Hazelwood House

On this page

• 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

Effective - This means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence. We rated this key question Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. We found the care and treatment provided by the service was effective. It was evidence based, measurable, and monitored for outcomes. Processes and training were in place to support staff to perform their roles and responsibilities effectively. Patients and their families were encouraged and supported to be involved in their care assessments and treatment planning, which promoted a person-centred approach. Staff demonstrated good knowledge of the importance of capacity to consent. Processes and assessments were in place to safeguard patients and their best interests. Patients were supported if they had communication needs and had access to internal and external resources to help capture their voice, which ensured they were heard.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients and, where appropriate, their families participated in their care and treatment planning, and told us they felt involved, listened to, and their needs and preferences were understood and met. Due to diagnosis and presentation, some patients were not always able to be fully involved. On these occasions, staff supported involvement as much as possible and adhered to the appropriate legal frameworks when a patient lacked the capacity to consent and make informed decisions. Where patients were unable to communicate their needs directly, staff supported their families to have input into assessments, care planning, and risk management.

Staff completed comprehensive and timely assessments of a patients’ physical, mental, emotional, and communication needs. The assessments were person-centred, and reviewed regularly with the patient, and their families wherever possible. Staff used clinical tools alongside professional judgment to build a comprehensive understanding of each person's individual needs. When patients lacked capacity to make decisions, staff adhered to legislation, and best practice which ensured decisions were made lawfully and, in the person’s, best interests. The patients' families were supported in their roles, with appropriate information and resources available to them.

We reviewed 7 care records. All records evidenced that staff completed a full mental and physical health assessment either prior to admission or shortly afterwards. Care plans were holistic, person-centred, and focused on meeting the patient’s needs and achieving meaningful outcomes. Care records were reviewed and updated regularly. Communication needs and preferences were clearly recorded, and where necessary, staff adapted their approach using various methods to improve the patient’s understanding and involvement.

The service delivered a wide range of care and treatment interventions, for example, Cognitive behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and Compassion Focused Therapy (CFT). The psychology team formulated and promoted positive behavioural support planning (PBS), completed behavioural assessments, and individualised targeted interventions.

Staff followed National Institute for Health and Care Excellence (NICE) guidance, accessed regular clinical updates and we observed care aligned with current best practice guidance.

Staff facilitated patients' specific dietary requirements providing individualised support. Hydration and nutrition needs were assessed by staff and monitored in line with national guidance and consistently evidenced in patients’ care records.

Staff were encouraged to explore new, research-backed approaches to improve outcomes. Staff took part in clinical audits, benchmarking, and quality improvement projects. For example, a quality improvement project for safer wards. The project was patient led had improved the patients’ perceptions of different areas of safety within the service environment and had received positive feedback from them.

The service also championed Lived Experience Partnership working. The initiative engaged people who had lived experience of services, for example, patients, and their families or carers. There was genuine coproduction with all involved being seen as equal partners with the shared goal of driving improvement for all patients using services, and their families. Outcomes influenced the way services were designed, commissioned, and delivered.

Patients and their families experienced coordinated care across teams and services. The service promoted a multidisciplinary approach, including doctors, nurses, psychologists, occupational therapists (OTs), occupational therapy assistants (OTAs), speech and language therapy (SALT), a dietician, and health care assistants (HCAs). External partners, for example, the Assertive Transitions Service (ATS) team, and community-based Forensic mental health teams (CFMHT) were invited to care and treatment reviews, which ensured continuity and effective joined up care for patients, and their families.

The service had strong collaborative working relationships within their teams, the wider organisation and with external partners. They held regular multidisciplinary team meetings (MDT) where care and treatment plans were formulated, reviewed, and updated. Handovers were effective, and took place before the start of every shift, with comprehensive information shared consistently throughout the teams. Staff reported good communication with external services, for example, the local authority social work team.

Processes ensured care was well coordinated when patients transitioned between services. Discharge planning was robust, considered the individual needs, preferences, and circumstances of the patients. Clinical tasks were delegated effectively, and referrals made, to maintain safe and effective care through accurate, timely information sharing.

The service and its staff empowered and supported patients to manage their health and wellbeing and promoted healthier choices. Patients were supported to retain as much independence as possible. Staff encouraged health-promoting activities, for example, healthy eating advice, physical activity such as, cycling, walking groups, gardening/horticulture, outdoor pursuits, and sessions in the gym. Meals were freshly prepared on site, and healthy options were available, staff encouraged and supported patients to make nutritional choices. One staff member told us “The food is really good quality; the patients tell me they think it’s nice. We advise patients about nutritional content, and portion size.”

The service had positive working relationships with local external partners in care, for example, GP’s, Dentists, and Opticians. Patients were registered with local services upon admission, and according to their needs. A GP visited the service for patients that were unable to attend the surgery.

Health assessments were conducted regularly, and staff referred patients to specialist services, for example, occupational therapy (OT) to meet their individual needs. The service focused on identifying any potential health risks early, ensuring timely interventions, maintained wellbeing and prevented any unnecessary deterioration.

Staff routinely monitored people’s care to achieve consistent and positive outcomes. They used recognised rating scales, such as the Malnutrition Universal Screening Tool (MUST), and physical health screenings to assess severity and track progress. For example, National Early Warning Score 2 (NEWS2). This ensured care aligned with clinical expectations and met individual patient needs.

The service had effective systems in place to maintain consistent, and positive outcomes. Staff actively participated in monitoring and improving care using technology to support this. Regular reviews of care plans ensured they remained current and aligned with people’s changing needs.

External benchmarking schemes and clinical audits supported continuous quality improvement (QI). The service engaged in and promoted continuous quality improvement initiatives and projects (QI), working collaboratively with other services and teams. For example, The regional mental health act administration project. This project initially created 4 regional teams which covered 49 hospital sites, and supported staff, and patients across all sites. This evolved into the central quality & professional leadership team. The project has improved outcomes in community involvement, and communication, Digital and virtual communication, and inclusion, flexibility for effective working to support all hospital sites, effective sharing of knowledge, and practice, care quality, and support, and development with induction training.

The service ensured patients were supported and empowered to make their own decisions about their care, treatment and support were possible. For patients who may have lacked mental capacity, staff assessed and recorded their capacity on a decision-specific basis, emphasising significant decisions to safeguard the patient, and protect their interests. The process adhered to the Mental Capacity Act 2005 (MCA) guidance and supported individuals to make decisions for themselves wherever possible. If patients lacked capacity to make informed decisions, staff followed the appropriate process and involved family members and the relevant professionals in any of the decisions made on their behalf. Staff considered patient’s wishes, feelings, cultural and religious beliefs, social background, and history when making decisions.

For patients detained under the Mental Health Act 1983, staff adhered to the legal requirements, and framework of the Act. Staff respected patient’s rights and ensured they were informed of their rights verbally, and also in writing, this included their right to appeal. For example, staff read patients their Section 132 rights on admission and regularly thereafter or when their Mental Health Act status, Responsible Clinician (RC) or treatment plans changed. Staff consistently recorded the reading of Section 132 rights in patients care records. Consent to treatment regarding medicines, T2 and T3 forms were present, and well organised. We identified no concerns in the records we reviewed.