Bere Clinic

On this page

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

At our last assessment we rated caring as good. At this assessment the rating has remained good. Staff treated young people with compassion and kindness. They respected young people’ privacy and dignity. They understood the individual needs of young people and supported young people to understand and manage their care, treatment or condition. Staff involved young people in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

The quality of therapeutic relationships was a strength of Bere Clinic. We observed many interactions where staff engaged with young people warmly and respectfully. Staff used preferred names, knocked before entering bedrooms and maintained privacy during personal care and clinical procedures.

Young people described staff as kind, approachable and genuinely interested in them as people. Several made positive comments about specific staff members, describing them as caring, non-judgmental and easy to talk to.

We observed mealtimes, which are particularly anxious moments for young people with eating disorders. Staff gave calm, consistent support without coercion. The quality of staff behaviour showed a team that understood the emotional experience of eating for this patient group.

Young people felt confident that personal information was handled sensitively. Staff understood their confidentiality obligations and could explain when and why information might need to be shared.

The Forest and Beach bedrooms were very warm during our inspection. This affected the comfort and dignity of young people in those rooms. This is addressed fully in the Safe section. Air conditioning units had been added following the inspection.

Three young people said they could not access their bedrooms or en-suite toilet facilities freely during the day, until after 9pm. They said this had not been explained to them and felt undignified. However when we asked staff if young people were able to access their rooms to use the toilet we were told they were, but would need staff to open the door for them. There were also communal toilets available around the service for the young people to access during this time.

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

The service made genuine efforts to know and respond to each young person as an individual. On admission, staff gathered information about interests, hobbies, routines, communication style and cultural or religious needs. This shaped the therapeutic programme and how individual staff members engaged with each patient.

Young people said they felt known as individuals. Several described staff remembering things they had shared about their interests or concerns. They found this meaningful. It contributed to their sense of feeling listened to and respected.

Cultural and religious dietary requirements were accommodated in the nutrition programme. The dietetic team worked with young people and families to adapt meal plans. No young person was asked to compromise their cultural or religious dietary practice.

Communication needs were assessed and met. Where a young person had a learning difficulty, communication difference or English as an additional language, information was adapted accordingly. Interpreting services were used and documented in records.

The quality of day-to-day care was of a higher standard than the care plan documentation reflected. Four of six care plans were generic and did not capture the individual’s voice or preferences in writing.

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

The service supported young people to maintain independence and exercise choice and control within the boundaries of clinical safety. Staff understood the clinical tensions in eating disorder treatment and navigated them thoughtfully. This was explained clearly to young people and their families.

Young people were actively involved in setting goals. Goal-setting conversations were described as collaborative and genuine. Several young people said their priorities had been discussed. However, these were not always documented fully in care plans.

The ward ran a graduated leave programme. Leave was planned with the young person and their family. There were clear criteria for progression and a structured risk assessment for each leave episode. Young people said leave was meaningful. Young people and families understood it as a clinical framework, not a punishment.

Choice was offered wherever it was clinically safe to do so. Young people chose how to spend free time and had some choice over their environment. Where restrictions were in place for clinical or safety reasons, these were explained and documented with a rationale and review date.

Young people detained under the Mental Health Act were supported to access an advocate. Those eligible for IMHA were told about this right and helped to use it. Advocacy had been accessed and was viewed positively by young people and families.

We scored the service as 3. The evidence showed a good standard. The service 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 were observant and proactive. They noticed changes in a young person’s presentation and acted without being asked. Young people said staff spotted when they were struggling before they could put it into words.

When a young person became distressed, staff offered a relational, de-escalating response. They sat with the young person, listened and offered reassurance. The investment in TMVA, de-escalation training and reflective practice, was evident in the staff responses we observed. Young people said they mostly felt supported during difficult moments and did not feel alone.

Physical needs were dealt with promptly. The escalation process for physical health concerns was clear. Observations were done at the required frequency and reviewed by the clinical team in good time. On-call medical cover was available quickly when needed.

The service supported young people to stay in touch with family and friends, in line with clinical and therapeutic goals. Contact was through daily phone calls, video calls and planned visits. Where contact was temporarily restricted, this was explained to the young person and reviewed regularly.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

The service took the wellbeing of its workforce seriously. Leaders understood that working with young people with eating disorders is emotionally demanding. They put structures in place to support the team.

Supervision was regular, documented and described by staff as genuinely useful. Registered nurses had monthly one-to-one supervision. All staff had access to reflective practice groups to process the emotional impact of their work.

Staff said they felt well supported by their managers. The service manager was visible, approachable and interested in the wellbeing of the team. Staff felt able to raise concerns or ask for support without fear of judgment. The freedom to speak up culture extended to personal wellbeing, not just clinical and safety issues.

Sickness absence was low compared with similar NHS inpatient settings. Staff said this was partly due to the supportive culture and the availability of supervision and reflective practice. Longer-serving staff expressed strong loyalty and commitment to the service.

Staff felt enabled in their roles. Junior staff were encouraged to develop professionally. Senior colleagues actively supported their learning and progression. Healthcare support workers spoke positively about the competency pathway and the respect they received from the wider team.