Michelle Weekes, Clinical Team Manager:

“Our team culture diagnostic came back with a high level of burn-out amongst staff, so we looked at ways of ensuring people were getting breaks. More experienced staff sometimes regarded not having a break as a badge of honour. This had a knock-on effect with new staff, who thought they shouldn’t take a break, even when they wanted one.

“We got the team together and redesigned our allocation sheet. There’s now a section on that where the nurse in charge allocates breaks. Now we can say, ‘you’ve got 10 minutes – go and have a cup of tea!’.

“It’s a different ward now. Everybody gets breaks, everyone’s got time to do their jobs. Staff have always said to me that their main frustration is not being able to get one-on-one time with their patients, sitting down and having a chat for five minutes. I see that happening more often now, and that will benefit patients in the long run.”

The Coaching Academy

The Innovation Agency’s Coaching Academy is a programme that enables health and care professionals to improve culture, quality and safety of health and care through structured, focused interactions.

Coaching for a safe and continuously improving workplace culture is a one-year programme for clinical teams focused on developing safe, high-quality and compassionate services. The programme includes accredited coaching training for team leaders; a collaborative action learning programme with other teams, creating a community of practice; an accredited team culture diagnostic to identify key areas of focus; and quality improvement and innovation practical knowledge and skills.