St Bernard's Hospital

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

We looked for evidence that the service met people’s needs.

At our last assessment we rated responsive as good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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.

The service made 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.

Care plans were individualised. Staff involved patients and family members to understand people’s preferences, needs and circumstances as appropriate. We observed a ward round on Meridian Ward and saw staff providing clear explanations to support patients to make informed choices about their care and treatment, promoting independence and self‑management wherever possible.

The service had occupational therapists that were responsible for offering and organising leisure-based activities and was also responsible for ensuring people had the resources and equipment for activities.

The service understood the diverse health and care needs of older people and local communities and aimed for joined-up, flexible care that supported choice and continuity. Staff had a good understanding of the health and social care needs of the patient group, enabling them to deliver tailored support for age-related conditions such as dementia and mobility limitations. Discharge coordinators contacted family members within 3 days of their relative being admitted to the ward. This helped to ensure families were involved at an early stage, received relevant information about the person's care and treatment, and were able to contribute to planning for discharge from the outset.

Staff supported patients to maintain contact with their families and carers. We observed carers and family members visiting their relatives on the wards.

The service provided appropriate, accurate, and up-to-date information in formats tailored to meet individual needs of patients and the client group.

Information governance systems ensured the confidentiality and security of patient records.

Staff made the necessary notifications to external bodies, including the Care Quality Commission (CQC), when required. Clear policies and procedures were in place to support staff in managing incidents and reporting requirements. The service safeguarding leads submitted safeguarding referrals to the local authority when required.

Patients were able to access information about their treatment, local services, their rights, and how to raise concerns or make a complaint. Information was available through a range of sources, including the trust's website, brochures, and leaflets displayed on the wards. Each ward had a welcome pack which provided patients and carers with essential information.

Staff ensured that information was provided in accessible formats to meet the needs of the patient population, including easy-read versions of complaints information and translated materials where appropriate. Staff also ensured that carers, family members, and commissioners received regular updates regarding patients' progress, helping to maintain effective communication and involvement in care.

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.

Staff enabled patients to provide feedback on the service they received. Wards held regular community meetings where patients could share their experiences and suggest improvements. We reviewed community meeting minutes from all 3 wards, which documented patient feedback and identified areas for improvement. On The Limes ward, we saw patients requested access to Asian music, and this was subsequently provided on an individual basis. On Jubilee ward, patients commented on the ward culture and reported that staff could occasionally be abrupt in their manner. This feedback was being addressed through the ward's support and intervention plan. On Jubilee ward, we saw that new armchairs had been ordered following patient feedback to replace the existing chairs, which were low and no longer met the needs of some patients. On Meridian ward, community meeting minutes recorded patient feedback; however, they did not clearly detail the actions to be taken in response to the issues raised.

One carer with a relative on Jubilee ward told us they did not feel as involved in their loved one’s care as they would have liked. They felt they had valuable information that could support staff in providing care and treatment but did not feel sufficiently included in care planning and decision-making. Other carers told us they were involved as appropriate.

Patients, relatives and carers knew how to complain or raise concerns. Patients and carers we spoke with understood how to make a complaint and told us they would feel comfortable doing so. Complaints were regularly discussed at community meetings. Patients were also able to raise complaints through the ward advocates.

The service clearly displayed information about how to raise a concern in patient areas. The patient information pack also contained information about how to make a complaint.

Staff understood the policy on complaints and knew how to handle them.

The service had received a total of six complaints in the previous six months. Managers investigated all complaints and identified any recurring themes and trends. Complaints were reviewed and discussed at monthly clinical improvement meetings, with learning shared across the wider service. For example, communication with carers was identified as a theme, resulting in staff receiving additional guidance and reminders regarding the importance of timely, clear and consistent communication.

Staff protected patients who raised concerns or complaints from discrimination, harassment or disadvantage. Staff demonstrated an understanding of how to acknowledge and respond to complaints appropriately, and patients received feedback from managers following the investigation of their concerns.

