Archived: The Chimneys Clinic

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

The service made sure people were at the centre of their care and treatment. They listened to the patient and their views and wishes were included in care planning. They kept families and carers informed of patients’ progress, when appropriate to do so. They made it easy for people to share feedback and tailored the care to meet the needs of the individual.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

We reviewed 6 care records and saw evidence of patient involvement in their care planning. Care plans reflected patients’ physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act.

We saw good Positive Behaviour Support (PBS) plans in place, which were tailored to the individual. We saw an example of a recent focus group where patients were asked to be involved in drafting their own daily and weekly timetables with an aim of improving self-care routines.

Staff listened to patients when they expressed their views and responded appropriately. Patients we spoke with told us they felt involved in their care and treatment, were well informed and had copies of their care plans.

Staff told us they put the patient at the centre of their treatment. Staff tailored therapies to meet the needs of the individuals. They worked together with the patient to understand the person for who they are.

We saw examples of a range of initiatives and co-production projects, which were patient lead. These included, searching of patients, reducing restrictive practices, gender and the transition between children’s and adult mental health services.

Staff involved family and carers in planning and making shared decisions about care, so it was centred around the individual with their consent to do so.

The service understood the diverse health and care needs of people. Care was flexible and supported choice and continuity.

The service worked with other health and social care providers to ensure that patients’ needs were met and that they received joined up care.

Staff ensured that patients could access activities in the community. For example, day trips, visits to the cinema and theatre, trips to the park and sports activities.

Staff supported patients to maintain contact with their families and carers. Carers told us they were in regular contact with their loved ones and could visit them at the hospital. The service held a monthly parent forum. We reviewed notes from the 2 previous monthly parent forum meetings. Staff shared information and updates on the service, carers were given the opportunity to raise questions, and time was offered for carers to discuss any issues between each other. Staff accompanied patients on home leave, if they had been risk assessed as needing continuous observation.

The service provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The information provided was in a form accessible to the particular patient group.

The service provided interpreters if needed and written information could be translated.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, and how to complain. Patients told us they knew how to complain, if they needed to. How to raise an issue and how to make a complaint were explained in patient welcome packs.

Information governance systems included confidentiality of patient records.

Staff ensured carers and families and were regularly updated about the patient’s progress, if the patient had given consent for their information to be shared.

Care plans were written in a way that was easy to understand. We saw examples of PBS plans written in large fonts and patient surveys that were made available in easy read format.

Staff made notifications to, and shared information with external bodies as needed. We saw the service recorded their safeguarding referrals and outcomes.

Staff ensured that patients could obtain information on treatments, local services and patients’ rights on the wards. Information provided was accessible and we saw a wide range of leaflets and posters on noticeboards.

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

Patients and carers knew how to complain or raise concerns, if they needed to. We reviewed the service’s complaints and concerns log for the 6-month period prior to inspection. There had been 4 formal complaints during this time. Staff recorded the actions taken in response to the complaints. We saw evidence that letters of acknowledgement were sent and that the service admitted when things went wrong or apologised, when appropriate.

Staff also recorded informal concerns raised by patients, there had been 9 concerns logged for the 6-month period prior to inspection. We saw that actions had been taken following investigation of all these concerns.

Staff enabled patients to give feedback on the service they received. We reviewed examples of patient community meeting minutes and saw staff asked for feedback and suggestions on the service at every meeting. For example, there was a suggestion to visit a zoo, which was arranged.

The service gave patients the opportunity to give their views on the service via a survey called “my care survey”. Surveys were made available in easy read options. Family, friends and carers also had the opportunity to feedback their experiences via a survey.

The service involved patients in meal planning with a chef attending the community meeting to discuss planned menus and get feedback on food, and a suggestion box where patients could add meals they would like added to menus.

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

Staff ensured the needs of patients with mobility issues were met, for example, wheelchair users had accessible bedrooms and were supported with specialist transport to access the community. We saw in patient community meeting minutes that wheelchair friendly access to Sapphire Garden had been requested, and the service were working towards improving access.

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.

The service actively sought out and listened to information about people who are most likely to experience inequality in experience or outcomes. They tailored the care, support and treatment in response to this. Staff promoted a culture in which the people using the service felt empowered to give their views.

The service welcomed referrals for transgender and non-binary individuals. Staff told us the service promoted diverse gender identities and sexual orientations (LGBTQIA+) through presentations and making sure it was openly talked about and normalised on the wards. We saw examples of how staff had supported a patient with their gender identity. We heard from a carer that the service had been “incredible” in supporting the views and values of their loved one and helping other patients understanding. We saw from parent forum notes that a patient had the opportunity to share a presentation with this group on gender identity.

Staff were trained in equity, diversity, inclusion and human rights. At the time of inspection, the training compliance rate was at 99%.

The service supported people to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff created personalised care plans to account for the patient’s needs, wishes and feelings which supported patients to make decisions about their care and treatment and their future.

The service had a discharge and transfer policy in place, the policy included self-discharge where a person chooses to discharge themselves against clinical advice. Discharge planning started with the patient, on admission. Staff discussed options and explored these with the patient and their family, or carers where appropriate. We saw from care plans that patients had an estimated discharge date recorded in their notes on admission.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.

The average length of stay for patients was between 12 to 18 months. In the 6 months prior to inspection, there was 1 delayed discharge.