St Andrew's Healthcare - Essex

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

This means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question as good. At this assessment the rating has remained as good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition. Staff involved patients in care planning and risk assessment and sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

We have not awarded this service a score for Caring.

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

We scored the service as 3. Staff treated people with kindness, empathy and compassion and respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed they were kind, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. All patients and family members were very positive when talking about staff and the kindness and care they received from staff and the service.

We saw examples of positive feedback received by the service. For example, ‘I would like to say how great I have been treated…the staff do a fantastic job and take the time to sit and talk and genuinely care…they have helped me with my recovery so much…thank you from the bottom of my heart’ and ‘I came to this ward very unwell thinking I would never be well enough to carry on with my life, but thanks to the great staff on this ward, I am well enough to leave today. I believe (the staff) have saved my life and I can be successful’. Patients told us that staff got to know them well and were genuinely invested in their recovery.

Staff developed therapeutic relationships with patients based on trust, compassion, and understanding. They demonstrated a strong awareness of individual needs, preferences, and personal histories and always treated patients with dignity and respect.

Family members, visiting professionals and external stakeholders told us they were always made to feel welcome at the service and were always treated with kindness and respect.

Staff helped patients to keep in touch with their families and facilitated visits and trips to see their friends and loved ones.

We scored the service as 3. The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff within the service had a good understanding of each patient’s mental health, their risk history and their social circumstances outside hospital. Staff, including occupational therapists, supported patients to participate in activities they enjoyed, and patients all had an individualised activity timetable and an individual positive behaviour support (PBS) plan if appropriate.

The service made adjustments for disabled patients – for example by ensuring disabled people’s access to premises and by meeting patients’ specific communication needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain.

Managers ensured that staff and patients had easy access to interpreters and/or signers. We saw an example where staff had used interpreters to support a patient who did not have English as his first language.

Patients had a choice of food to meet individual preferences, dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Patients could choose from several different menu options daily and the in-house chef would adapt menus to meet individual needs.

Patients and staff came from diverse cultural backgrounds. Staff recognised this and provided facilities to meet patients cultural and religious needs. For example, there was a well-equipped multi-faith room available to patients including a wudu basin, (a wudu basin, also known as an ablution basin, is a specialized sink used for the Islamic ritual of wudu a washing process performed before prayers). Chaplains (Christian and Muslim) visited the wards every week, and representatives from other faiths were able to visit on request. Celebrations and religious events took place throughout the year, for example staff and patients had celebrated Remembrance Sunday and Eid, and the annual carol service was well attended by patients and staff.

We scored the service as 3. The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff made sure patients could access information on their rights and how to complain. Up to date information about the Mental Health Act, advocacy, the Care Quality Commission, making complaints and how to request spiritual care was displayed on notice boards on all the wards.

Patients were given information about their rights and were able to feedback to staff their views and wishes during 1-1 meetings with their key nurse, during ward rounds and discharge planning meetings.

Staff held a weekly community meeting where patients could express their views on the service and make suggestions for improvements to the ward. Staff displayed the outcome of these meetings on ‘you said, we did’ notice boards on the wards. We attended a community meeting during the inspection and looked at recent meeting notes and could see that meetings were inclusive and well attended by patients and staff, including members of the leadership team. Patients were encouraged to give their feedback and ideas and suggestions for ward improvements. People also showed appreciation for each other, as well as discussed complaints, frustrations and interpersonal issues.

Patients could make phone calls in private. Staff did not restrict patients’ access to their mobile telephones unless there was a clinical reason to do so. When patients did not have access to their own telephone, staff arranged access to telephones that could be used in a private space.

On Frinton and Benfleet wards, patients could make their own hot and cold drinks and snacks and were not dependent on staff. On Audley Ward, staff assisted patients promptly if they wanted a drink or a snack.

We scored the service as 3. The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff introduced patients to the ward and the services as part of their admission. Patients were given a welcome pack on arrival.

Staff responded promptly and effectively to changes in patients need, concern, or distress. Staff knew patients well so could identify changes in patient presentation or environmental dynamics and acted quickly to mitigate risk and safeguard wellbeing.

Patients felt confident approaching staff with issues or concerns, knowing they would be listened to and supported. Staff knew patients well enough to utilise de-escalation techniques specific to each patient when patients’ behaviours became heightened.

Patients on the ward had access to call bells when they needed immediate assistance.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. Staff received de-escalation training as part of their safety intervention training and staff we spoke with told us that they would always attempt to verbally de-escalate an incident before resorting to physical restraint.

Staff were aware of and dealt with any specific risk issues, such as risk of seizures or falls and care planned for these accordingly.

We scored the service as 3. The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt respected and valued. All staff told us the hospital director and other senior staff were approachable, supportive and engaged with staff on the wards.

St Andrew’s Healthcare provided a comprehensive employee assistance programme (EAP) and wellbeing support, including the HELP employee assistance service and a dedicated trauma response service. The EAP offered 24/7 confidential advice for personal or professional issues and various financial wellbeing tools. The service also offered a range of wellbeing support for staff, including a men’s health and wellbeing support group, a menopause support group, staff gym sessions and line dancing.

The provider’s staff sickness and absence rates were 7.1% for short-term sickness at the time of inspection. The turnover rate was 5.9%.

The provider recognised staff success within the service. The service had a staff recognition scheme, the CARE awards, where staff could nominate an employee who went above and beyond to demonstrate the provider’s values. The judging panel decided 1 winner and 4 runners up per category, who were invited to a quarterly awards ceremony receiving a certificate and prize from the hospital director.

Staff and patients regularly took part in celebrations to celebrate special days and cultural events, for example Christmas, EID and Diwali.

Staff and patients took part in the Care Premiership Program which was a strategic initiative aimed at empowering staff to deliver high-quality patient care, develop leadership skills, and foster a culture of continuous improvement. Staff could win points, for example, by winning CARE awards or meeting key performance indicators such as supervision rates and observations reports. Patients could gain points by taking part in activities, voluntary work or by winning ward challenges, for example fancy dress running races. Wards had their own team names, for example, ‘tigers’ and ‘elephants’ and the competitions were also a way for staff and patients to have fun together and boost morale and wellbeing for everyone.

Staff felt positive and proud about working for the provider and their team. Staff had good morale and staff enjoyed working at the hospital and they received good support from colleagues and managers.