Eleanor

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all the quality statements from this key question. Caring was not rated at the last inspection but had a rating of inadequate from previous inspections. Our rating for this key question is good. We found there was good therapeutic activities taking place. Care plans were clear as to how the patient was involved with their care planning and kept informed and up to date. Care plans reflected identified needs for patients and how staff should support them with these. There were a number of activities designed and supported by staff such as cycling, using public transport individually, weekly visits to the cinema and support with fund raising activities to help fund purchases.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The patient was positive about the politeness and respectfulness of staff. They spoke positively about staff who they worked with. Staff were described as supportive, kind, respectful and caring. They told us staff were compassionate and listened to them, and they received emotional support and advice. This was reflected in how staff had individualised activities to reflect the needs of the patient. They had weekly menu planning meetings with the chef who also prepared meals together.

Staff on observation duty could tell us about the risks and how they would engage with the patient if they became agitated. Staff felt there was enough staff, and this allowed them to engage positively with the patient, for example nurses told us they always had enough time to conduct one to one sessions.

We saw that the service was in constant communication with the commissioners and was actively supporting discharge planning.

Staff were present always present in communal areas. We observed positive interactions with the patient including staff sitting and chatting with the patient and engaging in activities and saw staff had a good rapport with the patient.

The patient told us they that staff accommodated their individual needs. They preferred cycling and the staff went with her. They had encouraged her independence and had supported her to travel on public transport by herself.

Managers could evidence that they had procedures in place to support patients who needed translation services or had dietary needs such as vegetarian or halal food. Staff also gave examples of how they used personalised approaches to help the patient de-escalate. For example, there were plans in place on how to approach the patient if they had returned to their room feeling anxious. All staff could explain the care plan to monitor but wait for the patient to reengage in conversation.

We observed positive interactions. We observed staff engaging the patient in activities such as preparing food, board games and general conversation about plans and what they wanted to do when they left the ward on leave. They also had items placed around the ward that the patient liked to talk about, and staff could easily refer to these while engaging the patient.

Care records showed that the patient was involved in care plans and risk assessments. Staff recognised the patients’ individual needs in their care plans. There were community meetings on a weekly basis, where they discussed issues on each ward. Staff received equality diversity and human rights training. Equality, diversity and human rights was considered within governance meetings and there was access to advocacy.

Staff supported, informed and involved families or carers. The patient’s family visited regularly, and they confirmed they were able to attend ward rounds and meetings when the patient wanted them to attend. Carers spoke positively about the support their loved ones had received; they were impressed with the support the service had offered the patient following the bereavement of a close personal friend. The carers we spoke with were positive and described the service as the best one their loved one had been involved with.

Staff involved the patient in the daily operation of the ward as much as possible. They also had staff information boards with information and pictures of staff. Staff involved the patient and gave them access to their care planning and risk assessments. Care records showed they were always offered copies of care plans, and risk assessments showed evidence of patient involvement. Staff made sure the patient understood their care and treatment and could provide evidence they had systems in place to communicate with patients who had communication difficulties. For example, there was provision for patients who did not speak English as their first language to receive translated information, including relating to their rights under the Mental Health Act. Community meetings were held on the wards, we saw minutes from meetings on the notice board. These showed consideration of patients’ thoughts and outlined attempts to include patients on improving the service. Staff made sure patients could access advocacy services. The patient told us they had access to advocacy services and that they found this helpful.

We saw staff ask the patient if they wanted to engage with an activity, if the patient declined staff would follow up suggesting other activities that the patient might like. We saw the patient taking unescorted leave and their return staff were ready to welcome them, they conducted a quick search to ensure no prohibited items were with the patient in a quiet, professional and friendly manner. We saw other staff entering the ward to engage with the patient in activities or therapeutic sessions.

Care plans were clear and recorded patient involvement with their care planning. They were up to date and recorded when they were offered a copy. Care plans were off good quality and reflected the patient voice and identified their needs and how staff should support them with these. The hospital collated data so managers could see how often care plans were updated. Carers gave positive feedback in being involved in the patients care and treatment as well as being treated with respect and dignity.

The patient told us they felt staff were responsive to their needs and that they were making progress towards their targets. We saw evidence that occupational therapists had assessed the patient before designing individualised therapy sessions. The patient confirmed they had constant contact with their named nurse and that they knew how to make official complaints, but felt they had no need to do so. They had raised minor concerns and were happy that staff had taken them seriously and dealt with the issues raised. They told us they had no difficulty getting support both on and off the ward.

Staff gave us examples of how they supported the patient. For example, occupational therapy staff completed assessments within the community whilst the patient was on leave, this allowed therapy staff to see the patient perform in everyday settings such as shops or social visits. Staff felt that they could raise concerns with managers about disrespectful, discriminatory or abusive behaviour or attitudes towards patients and staff.

We saw staff interacting positively with the patient, they both knew each other well. Staff were always present, and they were always engaging the patient in either activities or discussing previous or future planned visits.

Managers were available both in the day and at night to support staff and there was an on-call system in place. Staff had regular handovers to share patient information. These were thorough and detailed and contained all the relevant information about all the patient and the current risks on the wards. Managers met weekly to discuss how the patient was responding to the care and treatment offered to them.

Staff told us that managers considered their wellbeing and were supportive when they needed help to adjust or move a shift for appointments. Some of the staff worked reduced hours to give them a better work life balance.

Managers conducted staff surveys and had acted upon the feedback. They had responded by introducing more recognition for good work including systems where praise could be recorded. They had asked external mental health professional to develop confidential counselling and workshop sessions.