Nottinghamshire Healthcare NHS Foundation Trust

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Patients felt staff were supportive from the start of their admission and partners and families were involved in care and treatment where appropriate. Patients needs were continually assessed and patient care and treatment plans were holistic and person centred. Staff used nationally recognised tools to assess patients progress and used various interventions to support patients. Staff supported patients after discharge in providing debriefs for incidents that may have occurred when they were on the ward and maintained positive relationships with other services to ensure that patients received the best support to meet their needs.

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.

All patients we spoke with told us staff were very supportive from the start of their admission. Staff worked with them to identify and develop individual wellbeing plans, and their partners and families had been involved in these, where appropriate.

Staff told us they supported patients to ensure their needs were continually assessed. They used a weekly summary form where patients were encouraged to identify any changing needs, what had gone well in the previous week, medication queries and other updates regarding their experience.

We reviewed 5 patient care and treatment records, all were holistic, person centred and evidenced the patient and family voice throughout. Staff completed additional wellbeing plans for all patients which were kept in the patients’ bedrooms. Care plans were also developed for babies residing on the unit, where they were referred to as guests.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Patients told us staff supported them to ensure their needs were continually assessed. They used a weekly summary form where patients were encouraged to identify any changing needs, what had gone well in the previous week, medication queries and other update regarding their experience.

We spoke with 5 members of staff including, nurses, healthcare support workers, nursery and student nurses. We were told about the use of video interactive guidance. This was an intervention where a member of staff used video clips of the mother and baby to review their interactions, looking at what worked well and areas where the parent may like to develop. Staff described how they used the Bethlem Scale to assess and monitor the mother and baby interactions whilst on the ward. Leaders told us they were an active part of the Royal College of Psychiatrists Perinatal Quality Network (PQN) which shared and highlighted notable practice in the field. Two staff were on the advisory committee and 3 on the accreditation committee with 1 being the chair.

Staff had developed a process for debriefs to support patients discharged from the unit as a time for them to discuss their care and treatment, ask questions, and for them to just have the space to reflect on their care. We saw an example whereby staff supported the team caring for a patient who did not meet the admission criteria of the mother and baby unit because of trauma or substance misuse, to ensure best outcomes for the patient.

All patients we spoke with told us staff ensured they knew their rights and supported them to access advocacy services. They said their consultant talked to them about consent at every care plan review meeting.

Staff we spoke with described how they gave patients every possible assistance to make a specific decision for themselves before they assumed that the patient lacked the mental capacity to make it. They told us for patients who might have impaired mental capacity, they assessed and recorded capacity to consent. They did this on a decision-specific basis.

We saw posters on display advising patients how to access advocacy services. We looked at 5 patient care and treatment records, they all demonstrated capacity had been reviewed at each care plan review meeting.

Managers undertook regular audits of Mental Health Act documentation.