Lombard 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

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 good. At this assessment the rating has remained good.

Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Staff from different disciplines worked together as a team to benefit patients. Staff understood their roles and responsibilities under the Mental Health Act and the Mental Health Act Code of Practice and discharged these well.

This meant people’s outcomes were consistently good, and people’s 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 people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

We reviewed 4 care records during the assessment. Staff completed a comprehensive mental health & physical health assessment of the patient in a timely manner at, or soon after, admission. There were easy read and understandable plans for patients. Plans included speech and language assessments, community and communication passports, keeping well, safety and health action plans. Health action plans included routine diabetic monitoring, health appointments such as dentist, occupational therapy kitchen skills and falls risks. Care plans were updated at multidisciplinary meetings.

Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and recovery oriented. Plans were written in the patient voice and patients had been offered a copy. 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.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act and the Mental Health Act Code of Practice and discharged these well.

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. These included medication and psychological therapies and activities, and training and work opportunities intended to help patients gain living skills.

The service used Dialectical Behaviour Therapy (DBT) skills group, during which patients discussed their thoughts and feelings. A patient with a memory impairment was supported by each of the multidisciplinary team (MDT) to plan assessment and treatment options. The service used Tactic cards (visual and prompt-based tools) to facilitate self-discovery, emotional regulation, and communication in therapy. The service used Positive Behaviour Support Plans (PBS).

All patients accessed the community with staff support. Staff used these visits to increase independent living skills such as using public transport, using technology through different ways to pay and interacting with members of the public. Where possible patients carried out volunteering opportunities. For example, farm work and feline care. Staff worked hard to find new opportunities for patients to volunteer and work. Staff used an awards system called the Drake Awards to encourage patients to achieve independent living skills, work, and volunteering.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. Patients had access to local health services including GPs and dentists. Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration. Patients were encouraged to make healthy nutrition choices. In addition to learning disability, physical and general nurses, the service employed occupational therapists, psychologists, a teacher and had access to a locum doctor, dietitian, art therapist, chiropodist, and a speech and language therapist.

Staff participated in clinical audits, benchmarking, and quality improvement initiatives.

Staff were experienced and qualified, with the right skills and knowledge to meet the needs of the patient group.

Managers provided staff with supervision and appraisal of their work performance. The percentage of staff that had had an appraisal in the last 12 months was 100%. The percentage of clinical staff that received regular supervision from July to September 2025 was 98%, and managerial staff 100%.

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. Managers ensured that staff received the necessary specialist training for their roles. The service had an induction policy in place, and all staff were given a 2-week face to face induction when they joined the service. Managers dealt with poor staff performance promptly and effectively.

Mental Health Act

All staff had received training and had a good understanding of the Mental Health Act, the Code of Practice, and the guiding principles. Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew their Mental Health Act champions.

The provider had relevant policies and procedures that reflected the most recent guidance.

Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.

Patients had easy access to information about independent mental health advocacy. Patients had access to an independent advocate and were provided with accessible information in the communal lounge via a pictorial poster.

Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it. Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.

Care plans referred to Section 117 aftercare services to be provided to those who had been subject to section 3 or equivalent Part 3 powers under the Mental Health Act 1983 authorising admission to hospital for treatment.

We 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.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings. Staff worked collaboratively to create risk assessments care and treatment plans. Staff shared information about patients at effective handover meetings within the team at the beginning and end of shifts.

The teams had effective working relationships with other relevant teams. The teams had effective working relationships with GP and health professionals, commissioners, and new providers during transition when patients moved on to new services. They also worked with community organisations and voluntary agencies to enable patients to gain volunteering opportunities.

The hospital worked in partnership with the 2 other nearby hospitals (within the same organisation) and the leaders held regular meetings to discuss learning and good practice.

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.

3. We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff supported patients to live healthier lives. Ward activities helped promote a healthy lifestyle for patients. Patients were encouraged to choose healthy snacks and meals. Fruit was available for patients provided by the hospital. In the lounge there were easy read healthy recipes for patients to use.

Physical health checks included weight and height and there was access to a dietitian to assist with planning a healthy diet.

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.

3. We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record severity and outcomes (for example, Health of the Nation Outcome Scales). Staff used technology to support patients effectively.

Outcome data was regularly recorded and reviewed to support care planning, monitor change, and adjust treatment where needed.

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

3. We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. Patients and carers were fully involved as appropriate, in multidisciplinary team meetings (MDT) and Care Programme Approach meetings (CPA). Patients were regularly read their rights which was recorded in their care plans.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a time and decision-specific basis regarding 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.