St Andrew's Healthcare - Birmingham

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

This means we looked for evidence that the service met patients’ needs.

At our last assessment we rated responsive as requires improvement. At this assessment the rating has changed to good.

Good: This meant people’s needs were met through good organisation and delivery.

Staff worked with commissioners to manage beds well. Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

We saw examples of staff developing patient centred care plans that identified patients’ individual needs, wishes and took into account their protected characteristics such as ethnicity, gender or age.

The service had introduced “flash cards”, a single page guide to a person’s positive behaviour support plan. Staff told us these were helpful to let them see at a glance what was really important for a person.

However, we found patient records contained numerous different care plans, some of which were out of date, which made it difficult for staff to find the most up to date, relevant care plan for patients.

Managers told us they were in the early stages of improving care plans across the hospital. The Quality Matrons were working to improve care plans on each ward until everyone had a clear, more person-centred, individualised care plan that was up to date and truly reflected patients’ wishes and preferences.

Lifford ward specialised in the care and treatment of older men. Staff on the ward made sure they had quick access to things like mobility aids for patients to use to maintain their independence with mobility. Staff also supported patients to manage their continence in a dignified way.

The service provided information in accessible formats and patients had access to interpreters if they needed one.

Patients had access to independent mental health advocacy services to support them to understand their rights under the Mental Health Act.

Patients knew how to make a complaint about the service and staff knew how to support patients to make a complaint if they needed help.

Patients told us they felt better listened to since the provider appointed a Director of

Improvement at the hospital earlier this year. They gave us examples of new initiatives they had been invited to be part of, such as a review of hospital food provision.

One person was a keen gardener and wanted to plant flowers in the hospital grounds, outside their ward. They initially wanted to do this using their own money but managers arranged for them to access a small budget to continue their planting efforts. Lots of patients told us they enjoyed seeing the flower displays in the grounds.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

When appropriate, staff ensured that patients had access to education and work opportunities. Patients told us they really liked the educational opportunities they were given and shared personal stories of how they had improved their literacy and use of technology because of the support.

The hospital had a work placement service on site but it was closed for re-evaluation and refurbishment when we carried out our assessment.

Staff supported patients to maintain contact with their families and carers. This included supporting patients to develop their independence skills by using public transport if they were ready. Alternatively, the service provided transport for patients and supported them with staff escorts when needed.

Staff supported patients to access their chosen place of worship within the community. Patients told us they could either go to a community facility such as a church or mosque but if they preferred, they could attend a religious ceremony at the hospital.

Staff supported patients to visit or spend time in their potential discharge placements. The service supported patients being admitted or discharged by offering staff from other providers the opportunity to work together for the benefit of supporting each other so they could understand and get to know patients before important moves took place.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed, including to commissioners, the local authority and Care Quality Commission.

Information governance systems included confidentiality of patient records. Staff were up to date with training in information governance.

The service complied with the Accessible Information Standard, providing information in a way that was meaningful and accessible to patients.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Each ward had a noticeboard that was easily accessible for patients.

The information provided was in a form accessible to the particular patient group (for example, in easy-read form on wards for patients who needed it).

Staff made information leaflets available in languages spoken by patients.

Staff ensured carers, families and commissioners were regularly updated about patients’ progress at the hospital.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Patients were encouraged to share their views and join in their ward community meetings.

Staff involved patients in their care and treatment, including their medicines. Doctors discussed medicines changes with them. Patients said staff would give them written information about medicines if they wanted it.

Staff encouraged patients to become part of the Experts by Experience programme.

Patients were offered opportunities to take part in local, regional and national patient forum groups. Some told us they found the experience really rewarding. Others told us they were involved in candidate selection and interviews for staff roles at the hospital.

The service had recruited 12 volunteer Experts by Experience who had undergone a structured 2 day training to develop their skills and confidence to advocate effectively for themselves and others. They also attended a 5 week Recovery College training course covering modules essential to recovery, participation and advocacy.

The service received 19 complaints across the 6 wards in last 6 months.

The service did not record if a complaint was upheld but we found each complaint was investigated and an explanation provided for the person making the complaint. The records clearly showed any learning that was identified as a result of each complaint.

No complaints were referred to Ombudsman in last 6 months.

Patients knew how to complain or raise concerns and knew the matter would be taken seriously and they would receive a response from the provider.

Staff protected patients who raised concerns or complaints from discrimination and harassment. Staff encouraged patients to raise concerns if they were unhappy.

Staff knew how to handle complaints appropriately.

Staff received feedback on the outcome of investigation of complaints and acted on the findings. Sometimes this included learning for staff, such as to provide clearer rationale for patients when carrying out search.

The service received for 3 compliments for staff between January and June 2025. Compliments were for individual staff members and a team. Patients wanted to show their appreciation for how staff supported them and helped them achieve things that boosted their confidence.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met – for example, wheelchair users were placed in bedrooms at ground level or had access to lifts.

Staff made reasonable adjustments for patients – for example, patients with mobility issues were provided with walking aids, shower chairs etc.

The service had access to physiotherapists, tissue viability nurses, dieticians and occupational therapists, so patients could get specialist assessments and equipment without waiting for lengthy referral times.

There was adequate medical cover day and night, a doctor could attend the wards quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

Staff worked with partner agencies to make sure patients had access to post-discharge care and support – for example, Section 117 aftercare, community mental health services and crisis services.

Staff planned for patients’ discharge, including liaising with commissioners, alternative inpatient stepdown services, housing services, local authority social care teams and community mental health teams.

Discharge was never delayed for other than clinical reasons, but staff told us patients could be waiting for a local authority Care Act 2014 assessment.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the patients using the service felt empowered to give their views.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable patients or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights.

The service had a lead for the patient and carer race equality framework (PCREF) and had joined a national PCREF pilot project. Managers acknowledged that some staff were often subject to verbal racial abuse by patients. Staff were encouraged to report the abuse but some told us they only reported the physical abuse they experienced because the verbal abuse they got from patients often reflected wider societal and cultural issues in the country, for which the provider was not accountable. Managers told us they understood why negative societal views might be reflected in the workplace, but they told us they always encouraged staff to report any element of abuse, and they were committed to supporting staff to feel and be safe from discrimination at work.

The service had a co-production lead. The service was developing ways of involving patients with lived experience in how the service could be run.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

If patients were willing, staff supported them to consider and record what they wanted their care and treatment to look like in the future. This included how they might wish to plan for the end of their life, so their preferences and wishes for their end-of-life care were clearly recorded. This included supporting patients to understand and plan a DNACPR wish (do not attempt cardiopulmonary resuscitation).

Staff were making improvements in the way they created personalised care plans to account for the patient’s needs, wishes and feelings. We saw some improvements and the provider shared the result of their recent audits which confirmed the service needed to carry out further improvement work on patients’ care plans. Care plans needed to be clearer, more personcentred and more up to date.

Staff gave examples of when they had effectively and sensitively managed the care needs of patients who were nearing the end of their life, so the person could continue to receive support from staff they knew and trusted.

Staff gave examples of working closely with other relevant healthcare professionals and relevant bodies to plan the care and treatment of patients with complex needs.