Ellern Mede Barnet

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

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.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at making 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.

The care and treatment records we reviewed demonstrated that care planning was personalised and there was clear evidence of patient involvement throughout. Plans were written in the first person. Patients told us that staff supported them to understand and manage their own risks better.

There were activities on offer to suit different interests, available in one-to-one or group settings. Patients were positive about the choice of activities, although they would have like more activities at weekends. The activities coordinator was available daily between 11am and 7pm. In addition to ward-based activities, there were trips out of the hospital in the local area, including most recently to a cat café.

Staff empowered patients to make their own decisions about their care and treatment. Activities were designed specifically to meet patients’ needs. For example, the physiotherapist was working with individual patients on desensitisation using virtual reality headsets, and use of a music punch pad to support with managing difficult feelings. An Eye Movement Desensitisation and Reprocessing (EMDR) therapist visited the service to support patients with trauma needs, including the trauma caused by naso-gastric feeding under restraint.

External stakeholders were positive about the person-centred plans put in place for patients. For example, for one patient for whom exposure to sudden loud noise caused significant distress, the team alerted them when the fire alarm test would occur and provided ear defenders.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of patients and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported patients to continue with their education, keep in contact with workplaces, and maintain contact with their families and friends. Many patients were admitted out of area, including several international patients. Their relatives or carers could join ward rounds virtually. Staff also told us about the provider’s charitable fund available to help with carers’ travel costs.

Staff involved other relevant services as appropriate, including the local acute hospital, GPs, community eating disorder services and NHS commissioners.

Stakeholders we spoke with were very positive about how the service facilitated continuity of care. They found pre-admission meetings to be very helpful in joint goal setting between patients, carers, referrers and community teams.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff provided information to patients in accessible formats if required, in line with their communication needs and preferences documented in their care plans.

Staff ensured that people could obtain information, such as treatments, their rights, key contacts, independent advocacy and how to complain. This information was available in booklets tailored for patients and carers and displayed within the hospital.

Patients and carers told us they were satisfied with their level of involvement in care and treatment. Carers were positive about communication from the service and said they received clear and regular updates. Carers were grateful for regular contact from the service with updates, and said staff were prompt in responding to their queries.

Staff kept commissioners and other relevant professionals regularly updated. Stakeholders we spoke with were positive about the way staff communicated and shared information with them and their teams.

We scored the service as 3. The evidence showed a good standard. The service made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. They involved patients in decisions about their care and told them what had changed as a result.

Carers we spoke with knew how to complain, if needed, and believed that changes would be made as a result. They gave examples of changes made following complaints including altering dates of meetings, and improved communication. Carers said there were regular opportunities to give feedback to the service, for example through feedback forms and surveys, and directly by phone.

The provider’s patient inclusion lead and expert by experience were accessible to staff and patients.

Patients could raise queries or concerns at weekly community meetings. However, not all patients attended these meetings. Patients knew how to make a complaint about the service, but some patients told us that they did not feel able to speak up about their care.

Staff involved patients through community and patient co-production meetings, and carers through family governance meetings.

Staff and managers handled complaints appropriately, in line with the provider’s policy. During the previous quarterly reporting period, the hospital received concerns relating to the use of torch lights by staff checking on patients at night, an altercation with staff, medicines administration, and staff use of their personal phones. All of these issues were resolved with patients and carers involvement as appropriate.

Staff discussed feedback and complaints in daily meetings and clinical governance meetings. Learning from complaints was cascaded and workshops were run on the themes identified.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Stakeholders from partner agencies told us the service was swift to respond to new referrals. Two stakeholders shared their positive experiences of referring patients who went on to be successfully treated at the hospital and discharged.

The service was accessible for people with mobility needs. The hospital was equipped with a lift and equipment such as a hoist was available. Staff had practical training in moving and handling patients, with 92% completion in this area.

Staff ensured patients had access to appropriate care post-discharge and planned for this jointly with them, carers and relevant professionals. There was evidence of effective discharge planning in the care and treatment records we reviewed. Due to the level and complexity often involved, lengths of stay at hospital varied. Staff recorded and regularly reviewed provisional discharge dates for each patient.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff completed mandatory training in equality, diversity and inclusion (EDI), with 100% compliance. There was information displayed on the wards to make diverse groups of people welcome and included. Staff and patients celebrated religious festivals together.

Staff we spoke with told us about making personalised adjustments for people with protected characteristics under the Equality Act 2010. All staff had completed LGBTQ+ awareness training and the Oliver McGowan Tier 2 mandatory training on learning disability and autism. Staff told us about supporting transgender and non-binary patients with respect and dignity.

Carers were consistently positive about the dedicated family provision on offer, such as weekly carer groups, and opportunities for peer support.

We scored the service as 3. The evidence showed a good standard. Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff actively involved patients and their families in making decisions about their care. We saw evidence of effective discharge planning in the care records we reviewed. Care planning included patients’ and carers’ views on discharge goals and transition planning. Discussions about discharge plans started at pre-admission meetings.

Staff ensured that all relevant teams and professionals were involved in planning the care and treatment of patients with complex needs including local authorities, GPs, community teams and NHS commissioners. For example, community teams were invited to weekly multidisciplinary meetings to help with planning step-down care.

Staff recorded provisional discharge dates, which they regularly reviewed with the patients, carers and professionals throughout the treatment journey.

Feedback from partner agency stakeholders demonstrated that the service worked well jointly with them in planning complex care and achieved positive outcomes for patients.