Managers shared feedback and learning from complaints with staff, using this information to drive service improvement. Staff told us that complaints and associated learning were discussed during handovers, clinical improvement meetings, senior leadership meetings and team meetings, helping to inform and improve patient care. Action plans arising from complaints were monitored, completed and followed up at the appropriate level to ensure lessons were embedded within practice. Following a complaint on Jubilee ward, leaders developed a frequently asked questions (FAQ) information pack for patients and carers. The pack included details about key meetings, ward processes and explanations of commonly used terms and abbreviations, helping to improve understanding, engagement and communication between staff, patients and carers. Team meeting minutes we reviewed showed that complaints and compliments were standing agenda items.

The service provided patients with access to care, treatment and support that was tailored to their individual needs.

Each ward accepted patients after conducting a thorough assessment, to determine if their needs could be met. Staff made reasonable adjustments to meet patients' individual needs. For example, occupational therapists completed comprehensive assessments and recommended environmental adaptations and equipment, which wards implemented to support patients' independence, safety and wellbeing.

The service was responsive and made adjustments to the complex needs of patients. On Jubilee ward, there was one patient being nursed with a member of staff present at all times. The patient was not subject to seclusion but required intensive physical healthcare due to being bed-bound. The volume of specialist equipment required meant that the patient was being cared for in a lounge area rather than a bedroom. To maintain the patient's privacy and dignity, the two adjacent bedrooms in that area were taken out of use. These care arrangements supported their health, safety and dignity.

Staff ensured the needs of patients with mobility issues were met. All wards were on the ground floor and could be accessed by wheelchair users. Each ward provided shower chairs, walking aids, recliner chairs and a variety of hoists to support mobility needs. Due to the limitations of the ward environment on Jubilee ward, all patients were assessed prior to admission for frailty and mobility using the Rockwood Clinical Frailty Scale. This enabled staff to identify patients who may be at increased risk of falls, deterioration, or reduced mobility, and to ensure that appropriate care, support, and discharge planning arrangements were put in place to meet the individual needs of the patient.

Staff ensured patients had access to post-discharge care, including section 117 aftercare, community mental health services, crisis services and community health teams, depending on their needs.

Staff planned discharge collaboratively with patients and their families, ensuring people were fully involved in decisions about their ongoing care. Staff teams worked closely with social workers, occupational therapists, care co-ordinators and discharge co-ordinators. Ward managers attended monthly Multi-Agency Discharge Events (MADE) with partners from health, social care, commissioning, and community services to collaboratively support patients with complex discharge needs. Leaders reported that Multi-Agency Discharge Events (MADE) had enabled quicker resolution of complex discharge issues, reduced delays, strengthened multi-agency collaboration, and improved patient flow. Two patients had been discharged within two weeks of a MADE meeting after lengths of stay over 150 days.

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.

Staff told us how adjustments were made to accommodate patients with diverse needs. Information was also made available in various formats to ensure accessibility. For instance, patients with dementia benefited from accessible information appropriate to support them such as easy read information, communication cards and pictorial cards.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Each ward held weekly community meetings.

Over 97% of staff were trained in equality, diversity, inclusion and human rights.

The service trust was committed to advancing race equity and improving outcomes for racialised communities in line with the Patient and Carer Race Equality Framework (PCREF). The trust had developed a comprehensive delivery plan and had established a PCREF steering group that met regularly to oversee progress and drive improvement. We saw that the trust's PCREF delivery plan was aligned with the Northwest London inequalities plan, helping to ensure a coordinated approach to reducing health inequalities and improving the experiences and outcomes of people from racialised communities. Listening events had taken place for Older People’s Mental Health Services, to gather information about what improvements were needed and what people’s experiences were.

People were supported to plan for important life changes and given sufficient time and information to make informed decisions about their future care and treatment, including end-of-life care where appropriate. At The Limes, we saw evidence of advance care planning in practice, with one patient having a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision in place, demonstrating that their wishes and clinical needs had been considered and documented.

Staff developed personalised care plans that reflected each patient’s specific needs, preferences and emotional wellbeing. Care and treatment planning followed a multidisciplinary approach, with all relevant healthcare professionals and external agencies contributing to ensure plans were safe, coordinated and holistic. At The Limes we saw that a carer had been provided with psychoeducation support to help them understand the decisions being made regarding their relative's move to a care home. This support enabled the carer to better understand the person's needs, the rationale for the decision, and how the move would help to meet those needs.

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

Staff planned for patients’ discharge upon admission. The wards had weekly discharge planning meetings to ensure that the appropriate support was in place before a patient was discharged.