Ellern Mede Ridgeway

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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 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.

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.

The service made sure patients’ care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 8 care and treatment records. Staff completed comprehensive mental and physical health assessments on admission.

Staff developed care plans that met the needs identified during assessment. Care plans were personalised and holistic, written in the first person, and included young people’s preferences. Staff updated care plans regularly. Young people’s communication needs and preferences were reflected in their care plans.

Staff involved patients and carers in care planning. Most young people told us about being involved in their care planning and said they had access to their care plan. Carers we spoke with thought their relatives’ individual needs were met well. Most carers said they were involved in their relative’s care and treatment and received regular detailed updates. In the multidisciplinary ward rounds we observed, staff discussed and addressed patient and carer feedback in detail. However, one young person was not sure who to ask for their care plan, and another said they had not been offered a copy. Another young person said they could give their views, but they were not always listened to.

We saw evidence that young people’s physical health was regularly monitored. This included young people’s feedback on their physical wellbeing, sleep, daily food and fluid charts, monitoring of nutrition and hydration status, medication reviews and when indicated, electrocardiograms (ECG).

The service planned and delivered patients’ 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 delivered a range of care and treatment interventions which were recommended by guidance from the National Institute for Health and Care Excellence (NICE). These included medication, dietetics, psychological therapies and family therapy. The care and treatment records demonstrated that treatment was provided in line with current guidance. Staff offered CBT (cognitive behavioural therapy), CBT-E (enhanced cognitive behavioural therapy), DBT (dialectical behavioural therapy), schema therapy and art psychotherapy. The service offered neuropsychological assessments and diagnostic tests, for example to support diagnosing autism, ADHD (attention deficit hyperactivity disorder), PTSD (post-traumatic stress disorder) and OCD (obsessive-compulsive disorder).

The multidisciplinary team (MDT) included, or had access to, the full range of specialists required to meet the needs of patients. As well as doctors and nurses, these were dietitians, psychologists, psychotherapists, occupational therapists, social workers, activity coordinators, speech and language therapists, pharmacists, experts by experience and autism champions. The MDT worked with the provider’s autism lead to adapt interventions for the needs of autistic young people. The service worked closely with a Behavioural Support Clinician from the local provider collaborative.

Staff participated in clinical audit, benchmarking and quality improvement (QI) initiatives. The audit schedule was comprehensive and covered care planning, medicines, nasogastric feeding, supplements, dietetics, weight monitoring and outcome measures. The service was a member of QNIC, Royal College of Psychiatrists’ Quality Network for Inpatient CAMHS, which focuses on benchmarking and quality improvement in services. Staff participated in the network’s meetings and acted as peer reviewers. Staff received training in QI. Recent projects included reducing one-to-one observations, and a new QI project was planned on reducing nasogastric feeding.

Staff had access to regular team meetings, reflective practice, debriefs, continued professional development (CPD) and specialist training. For example, the psychology team offered training and upskilling to staff in areas including trauma-informed care, autism and support with self-harm. Competency assessments for clinical staff were undertaken and signed off annually. Staff we spoke with felt they had been able to contribute their specialist skills within their roles.

The service did not always work well across teams and services to support patients. They did not always share their assessment of patients’ needs when they moved between different services.

Staff we spoke with described working well together within the multidisciplinary team (MDT), including nursing, psychology, dietitians and family therapists. The MDT meetings we observed were well-attended by the professionals and conducted collaboratively.

However, at the same time staff reported that MDT meetings could be too long and without clear timings, which could result in carers being left waiting to join. Staff also said that highly personalised nature of care sometimes resulted in inconsistent practice. Care plans were not always communicated well across teams or carried over effectively between shifts. This was echoed by feedback from some carers and young people, who shared examples of inconsistencies in food exposure, meal support or completing observations. For example, one young person on Nunn Ward told us that although staff had discussed what support they found helpful at mealtimes, some staff did not review or follow this information. This created a risk to continuity of care and rapport between patients and staff.

Staff shared key information about patients at handover meetings. However, one carer thought that communication in handovers from weekend to weekday staff could be improved.

The teams worked well with other teams within the provider group and externally. Key system partners included NHS commissioners, local authorities, GPs, schools and community mental health teams. Stakeholders we spoke with reported good working relationships and effective communication with the service.

The service supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

There was a range of activities on offer to help promote a healthy lifestyle for young people. These included yoga, pilates, swimming, mindfulness, walks and cooking activities. Young people could choose to spend time in the garden or go for walks. Animal, art and music therapy was available to promote mental wellbeing.

Dietitians supported young people and staff with dietetic assessments, meal support and healthy eating advice. Fresh food was prepared daily. Healthy eating was promoted both on the ward and at home. Carers were involved in this process through family therapy sessions. When young people went on home leave, staff encouraged them to develop and practise good eating habits within the home environment.

The service routinely monitored patients’ 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 patients themselves.

We reviewed 8 care and treatment records. In 5 of those, we saw evidence that staff had used recognised scales and outcome measures such as the Children's Global Assessment Scale (CGAS), Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), and height and weight monitoring. However, in one record on Nunn Ward, no updated outcome measures were recorded after 2 February 2026.

Psychology staff we spoke with shared examples of other outcome measures used within the service, which were tailored to different age groups. These included the self-report Likert scale, ARFID (avoidant restrictive food intake disorder) screening tool, Revised Child Anxiety and Depression Scale (RCADS), AQ-10 (autism screening tool) and others. The provider routinely collected and analysed outcome data across the hospital group.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff followed the provider’s policies on consent to treatment and 98% had completed the mandatory training in Mental Capacity Act 2005.

In the care records we reviewed, there was clear evidence that staff had obtained and documented consent appropriately. This included patient and carer consent where relevant. For example, for one young person this section detailed their consent to share information with their GP, community team, school and hospital. Most carers we spoke with said staff had explained consent, confidentiality and information sharing clearly.

Staff considered Gillick competence for young people under 16 years of age or mental capacity for those aged over 16 years. We saw evidence that staff had assessed capacity on a decision-specific basis and documented the outcome appropriately.