Thornford Park

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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

This means we looked for evidence that patients care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good

Good: This meant patients outcomes were consistently good, and patients feedback confirmed this.

We have not awarded this service a score for Effective.

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

We maximise the effectiveness of patients care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We looked at 8 care records during the assessment.

Staff completed a comprehensive mental health assessment of patients in a timely manner at, or soon after, admission. Staff assessed patients physical health needs in a timely manner after admission. However, some patients declined physical health checks and staff used non invasive physical observation skills to observe signs of health.

Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and recovery oriented. For example, we saw staff using a trauma informed approach when dealing with a person with complex needs.

Staff updated care plans when necessary including after any incidents or changes in risk assessments.

We plan and deliver patients' care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the patients. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). There was a multi-disciplinary approach to care with a team consisting of psychiatry, nursing, occupational therapy, psychology and social work colleagues.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. For example, we saw evidence of speech and language therapy (SALT) assessments completed for patients with swallowing difficulties.

Staff assessed and met patients' needs for food and drink and for specialist nutrition and hydration.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. For example, the team on Crookham had a QI project to reduce time patients spend in seclusion by havingregular hourly reviews.

Managers provided staff with supervision meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development.

Managers ensured that staff had access to regular team meetings.

The percentage of staff across the hospital that had had an appraisal in the last 12 months was 90%

The percentage of staff that received regular supervision across the hospital was 91% clinical, 88% safeguarding and 87% managerial. Managers dealt with poor staff performance promptly and effectively by regular supervision

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. For example, HCAs had trained in phlebotomy and performing electrocardiograms. HCAs also held specific roles such as anti barricade training.

We work effectively across teams and services to support patients, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

Staff held regular and effective multidisciplinary meetings. We observed a multidisciplinary team (MDT) meeting on Curridge ward which was attended by a range of professionals including members of the person’s community mental health team (CMHT).

Staff shared information about patients at handover meetings between shifts. Handover sheets were easily accessible to staff and included the key information they needed to provide care to the patients. We saw completed examples of these sheets with a pen profile for each person.

The teams had effective working relationships with both internal and external teams. For example, we saw evidence of joint working with NHS care coordinators, CMHT and local authority social services. This included attendance at MDT meetings.

We support patients to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

Staff supported patients to live healthier lives for example, through participation in physical activities such as the gym and smoking cessation. Nicotine replacement therapy could be prescribed on the wards. Ward activities helped promote a healthy lifestyle for patients, for example sports activities and a range of healthy food options at mealtimes.

We routinely monitor patients' care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of patients themselves.

Staff used recognised rating scales to assess and record severity and outcome

Staff used technology to support patients effectively. For example updating MHA records with tribunal and review dates.

We tell patients about their rights around consent and respect these when we deliver person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. We saw completed examples of MCA assessments with regards to consenting to medication. Second opinions from specialist doctors (SOADs) were sought appropriately as needed.