Some of the staff at the Bolton NHS Trust do not feel respected or supported, according to a watchdog, and these staff do not feel able to speak up for fear of "retribution".

The revelation is one of several made by inspectors from the Care Quality Commission (CQC) resulting in them rating the leadership of the trust as "Requires Improvement".

The inspection this year was the result of concerns about the Bolton NHS Trust, which is responsible for Royal Bolton Hospital  and a lot of other services, as raised by whistleblowers.

Although the inspectors from the CQC rated the leadership of the trust as "Requires Improvement", they said the trust remains "Good" in all other areas, including its children's services, which were the subject of another inspection at around the same time.

Karen Knapton, the deputy director of operations in the north, said: "We found there was a commitment to wellbeing from senior leaders, however, there was a breakdown of trust and relationships between some of the board and the Council of Governors which affected how well the trust was run.

"We found staff did not always feel respected or supported by senior leaders, however, they remained focused on the needs of people receiving care. Some staff expressed concerns about a closed culture where they couldn’t raise concerns without fear whilst others described it as a fair workplace."

The inspection report stated: "Some staff expressed reservations about raising concerns without a fear of retribution, did not always feel listened to and feedback was not consistent, whilst others described a just culture.

"This included concerns about the effectiveness of the Freedom to Speak Up function within the trust. The processes for the management of disciplinary and grievance issues required improvement. However, the children’s service had a culture where patients and their families could raise concerns without fear."

However, Ms Knapton praised the children's services in particular, where the leadership was "accessible" and "approachable" and the treatment was "compassionate" and "kind".

Bosses at the Bolton NHS Trust accepted the outcome and apologised to the staff who felt the impact of the issues at the trust.

The Bolton News:

Fiona Noden, the chief executive of the trust, said: "I am really sorry some of our staff do not feel able to speak up and do not have confidence in the process we have to act on feedback. We welcomed the opportunity to work with the CQC to understand the areas we can improve and we will do everything we can to learn from this report.

"We have already started to take action in this area including the expansion of our Freedom To Speak Up champion network, arrangements are now in place for people who do not feel able to speak up internally and a review of the confidentiality and effectiveness of the process is currently underway. Thank you to those staff who have had the courage to raise, and those who continue to raise, their concerns."

Niruban Ratnarajah, a GP and the chair of the trust, said: "Our rating for well-led is a fair reflection of where we were at the time of inspection. We acknowledge the feedback we have had from the CQC. 

"The report has validated our areas of focus and is already helping us to strengthen our organisation and be the best we possibly can for the people of Bolton. 

"We've thoroughly reviewed the report and we have taken on board all of the recommendations and actions are either already in development or in progress.

"We're so proud of our services for children and young people achieving a "Good" rating across all areas. We are focused on all our services to be able to continue to provide safe, high quality care for the people of Bolton."

This article was written by Jack Tooth. To contact him, email jack.tooth@newsquest.co.uk or follow @JTRTooth on Twitter.