The Limes

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

Responsive – This means we looked for evidence that the provider met patient’s needs. At our last assessment we rated this key question Good. At this assessment, the rating has remained Good. This meant patients’ needs were met through effective care planning and delivery.

Staff collaborated well with external partners and patients when planning and delivering care, treatment and ongoing support. Staff completed the appropriate assessments and demonstrated a person-centred approach which ensured they responded quickly and effectively to the needs of patients. Accurate information was readily available and given to patients and their families whenever needed or requested. Training and processes were in place that enabled staff to identify possible bias, discrimination and barriers to treatment and how to act on this to support patients appropriately. Patients’ families were encouraged and supported to be involved in all aspects of their care and treatment.

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.

Patients were at the centre of their care and treatment planning, ensuring plans reflected individual needs, preferences and ambitions. Patients were fully supported and encouraged by staff to write their own daily notes. Patients wrote their own entries about their day, accurately capturing their views, and opinions regarding all aspects of the care and treatment they were receiving, the way they were feeling and their needs, wishes and aspirations. Each document was scanned and uploaded to the patients care records for consideration, reference and discussion, and complimented the clinical note entries made by staff. This enhanced the person-centredness and co-production ethos of the service and fostered a culture where the personal needs and wishes of patients remained a top priority in the delivery of care, and ensured their voices were heard.

Patients achieved a wide range of outcomes during their admission, including vocational achievements, development of social and daily living skills, and participation in walking, sports, and wellbeing programmes. Personal goals included building confidence, progressing in community-based activities, and preparing for future transitions. Patients successfully rejoined their communities, which demonstrated improved independence, resilience, and sustainable recovery.

Care plans were holistic, individualised, and recovery focused. Patients and their families actively contributed to shaping care plans and reviews, and staff ensured patients fully understood their condition, treatment options, and associated risks. Patients, and their families or carers were encouraged and supported to take lead roles within the service, for example, patient and carer representatives who attended governance meetings, and were empowered to be involved in discussions, and decisions about the shaping of the service.

Patients were encouraged, and supported to engage in vocational training, education courses, gymnasium classes, and groups within their local communities, which promoted skill building, confidence, and resilience. Staff enabled patients to make informed decisions about their care, and balanced safety with independence and personal growth. Staff facilitated a patient engagement initiative, where patients were recognised and celebrated for consistent therapy or activity attendance and the progress they had made towards personal rehabilitation and recovery goals. Patients received a gift, and a certificate which was displayed within the service with their consent.

Patients experienced coordinated care which was adapted to meet their individual needs, and personal recovery goals. Staff demonstrated a good understanding of the diverse health and care needs of the patients they supported and strived to deliver care that was joined up and flexible. Collaborative working was effective across the service’s wider teams and with external partners such as the community mental health team, and local housing providers to ensure care, and support was consistent and met patient’s needs and expectations.

Staff completed integrated community rehabilitation reviews (ICR) every 4 weeks. External care providers were involved wherever possible and worked collaboratively with staff to monitor pathway progress, which triggered the discharge preparation process. Goal setting was revisited and support increased prior to discharge. External partners, such as, GP’s and other relevant health care professionals had access to integrated community rehabilitation review outcomes. This ensured ongoing and collaborative care and maintained consistency which promoted and delivered better outcomes for patients leaving the service.

Patients received information in a timely and accessible manner, and all patients admitted to the service received a welcome pack which included information about the service, and what to expect from their treatment and stay. Staff adapted materials to meet individual communication needs, such as leaflets in different languages or the use of interpreters when necessary. Staff also utilised a translation app to meet the immediate needs of the patient whilst waiting for interpreter services. One patient told us “If I want any information, I can ask the staff or the doctor. They all know me well and can tell me the answer when I have questions about anything.” Staff gave examples of when they had provided information in multiple formats, such as, using flash card communication for a patient with a learning disability who was admitted to the service for respite, this demonstrated staff’s commitment to providing person-centred care and treatment.

Information was shared during patients’ community meetings and displayed in communal areas for those unable to attend. The service had patient and carer leads and champions, which ensured staff maintained ongoing communication with carers, families, and external agencies, ensuring patients’ care remained transparent, collaborative, and responsive to their needs.

The provider’s website used an assistive technology toolbar, which allowed users to customise their online experience to meet their individual communication needs. The assistive toolbar enabled visitors to the website to change font size and colour, and to have information translated into different languages, the website also and had a translate text to audio function.

Clear policies and processes ensured staff managed people’s information confidentially and securely by adhering to General Data Protection Regulation (GDPR). Staff actively identified, recorded and reviewed people’s consent to share information preferences regularly and in line with the Accessible Information Standard.

Patients and their relatives felt confident to raise concerns or provide feedback and staff supported them to do so. They knew how to complain, and the service displayed clear information on how to access support, including advocacy and interpreter services and external organisations. For example, the patient advice and liaison service (PALS). One patient told us, “I am able to tell staff what things could be better. They always listen, and very often things change quickly. It’s usually just small things, but you can tell that what you say is important, and your listened too.” Staff consistently applied the complaints process effectively, shared investigation outcomes with the wider team, and ensured lessons learned were embedded in practice to continuously improve patient experience. By involving people in feedback and communicating actions taken, the service built and maintained trust. This ensured patients, their relatives and visitors to the service felt valued, listened to, respected and included.

