We did not rate the service. We found:

• Staff were knowledgeable about their responsibilities around safeguarding and there was sharing of information internally and externally. Records were kept electronically and were clear, detailed and up to date.

• Staffing levels and caseloads were appropriate and in line with Royal College of Nursing guidelines. Staff followed infection prevention and control procedures. Staff completed appraisals and revalidation and achieved 100% compliance with mandatory training.

• Staff used evidenced based policies and guidelines and there was regular Multidisciplinary team (MDT) working.

• The school nursing service had received four complaints since December 2016. We saw evidence that learning from these complaints had been used to improve the service.

• There was a clear leadership structure in place and the culture within the school nursing team was open and supportive. The service routinely looked at ways of introducing improvement and sustainability.

• The leadership drove continuous improvement and staff were accountable for delivering change. Safe innovation was celebrated and there was a clear proactive approach to seeking out and embedding new ways of providing care and treatment.