Queensway Hospital Also known as Oak Tree Forest Limited

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

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

Good: Staff managed beds well. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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 2. The evidence showed some shortfalls. The service did not always use preferred pronouns consistently and patients told us some staff did not always follow their care plans. However, staff made sure people were at the centre of their care and treatment choices and they work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Two out of 6 patients we spoke with told us that not all staff always followed their care plans. Patients told us this related to the unplanned staff that the hospital used. The hospital tried, wherever possible, to use staff that were familiar with the hospital and they had comprehensive handovers in place to make every effort to provide consistent care. Two patients told us they had regular, consistent staff, including regular agency staff. 

During our review of 5 care records we found that staff did not always record patients preferred pronouns consistently. However on speaking with staff we were assured that they supported patients with protected characteristics and used preferred pronouns when speaking with them and discussing them. Our review of care records and discussions with staff, patients and relatives showed there was a team approach to meeting individual needs. Relatives told us their loved one’s communication needs were being well met. Patients’ communication needs varied and we observed that the service used a variety of methods to support this, including tablets and Makaton. At the time of our inspection 100% of staff had been trained in Makaton and we observed staff using this during our time on the wards. We saw that patient views were included in planning their care, even where patients did not agree, this was documented.

We received feedback from commissioners who said the staff “are professional in manner and person centered in their approach.” The advocates who provided feedback said, “on the whole the staff are compassionate and kind” and “patients are treated with respect and staff are kind and compassionate.”

Staff endeavoured to empower patients to make their own decisions about their care and treatment. The psychologist spoke with us about innovative ways they built therapeutic relationships with patients to engage them in therapy such as writing notes to a patient who was resistant to psychology and walking therapy for a patient as the therapeutic relationship improved being out of the hospital. 

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

The service offered group and individual activity sessions, including pet therapy, walking, cooking, ‘knit and natter’, crafts, beauty treatments and community sessions such as going to the cinema, farm and shopping centre. When appropriate, staff ensured that patients had access to education and work or volunteer opportunities. One patient was currently supported to attend a day centre. 

Staff supported patients to maintain contact with their families and carers and we spoke with 5 relatives during our inspection who confirmed this. 

The hospital had regular patient inclusion meetings offered by both the patient inclusion lead and the expert by experience. These meetings focused on feedback, service development and involvement in upcoming projects and events. 

Staff supported patients to access their chosen place of worship within the community. The hospital celebrated national events such as public holidays, cultural observances and awareness days such as Pride. 

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.

During our inspection, we noted that Care Quality Commission posters with ratings were displayed. Staff made notifications to external bodies as needed. Information governance systems included confidentiality of patient records. Staff audited records to ensure there were no gaps in record keeping, Mental Health Act documentation or Deprivation of Liberty Safeguards paperwork.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. We observed information provided was in a form accessible to the individual needs of the patient group and staff made information leaflets available in languages spoken by patients. There were several information boards throughout the ward areas which had been co-produced with patients. These included information regarding autism awareness, the Safewards model (the objective of the model is to reduce conflict and containment within mental health services), advocacy information, Mental Health Act, patient inclusion, complaints and CQC information. There was also a therapeutic wall of wellness which included information regarding Pride month, grounding techniques and affirmations.

Staff told us they strived to keep carers, families and commissioners updated about the patient’s progress. We spoke with 5 relatives who told us they were invited to all relevant meetings and were communicated with. Relatives felt they were mostly provided with relevant information, but 2 relatives gave us an example of where they felt communication could have been improved and they had fed this back to the hospital.

Commentary:

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

Patients and their families knew how to complain or raise concerns. People were given the opportunity to provide feedback in a range of different ways such as community meetings, verbally to staff or through an independent advocate. Patients and their relatives were also invited to their ward rounds and were able to express their wishes and needs and provide feedback.

The hospital made changes as a result of feedback, for example, staff noted that there was a lack of attendance of Elizabeth upper ward patients in community meetings, so the hospital alternated the place of the meeting to maximise attendance.

Staff we spoke with knew how to handle complaints appropriately.

As part of the inspection, we requested all formal and informal complaints made in the 12 months prior to inspection and the service recorded 20 complaints, with 4 of these recorded as formal complaints. No complaints had been referred to the Ombudsman. The complaints were recorded on a central database, learning points identified and any themes and trends 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.

We saw evidence that staff ensured the needs of people with mobility issues were met, for example, wheelchair users could be placed in bedrooms at ground level and the upper floors had access via lifts. The service made reasonable adjustments for people, if required, and had access to necessary equipment.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was close to the local acute hospital.

Staff ensured patients had access to post-discharge care – for example, section 117 aftercare, community mental health services and crisis services. We saw evidence in the 5 care records we reviewed that staff planned for patient’s discharge, involving the commissioners, local authorities, and future care providers. The service was collaborating with these partners to plan for patient’s discharge.

Discharge planning included good liaison with case managers and care coordinators, relatives and patients, when appropriate. The hospital were also sensitive to the needs of individual patients who struggled with progress and who had anxieties relating to discussion in terms of discharge planning. Relatives confirmed that the hospital understood some of the challenges their loved ones faced regarding this.

In the 12 months prior to our inspection, there had been 0 delayed discharges.

We scored the service as 2. The evidence showed some shortfalls. However, staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had a patient and carer race equality framework strategy (which sets out clear actions the provider must take to reduce racial inequalities in their services) and although we observed positive practice in relation to this, we found that staff and the hospital manager were not fully aware of this strategy or any specific actions that related to it.

Staff within the hospital and the wider organisation promoted a culture in which the people using the service felt empowered to give their views and the relatives we spoke with confirmed that they were invited to relevant meetings and were involved in discharge planning.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights and compliance at the time of our assessment was 95%.

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

Staff supported people to make decisions about their care and treatment and their future. This included holding best interest meetings involving relatives, carers and advocates, where appropriate, to ensure the best decisions were made regarding the patients’ future. Relatives told us they were involved in discharge planning and an advocate we spoke with told us, “Everyone can attend ward rounds, CPAs and have their say”.

Staff create personalised care plans to account for the patient’s needs, wishes and feelings. Patients had hospital passports in place to support them if they needed to go into hospital.

We observed 2 ward round meetings where staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.