Eleanor

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all the quality statements from this key question. There was insufficient evidence to rate effective at the last inspection but its rating from previous inspections was requires improvement. Our rating for this key question is good. The patient was always at the centre of how their care was planned and delivered. There were systems in place such as community meetings which provided opportunities to raise any issues they encountered in a formal way. They told us they had no concerns raising issues. There was access advocacy services. We saw that the patient could always access the care and support they needed. Individual needs were recognised and reflected in activities. Managers provided evidence that they had support systems in place with those needs, for example dietary, sexual, gender as well as protected characteristics. Reasonable adjustments and support were available for autistic patients and those with a learning disability.

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 care plans represented the patient’s needs. The patient had developed therapeutic activities around their core strengths. These included the planning and preparing of meals, physical exercise and their enjoyment of films. Carers felt consulted and involved with decisions around care. They were fully up to date with the support the patient was receiving for a physical health issue. They also told us that their care and discharge was discussed in weekly multidisciplinary meetings with those involved in that decision making present to support transitions of care.

Managers and staff were able to give examples of how they had planned activities around the patient. They had spent considerable time planning the patients visit to the Scare Fest night visit and had consulted with the patient on every step including which staff they wanted to attend the event with. Staff were well briefed on the individual needs of the patient, for example the patient attended the cinema every week and all staff knew about the care plan for those visits.

We observed staff interacting with the patient, they were friendly and engaging, it was obvious that bank staff working knew the patient and the patient knew them well.

Staff told us that there were leaflets and information available for patients whose first language was not English. Patients could express their likes and dislikes through care plans and in the ward round. We saw in care plans that the provider had worked with the patient when changing plans to reflect their needs. The psychology team was working with the patient to develop new therapeutic goals.

The patient and their carers told us that the service had helped them work toward and achieve their goals. They also confirmed they had access to external care providers such as the local GP practice and other community health services. They felt the care they received, especially the therapy sessions reflected their needs.

Managers could provide evidence that they had contact with external agencies and name contacts within those organisations whom they could refer new patients to should they require extra support for example from sexual health or community drug services. Through the senior management minutes and MDT minutes, we saw staff discussed what if any help those external agencies could provide to support the patient with their individual needs.

We saw that the service worked closely to support the patient with their physical health needs and supported not only the patient but external providers to understand their needs.

We saw that the individual characteristics of the patient were part of the care plans. Managers audited these plans to ensure staff had placed the patient at the centre of their care plans.

The patient told us they had access to their care plans and felt that staff had listened and developed that plan regarding those needs. They also confirmed that they had all the information they needed which included what medication they were taking and why they were taking it. We spoke with external agencies, and they confirmed that the provider always responded positively to requests for information.

Managers ensured that staff had easy access to information about the patient as well as the providers policies and procedures. These were all available on the intranet and all staff had access to these.

The provider had policies and training for data protection and had translation and interpretation services available as and when needed.

The patient knew how to complaint and they told us that they did so mostly informally, and staff did respond to those complaints. There were regular community meetings taking place, and complaints were also addressed in this forum.

Staff knew how to support the patient if they wanted to make a complaint. Staff told us there were posters and cards providing patients with information on how to complain. Managers had a complaints policy, and it was a standard item on staff meeting agendas.

We observed staff speaking with the patient, they talked with about the ward and what was happening and how that affected the plans for that day. The patient knew what was happening and when they had therapy sessions and when they had leave.

There was a complaints policy which was in date and provided relevant guidance to staff to manage complaints. There was one complaint, and this was a complaint after a patient had been discharged. From May 2024 the service had received three compliments from carers thanking staff for their efforts.

Patients could easily access the care and treatment they needed. Support for patients who spoke a different language was available. The patients told us they were supported and felt their needs were being supported. They did not raise any concerns about their experiences on the ward in respect of equality or discrimination. There were systems in place such as community meetings which provided the patient with opportunities to raise any issues they encountered in a formal way. They reported that they accessed advocacy services and described that they knew how to raise any concerns that they may have and that they would feel confident in being able to do this.

All staff had received an induction and the appropriate training. They could identify where they could access support if a patient had difficulty with translating speech or other communication problems. Staff could access services when they needed to, including out of normal hours and in an emergency. Physical premises and equipment were accessible. They felt supported to overcome barriers to ensure equal access. Managers gave examples of where adjustments had been made or were already in place to support patients who may have accessibility or mobility needs. Staff and managers described how patients would be supported with any spiritual or cultural needs that they may have, which included visits from religious leaders, having access to spiritual materials or being supported to attend places of worship. Staff also described how any dietary needs would be supported for any patients that had specific requirements for cultural or religious reasons.

Carers expressed no concerns that the patient had faced discrimination.

Managers and staff were alert to discrimination and inequality that could disadvantage a patients experience and access to treatment and support. Providers used people’s feedback and other evidence to actively seek to improve access for people more likely to experience barriers or delays in accessing their care. Advocacy was available for all patients, and they confirmed they had one to one therapeutic time with their named nurse, they could raise any concerns about equities in their experiences. We saw that Managers monitored complaints and concerns as part of the senior manager meeting processes.

The patient felt they were treated fairly and equally, and they were actively involved with planning care. No concerns were raised regarding discrimination and staff made every effort to ensure reasonable adjustments were in place to support equity in experience and outcomes.

Staff were 100% compliant in mandatory equality and diversity training which was refreshed annually. The service had links with local support and social groups to support new patients such as religious groups and LGBT+ organisations.

All incidents were recorded and investigated, and the service recorded the outcomes of these incidents. These were used to examine trends, and we saw they were discussed in senior management meetings. There was also a staff survey that recorded staff opinions on the equity of the service.

Through meetings with their named nurse the patient told us they discussed the options for their care and were provided with all information they needed and in way they could understand. They felt in control of planning their care and support. They were supported to plan ahead, and they could explain how they were progressing and the plans for their future care.

Managers were in constant communication about the future discharge of patients. There had been no delayed discharges in 12 months.

The patient had a discharge plan, and we could see from those records that they represented the wishes of the patient, and they were involved in developing those plans.