The service actively supported families and carers with carers assessments and signposted them to external resource and support. Staff held drop-in groups at the service for families and carers, which enabled them to speak with members of the clinical team, request information, and receive reassurances and support. Staff also booked external venues in the local area to hold family and carer meetings and groups if this was requested. Community meetings provided a regular forum for patients to express their views, suggest improvements, and influence ward practices.

Managers, and staff at the service fostered a culture where engagement, involvement and co-production drove and shaped the service. Co-production was very much integrated within the service, and patient’s input was seen as vital in providing high-quality person-centred care and treatment. The service had 2 patient co-production champions, and 2 staff champions, with patients being encouraged and supported to take the lead in service co-production meetings and arranging themed days. A weekly co-production group discussed current projects, and ideas and themes for potential upcoming projects. Patient champions had time through the week speaking with their peers to gain input in readiness for the next group meeting.

Co-production workshops were facilitated and delivered by patients. patients had an on-going project which was called “our voices our experiences” and involved patients creating a presentation by taking part in a short video or a written paragraph summarising their time in mental health services and their experiences. The co-production champions then delivered the presentation to all staff and peers within the service. The presentation raised awareness, promoted involvement and gave all involved a unique insight of an individual’s care and treatment journey through mental health services from their own perspective.

Staff made reasonable adjustments to accommodate individual needs and ensured patients received timely interventions in a way they understood. The premises were accessible, and the environment supported access for all people using or visiting the service. Patients and their families had access to information in multiple formats, therefore, removing any digital barriers, real or perceived.

Staff made reasonable adjustments for all patients using the service. Any needs were identified upon referral, and assessments completed in a timely manner. This ensured that independence and access to the service was maximised.

Medical cover was consistently available day and night. Doctors could attend quickly in emergencies, and the service location allowed timely transfer to the local acute hospital if necessary. This ensured the appropriate ongoing care and support was in place, with the goal being better outcomes for patients who used the service.

Staff captured the views of people who may be at risk of experiencing inequalities or poorer outcomes and used this feedback to enhance person-centred care and support. Patients felt empowered to share their views and were encouraged and supported to do so. The service promoted a culture where people’s voices were heard, their views and opinions respected, and feedback acted on. We found evidence of communication, and hospital passports in the care records we reviewed. Equality data was monitored across protected characteristics, helping staff to identify and address any inequalities in care, treatment, or outcomes. This included attention to communication needs, cultural and spiritual preferences, and the diversity of patient’s backgrounds.

Staff effectively supported patients with equality and human rights and adhered to legislation. Reasonable adjustments were made to meet each person’s social, cultural and religious needs, such as working with independent communication support services. Religious and cultural leaders were welcomed to visit the service to spend time with patients if this was requested or a need identified.

The service was part of the organisations patient and carer race equality framework (PCREF) and was the first hospital in the organisation to implement the framework. The PCREF aimed to improve mental health outcomes for people from racialised and ethnically diverse communities. It created a better understanding of racialised communities across the workforce, co-produced improvement strategies with racialised people and carers and embedded anti-racism practice throughout services. The intention was to create more equitable and inclusive mental health services that worked better for everyone.

All staff completed mandatory equality, diversity and inclusion training, which enabled them to identify, and address any potential inequalities or discrimination. The service had an equality, diversity and inclusion lead, and staff were alert to the risks of unfair treatment and where needed took the necessary actions, to address any disparities in equity in people’s experiences and outcomes. The service, and its staff worked collaboratively with the local police force, with an officer attending regularly to deliver presentations regarding anti-racism, hate crime and radicalisation.

There were effective policies in place which ensured the service adhered to equality, diversity and inclusion principles. Policies aimed to safeguard against disadvantage for vulnerable people or those with protected characteristics and to promote fairness across all aspects of care within the organisation to ensure the service was accessible. This approach ensured care was inclusive, responsive and effectively delivered to meet the individual needs of people most at risk of potentially experiencing poorer outcomes.

Staff supported patients and their families to plan ahead and make important and informed decisions about their future care, treatment and support. Family members were encouraged and supported to take part in discussions and decisions that reflected patient’s wishes, needs and preferences.

Staff provided holistic support to patient’s preparing for discharge, addressing their individual needs to ensure a smooth transition. They supported patients to access appropriate housing, and aftercare provision. Staff worked collaboratively with housing providers and escorted patients and their family members to view potential accommodation prior to discharge. This ensured patients who were approaching discharge were happy with the proposed accommodation, and could continue their recovery journey in a safe, and supportive environment which fostered the continued building of independence.

When required staff supported patients to complete advance care plans, such as do not attempt cardiopulmonary resuscitation (DNACPR) documents and recommended summary plan for emergency care and treatment (ReSPECT) documents.

Staff collaborated effectively across their teams and with external partners when formulating plans for people with complex needs. This promoted consistency, continuity and coordinated support across different care and support settings. Staff ensured people received compassionate and effective care, which was focused on their long-term wellbeing, future plans and successful recovery and rehabilitation outcomes.