Fir Trees Independent Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Staff managed beds well. A bed was available when a patient needed one. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy, and dignity. Staff supported patients with activities outside the service, such as work, education, and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy, and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

We have not awarded this service a score for Responsive.

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

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff empowered patients to make their own decisions about their care and treatment. They provided 1-1 meetings with their named nurse and recorded this. Patients had access to community meetings where they individually and collectively made suggestions regarding food, activities and concerns. Staff empowered patients to make their own decisions about their care and treatment and involved them in their multidisciplinary meetings if the patients wanted to attend and participate.

They had various groups that were tailored to individual needs, these included access to a gym, swimming, boxing, gardening and occupational therapy assessments and interventions in the local community. They had recently developed links with voluntary groups so that patients could access therapeutic employment when the patient had identified this as a need.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

When appropriate, staff ensured that patients had access to education and work opportunities.

Staff supported patients to maintain contact with their families and carers.

Staff supported patients to access their chosen place of worship within the community if this was what the patient wanted.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as required, including local authority safeguarding and to commissioners. CQC received appropriate notifications where necessary from the service. Staff ensured carers, families and commissioners were regularly updated about patient progress.

Information governance systems included confidentiality of patient records. The service complied with the Accessible Information Standard.

Staff ensured that patients could obtain information, for example on treatments, local services, patients’ rights and how to complain. This information was available throughout the hospital on notice boards. Patients had access to a patient information pack describing the unit and this was accessible to all patients.

The information provided was in a form accessible to the patient group in easy-read format. Some of these were also pictorial.

Staff made information leaflets available in languages spoken by patients.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. They involved people in decisions about their care and told them what had changed as a result.

There had been no complaints in the 12 months prior to inspection. Patients told us that if they had any concerns, they would not hesitate to speak with a member of staff. The corporate compliance officer had the responsibility to act as the administrator by ensuring all concerns and complaints were logged and a copy forwarded to the appropriate level of manager.

Patients knew how to complain or raise concerns. Easy read posters were displayed informing patients how to make a complaint. When patients complained or raised concerns, they received feedback. There was a complaints policy in place. Staff protected patients who raised concerns or complaints from discrimination and harassment.

Staff knew how to handle complaints appropriately. Staff received feedback on the outcome of investigation of complaints and acted on the findings.

The service asked patients and carers to complete the NHS friends and family test surveys; however, the results were still being collated at the time of the inspection. Carers and family members were also invited to coffee mornings.

The provider for the service had implemented a co-production action plan with the aim of involving patients in all aspects of their care at their hospital sites. This included the design, delivery, improvement and governance of the service. It clarified roles and responsibilities at every level of the organisation and set out when co-production must be considered and demonstrated. This was a collaborative approach where patients, care givers, and communities worked as equal partners with healthcare professionals.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff attended weekly referrals meetings with clinical teams and had discussions with commissioners regarding appropriate referrals into the hospital

Staff ensured the needs of patients with mobility issues were met through a pre assessment of their individual needs. The unit was located in a single-story building with good access to the whole of the unit.

Staff made reasonable adjustments for patients: for example, people with mobility issues were assessed and with walking aids and shower chairs. Easy read information was available for people who needed this.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

All patients admitted to Fir Trees were referred to a social worker at the earliest opportunity. This ensured that discharge planning began promptly and progressed in a timely and coordinated manner.

Staff ensured patients had access to post-discharge care – for example, Section 117 aftercare, community mental health services and crisis services.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support, and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. This included the friends and family tests, complements and complaints as well as regular 1-1 with their named nurse and community meetings.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Information was available to staff and policies were in place.

Staff were trained in equality, diversity, inclusion and human rights and this was included in the care certificate with 85% compliance.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future. Staff created personalised care plans to account for patient needs, wishes and feelings. They planned for the patient moving on from Fir Trees and involved them at all stages of any transition. Patients we spoke with told us that staff supported them and planned their future needs with them and their choices regarding moving onto their next placement.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of patients with complex needs. They planned and involved the patient and their families in discussions about important life changes. Staff involved patients and carers in their multidisciplinary teams and worked with housing and homeless services to help them find suitable accommodation.

Staff planned for patients’ discharge, including good liaison with care managers and co-ordinators. The service worked closely with other professionals when patients were near the end of their pathway to move individuals on to their discharge. Discharge was sometimes delayed but this was often due to seeking appropriate housing and placements. Over the 12 months prior to inspection, Fir Trees has experienced nine delayed discharges, with the primary issue being the difficulty in securing appropriate accommodation. To address this, the senior nurse practitioner attended a weekly multidisciplinary meeting with the Integrated Care Board (ICB), social care, the homeless team, and the complex care manager. These meetings focused on identifying and overcoming barriers to discharge, while establishing clear plans to support patients in moving on from Fir Trees once they were clinically ready.