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 as good. At this assessment, the rating has remained the same. Staff completed a comprehensive mental health assessment on admission or soon after. Staff delivered care and treatment in line with national guidance, and it was regularly monitored and reviewed with input from patients and those close to them.

The provider told us they were working with other organisations such as the NHS England's HOPE(S) team. The HOPE(S) model is an NHS programme aimed to reduce the use of LTS and restrictive practices such as restraint and seclusion in children and young patients, autistic patients and/or patients with learning disabilities in inpatient hospital settings across England. Staff told us the HOPE(S) team had provided support and training to staff around working with autistic patients and patients with learning disabilities.

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.

Staff had completed a comprehensive mental health assessment on admission or soon after in all 27 care records we looked at across all wards. We reviewed patients’ physical and mental health records and found that they were generally comprehensive, holistic, recovery orientated and updated on a regular basis on all but one occasion.

Staff assessed the physical health needs in a timely manner after admission, and thereafter on a regular basis. Staff told us that the doctors undertook vital signs checks for patients weekly. There was a visiting GP who patients could see where they had additional health needs. Patients said they were able to see the ward doctors when they wanted to for any physical health condition.

While staff developed care plans on most occasion following an assessment, care plans were not always personalised. For example, some patients reported they did not feel their care plans were relevant to them. One patient who was diabetic did not have a care plan to manage their diabetes. Staff recorded in the patients notes that the patient was concerned that their condition was not being managed well, but no action had been taken. Staff did not make appropriate referrals to a diabetic specialist or their GP.

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 receiving care. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence. These included medication and psychological therapies.

While there were a range of activities for patients such as art therapy and gardening, more than 50% of patients we spoke with said the activities were not relevant to them. However, we saw that some patients were being supported with their Maths and English.

The provider informed us that they were in the process of reintroducing opportunities for work and education

Staff told us that patients had good access to physical healthcare, including access to specialists when needed such as speech and language therapists and dietitians. However, staff did not appropriately refer a person with diabetes to the diabetes team.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. Some of the initiatives included improving communication and building therapeutic relationships between patients and staff as a mode to reduce incidents.

The team included or had access to the full range of specialists required to meet the needs of patients in the service including doctors and nurses, occupational therapists, clinical psychologists, social workers, pharmacists, speech and language therapists, dieticians and peer support workers.

Managers provided new staff with appropriate induction. However, staff reported that some of agency staff were not always very skilled and experienced enough to manage certain situations.

Managers provided staff with supervision which included meetings to discuss patients’ care, to reflect on and learn from practice, and for personal support and professional development, and appraisal of their work performance.

The wards held monthly staff meetings which had a clear agenda and were recorded. However, staff were not always able to attend team meetings because of either timing of the meetings or due to the acuity of the wards. Managers told us they always shared minutes from team meetings with all staff.

Staff had regular supervision and appraisal. Over 80% of staff had received clinical, managerial and safeguarding supervision across the hospital in between December 2024 and February 2025. In addition, over 90% of staff had an appraisal of their work performance in the last year.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Managers ensured that staff received the necessary training for their roles including dysphagia and communication training. Managers dealt with poor staff performance promptly and effectively.

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 weekly multidisciplinary meetings across all wards. The multidisciplinary teams consisted of doctors, nurses, occupational therapists, psychologists and healthcare assistants.

The teams had twice daily shift to shift handovers where they shared important information including any leave status, treatment plans as well as risks and management plans. Staff told us it was compulsory to attend handover meetings and that the meetings were recorded so that staff could refer to them.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation and externally such as Ministry of Justice, police, local authority, care co-ordinators, community mental health teams, and the crisis teams. The provider worked closely with the provider collaborative to ensure that patients were safely discharged to their localities.

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 told us they supported patients to live healthier lives, for example, through participation in smoking cessation schemes. Staff offered patients nicotine patches and vapes as alternatives to smoking.

While patients reported that there were not always enough ward activities, they spoke very highly of the gym. They said they were able to utilise the gym to do their physical exercises to stay healthy. Staff encouraged patients to engage in the weekly walking groups.

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 such as the Health of the Nation Outcome Scales (HoNOS)to assess and record severity and outcomes. The service also used other outcomes measures such as Recovery Star, My Shared Pathway, multidisciplinary care plans and Model of Human Occupation Screening Tool (MOHOST) to monitor and evaluate patients’s progress.

Staff used technology to support patients effectively. The provider had an online care record system which meant they could make prompt referrals to other specialists and professionals. Staff had prompt access to blood test results and where risk assessed, patients could access online self-help tools.

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

Staff were trained in the Mental Capacity Act and staff we spoke with were able to explain the principles underlying the Act.

The provider completed a monthly consent to treatment audit. All care records we reviewed showed that consent to treatment was clearly documented. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. Staff involved family members where appropriate and care coordinators as well as other key stakeholders in best interest meetings.