Kemple View

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

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.

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to good.

Good: 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 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 people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

• During our assessment we reviewed 11 care records. Staff completed a comprehensive mental health assessment of the patient in a timely manner at, or soon after, admission.
• Staff assessed patients’ physical health needs in a timely manner after admission and this was incorporated into their care plans.
• Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and recovery-oriented and focused on 4 key areas: keeping well; keeping connected; keeping healthy and keeping safe.
• Staff updated care plans when necessary.

We plan and deliver people’s 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 patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). These included medication and psychological therapies, activities, training and work opportunities intended to help patients acquire daily living skills. The site had a range of opportunities for patients including an allotment for gardening activities, a gym and a sports hall, an art room and a music room where staff supported patients to learn to play an instrument. Patients could access real work opportunities which they were paid for, for example in the shop and the mindfulness café. Education opportunities were also available on site.
• Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. There was a practice nurse and health care assistant on site to support patients with their physical healthcare needs and patients had access to a GP who came to the site once a week. Staff made referrals to other healthcare professionals such as physiotherapists and speech and language therapy when needed.
• Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration. There was a flow chart in place to monitor patients who had poor diet or fluid intake and these concerns were monitored and reviewed by the multi-disciplinary team. Staff considered patient’s capacity when they refused diet and fluids.
• Staff participated in clinical audit, benchmarking and quality improvement initiatives.
• Staff were qualified, experienced and had the right skills and knowledge to meet the needs of the patient group. The team included the full range of specialists required to meet the needs of patients in the service. The service had a team of clinical psychiatrists who worked across the hospital and were led by the medical director. The service also had a therapy team including psychologists, occupational therapists, a social work team, recovery workers and an education worker.
• Managers provided new staff with a full induction which reflected the needs of the service and staff received appropriate ongoing support during their induction period. However, staff did not receive a structured and recorded ward induction when they worked on a new ward.
• Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance. Staff received monthly clinical supervision and quarterly management supervision. The percentage of staff that received regular supervision was 97% for clinical supervision and 98% for managerial supervision and the percentage of staff that had had an appraisal in the last 12 months was 100%. Staff also had the opportunity to participate in reflective practice.
• Managers ensured that staff had access to regular team meetings.
• Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. For example, the service had a nurse training scheme which provided health care assistants with the opportunity to gain their nursing qualification.
• Managers ensured that staff received the necessary specialist training for their roles, for example staff had been supported to do compassionate boundary training, level 4 leadership training and NVQ3 training.
• Managers dealt with poor staff performance promptly and effectively.

We do not always work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

• Staff held multidisciplinary meetings for each patient once a month. Some patients felt this was not regularly enough and told us it could delay issues like concerns with medication being formally discussed. However, doctors told us they would see patients in between multi-disciplinary team meetings if required.
• Staff shared information about patients at effective handover meetings within the team. Handovers were mainly thorough and considered each patient’s support needs, however the night handovers were not always fully completed and did not always record information such as staff on duty or issues that may impact staffing.
• The teams had effective working relationships, including good handovers, with other relevant teams within the organisation, for example, care co-ordinators and community mental health teams. There were effective mechanisms in place for maintaining contact with commissioners.
• The teams had effective working relationships with teams outside the organisation including commissioners, social services and GPs and other health professionals.

We support people 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 a men’s health group, groups discussing substance misuse and healthy eating advice. Staff provided smoking cessation support to patients. The wards were smoke free, although vaping was permitted in certain areas such as bedrooms. Some patients were vaping excessively and this was affecting their engagement in activities and interactions with staff and peers. Staff encouraged patients to manage their use of vapes and join in other activities.
• Ward activities helped promote a healthy lifestyle for patients, for example sports activities including badminton and football, regular gym sessions and cooking healthy meals.

We routinely monitor people’s 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 people themselves.

• Staff used a range of recognised rating scales to assess and record severity and outcomes for example, Health of the Nation Outcome Scales secure for monitoring a patients progress and care in a secure setting, DIALOG which is a self reporting measure of quality of life and satisfaction with treatment and GAD-7 for measuring anxiety. The service had produced a leaflet explaining to patients what each of the outcome measures were for and giving patients a choice about whether they completed them.

We tell people 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.
• They did this on a decision-specific basis with regard to significant decisions. For example, we saw capacity assessments regarding decisions about whether patients had the capacity to decide whether to take a particular medicine. The patient’s views and wishes were considered during this process.
• When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history