Senior nurses at a learning disabilities hospital in the West Midlands have spoken to Nursing Times about how they turned services around, following years of poor Care Quality Commission (CQC) ratings.
Brooklands Hospital, which is run by Coventry and Warwickshire Partnership NHS Trust, has been awarded a ‘good’ CQC rating, after multiple years of being rated as ‘inadequate’ by the regulator.
“We were trying to turn a massive tanker around”
Emma Corke
The hospital is one of only a small number of settings of its kind, specialising in inpatient care for autistic adults and children, as well as those with learning disabilities.
Last month, Brooklands was rated as ‘good’ in all areas, including safety; effectiveness; caring; responsiveness; and leadership, in the wake of an inspection by the regulator during the autumn.
However, previous CQC inspections, in 2022 and 2023, had labelled the setting as ‘inadequate’ overall, and also for the specific categories of safety and leadership.
Nursing staff, inspectors previously noted, were burned out from the extra work they were carrying out due to a shortage of substantive workers.
One nurse told the CQC at the time that senior managers “didn’t acknowledge or care” about the impact shortages were having on the workforce.
The 2022 inspection report, published in early 2023, highlighted that permanent staff were treating patients kindly and well, but that the same could not be said for temporary staff.
As well as this, the CQC said patients were being put at risk by a lack of environmental checks; inspectors saw records of incidents in which people had eaten dangerous items like screws or batteries.
These records, the inspectors said, were not always completed properly, either.
Meanwhile, the 2023 report said “many” issues had been addressed but further improvements were required.
Speaking in response to the latest positive rating, Emma Corke, the trust’s associate director of nursing, learning disabilities and autism, said that progress on making improvements was difficult at first.
Emma Corke
“We were trying to turn a massive tanker around,” she said. “A year isn’t that long to do it… to completely shift an entire culture of a workforce.”
She explained that the hospital’s workforce had been stuck in a vicious circle.
Learning disability nurses are in short supply nationally, and there are not many inpatient facilities like Brooklands, meaning the hospital has historically relied on a local pipeline of students to supply its staff.
High turnover and a reliance on less well-trained bank and agency staff made Brooklands a difficult place to work.
This led to learning disability nursing students having negative experiences on placements, discouraging some from joining after graduation. In turn, workforce shortages were exacerbated.
But Ms Corke said the second CQC report did not discourage the team, and a concerted effort to improve the student experience, train up agency and bank staff to work substantively and otherwise make the trust a better place to work did make the difference.
Last month, the trust was informed that its CQC rating had been elevated from inadequate to good, following an unannounced inspection in September 2025.
Inspectors noted, on the awarding of the new rating, that the hospital had made “significant improvements” since the previous visit and that a “high level of care”, which focused on the individual needs of people, was being delivered.
They praised staff for not relying on restrictive practices, something which had been highlighted in previous inspection reports, and said leaders had managed to maintain “appropriate” staffing levels and skill mixes.
Brooklands, the CQC report said, had made many other improvements including implementing a carers’ forum to engage better with the community.
Head of nursing for inpatient services James Preston, who assumed his role shortly before the first inadequate report, noted the work done to improve the hospital’s domestic nurse recruitment pipeline.
“We had to go right back to making our ward a good experience for student nurses,” he said.
“We did a lot of work around improving the quality of support around students and selling the place to students, and I think that’s really helped.”
James Preston
The trust also made it easier for students to who completed placements with the hospital to apply for jobs after graduation, which Mr Preston said helped encourage more people to join.
This has had a tangible impact on staffing numbers. According to Ms Corke, the hospital in the last year has received 18 new recruits from local universities, compared to two in 2022.
As well as this, it invested in nursing associates and the registered nurse degree apprenticeship route into the profession.
Other changes to the workforce included creating a band 7 practice educator nurse post.
This post had helped to improve preceptorship for newly-qualified nurses who were, previously, struggling to find their feet at Brooklands with a knock-on effect on retention.
Ms Corke and Mr Preston said these measures eased workforce shortages, which had a knock-on effect of allowing protected learning time for nursing staff to improve their practice and address other issues, such as seclusion and restraint, which had been outlined in the earlier CQC reports.
Ms Corke, when asked what advice she had for other senior nurses trying to turn a service around, said “going back to basics” worked for her organisation.
“We really suffered from quality improvement fatigue at the start of our journey,” she said.
“We had to win hearts and minds and really think about why we were there: we’re there for the patients. They’re there at the centre of everything we do… but it sometimes gets lost, doesn’t it, in everything else you’re trying to do.
“So remembering really why we’re there and that the patients are at the forefront of what we do.”
Kyri Gregoriou
She said the planning phase took the longest, and that doing this helped ensure the most important changes were done first.
Kyri Gregoriou, director of nursing, added that a focus on recruiting the right staff – not just “bums on seats” – allowed the hospital to turn its fortunes around.
“What I saw from the team was a very heavy focus around getting the right workforce in,” said Mr Gregoriou, who joined the trust only a few months before the 2024 inspection.
Speaking after the publication of the CQC report in February, trust chief nursing officer and deputy chief executive Mary Mumvuri added: “We would like to take this opportunity to say how proud we are of everyone at Brooklands and of all the work they do.
“It is through the dedication and hard work of our caring staff that we have seen this significant improvement over the last three years to improve the quality of care for our patients, and we are very pleased that this has been officially recognised.
“We will continue to work together with our patients and their families and carers to ensure we carry on providing the highest standards of care for those who use our services,” she said.
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