255 Lichfield Road

On this page

• 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

Effective

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.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Good: Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Staff from different disciplines worked together as a team to benefit patients. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 6 patient care records. Staff completed a comprehensive mental health assessment of the patient at, or soon after admission.

Staff developed care plans that met the needs identified during assessment. There was some inconsistencies in the quality of care plans. Most care plans were comprehensive, personalised and holistic. Patients and staff were able to tell us what they were working towards in terms of their recovery however their goals were not specifically documented with the care plan.

Staff discussed patient care and treatment regularly and updated the care record following incidents and multidisciplinary review.

We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from NICE . These included medication and psychological therapies and activities intended to help patients acquire living skills. The hospital had previously implemented therapeutic work roles where patients worked on site as a domestic assistant and receptionist. A new role had recently been created for a charity event coordinator.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. The hospital had a physical health lead and there had been programme of physical health training for staff including phlebotomy training. We saw in care plans that physical health needs were being identified and actioned. Records showed that all patients had a physical examination on admission and individual needs were continually monitored and reviewed. We saw evidence and liaison with local primary health including GP’s and dental treatment.

Physical health checks took place regularly however there was not a examination couch in the clinic room and physical health checks took place in patients’ rooms or bungalows.

Staff took part in clinical audits. Staff discussed clinical audit findings in monthly governance meetings and shared findings and learning across the service group. Managers used results from audits to make improvements and discussed these with staff at team meetings

The team included a full range of specialists required to meet the needs of patients in the service. As well as doctors and nurses, there was full complement of multi-disciplinary staff including occupational therapists, registered and clinical psychologists, social workers, activity coordinators and an expert by experience..

There was a comprehensive occupational therapy programme in place which offered a variety of recovery-based activities for the patients. Patients were involved in planning activities relevant to their goals. These included activities that focused on daily living skills, healthy lifestyles, and social skills.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. At the time of our inspection there had been some changes to the leadership in the hospital. Staff told us that they had found some of the changes challenging but understood the rationale for these.

We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

Staff held regular multidisciplinary meetings to discuss patients and improve their care. Daily meetings took place with a range of staff from psychiatry, psychology, nursing and occupational therapy. These meetings were effective in discussing a range of issues including changes to clinical risk, incidents, changes in observation levels, leave, medication and patient views. Issues related to the safe running of the service were also discussed including staffing, training and environmental issues.

Multi-disciplinary ward rounds took place weekly, and each patient had a monthly review. We observed ward rounds during our inspection. Meetings were collaborative across the disciplines and active participation of patients was observed during these meetings.

Staff made sure they shared clear information about patients and any changes in their care, including during handover meetings. We saw evidence of effective handovers between shifts and detailed handover notes which included a brief overview of the patient’s presentation, concerns, risks and activities. Handover notes also included actions to be taken on the following shift such as additional health monitoring or planned appointments.

The manager and senior clinicians attended regular regional meetings. Ward teams had effective working relationships with external teams and organisations. Staff told us that that they had positive working relationships with the local authority safeguarding teams and community mental health teams.

We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

Patients’ physical health needs were assessed and documented within care plans. These were routinely monitored and reviewed.

Staff told us they understood the importance of ensuring patients’ physical health needs were met. Staff had appropriate training to ensure that they were able to effectively assess and monitor physical health needs and had access to other healthcare professionals.

Staff helped patients live healthier lives by supporting them to take part in programmes such as physical activity, relaxation and mindful groups. Staff encouraged patients to plan and eat healthy meals. Patients could make use of the bistro where hot and healthy meals were offered.

We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record patient outcomes. Staff used a variety of recognised tools to monitor patients depending on their needs. These were recorded in the patients’ care records and used to review and direct their care. Staff also monitored progress and outcomes at the point of discharge and there were examples of positive treatment episodes where patients had moved on to new placements or into the community.

Staff discussed clinical audit findings in a monthly governance meeting and shared findings and learning across the service group. Managers used results from audits to make improvements and discussed these with staff at team meetings.

We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

Staff understood the importance of ensuring that people fully understand what they were consenting to and the importance of obtaining consent. We saw evidence in care plans and during ward rounds of staff seeking consent to care and treatment. Staff explained rights to patients detained under the Mental Health Act and ensured they understood them. Patients told us that they were regularly informed of their rights.