St Andrew's Healthcare - Essex

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• 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 people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating had changed to good. This meant patient’s needs were met through good organisation and delivery. Staff managed beds well. A bed was available when a patient needed one. 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.

We scored the service as 3. The evidence showed a good standard. 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.

Staff regularly met with patients to understand their views on care and treatment. These discussions took place in one-to-one meetings with nurses and in multidisciplinary team meetings. Staff monitored patients’ conditions and discussed any changes at handover meetings.

The service provided therapeutic and recreational activities. A timetable of therapeutic activities was shared with patients, this included shop and cook, music sessions, visual arts, life skills, men’s self-care, community access, mindfulness walk and cognitive games. Patients said that there were plenty of activities available, they enjoyed the gym, swimming and going off the ward.

Patients had access to psychology input either in groups or 1-1 sessions. Psychology groups were based around psycho education, eye movement desensitisation and reprocessing (EMDR), dialectical behavioural therapy (DBT) and counselling sessions, providing patients support with emotional management and coping strategies.

We scored the service as 3. The evidence showed a good standard. 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.

Staff supported patients to maintain contact with their families and carers. All patients we spoke to told us they were supported to maintain contact with the people who were important to them. Staff told us they were able to support visits from children in an area away from the ward environment.

Staff supported patients to maintain contact with people in their local area. Staff ensured family members and care co-ordinators were invited to multidisciplinary team meetings. The service facilitated attendance by video link, if people were unable to attend the hospital in person.

Staff provided access to spiritual support with visiting Christian and Muslim religious leaders, and access to spiritual support for other faiths was available when required.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made sure patients could access information on treatment and local services. Staff explained that information was provided for patients if it was needed. Staff displayed information about safeguarding, infection control, the Mental Health Act and the independent mental health advocacy service.

Staff had access to equipment and information technology needed to do their work, the nurse’s station had enough room and access to computers for staff to be able to sit and do their work.

Leaders had access to information to support them with their management role. This included information on the performance of the service, staffing and patient’s care. This information was presented and discussed in clinical governance meetings.

Staff made notifications to external bodies as needed. The service submitted notifications to the Care Quality Commission in accordance with requirements. The service submitted safeguarding referrals to the local authority.

We scored the service as 3. The evidence showed a good standard. 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.

During the last year there had been no complaints for Tiptree ward. Patients, relatives and carers knew how to complain or raise concerns. Patients said if they had any complaints, they would speak to staff or the ward manager in the first instance. There was information on the wards about how to make a complaint and how to access advocacy. Patients told us they knew how to access an independent advocate.

Staff understood the policy on complaints and knew how to handle them.

Patients and staff participated in regular community meetings on the wards. Community meetings had a good uptake from patients, and a range of staff attended. Feedback on items discussed during previous meetings were given, and MDT members gave advice on staying safe online, purchasing nutritional supplements online and consumption of energy drinks. Once a month after the community meeting patients and staff would have a meal together and there would be an awards presentation, awards were given to patients for things such as chairing the community meetings, facing fears and stepping beyond comfort zones.

The service had a monthly service user forum for patients to attend; this was attended by the senior leadership team.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

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

The service had clear criteria for accepting patients on to the wards and did not accept anyone whose physical health needs could not be met. Where possible the service provided step-free access, widened doors, adapted bathrooms, adjustable furniture, grab rails and handrails.

Staff planned patients discharge from the wards and had effective liaison with care co-ordinators. Staff supported patients during transfers between services. There had been no delayed discharges in the last 12 months. Staff ensured patients had access to post-discharge care, including section 117 aftercare, community mental health services and crisis services.

We scored the service as 3. The evidence showed a good standard. 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 promoted a culture in which patients using the service felt empowered to give their views.

The service admitted patients from diverse religious and cultural backgrounds. Staff asked patients about their religious and cultural needs when they were admitted to the ward. The service provided culturally appropriate food. The service employed staff from diverse backgrounds. This meant the service was able to utilise the ability of staff to speak to patients in their first language whenever this was possible.

Staff shared adjustments that had been made to accommodate patients with diverse needs. Information was also made available in various formats and languages upon request to ensure accessibility.

The service had an equity, diversity and inclusion policy in place to guide staff in ensuring that patients were treated fairly. All staff completed training in equality, diversity and inclusion. Staff compliance with this training was 100%.

We scored the service as 3. The evidence showed a good standard. 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.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of patients with complex needs. The multi-disciplinary teams within the service were made up of consultant psychiatrists, specialty doctors, nurses, healthcare support workers, psychologists, occupational therapists and other support staff.

The multidisciplinary team planned for each patient’s discharge and return to their local area. Staff ensured that appropriate arrangements were in place to sustain the patient’s mental health. This included liaising with other professionals in the patient’s local area to ensure they had appropriate accommodation to be discharged to and that a package of care was provided by the local mental health services.