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Inspection report

Date of Inspection: 11 January 2011
Date of Publication: 9 February 2011
Inspection Report published 9 February 2011 PDF

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People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

Our judgement

We found the people who use services have their views and experiences taken into account in the way the service is provided and have their privacy and dignity respected. No gaps in assurance or areas of concern were identified during the assessment of this outcome for this location.

User experience

Positive comments were included in the CQC Quality and Risk Profile (QRP) for outcome 16 from the Sheffield LiNK which was also applicable to this outcome. LiNK participant’s work on the recovery wards has been fed back to managers and staff which lead to changes in care respect of people who use services sexuality, spirituality and problems with social interaction. The LiNK reported that the trust has cooperated with ongoing research involving members of LiNK which has lead to real care quality improvements in long term wards. A detailed submission from the Sheffield LiNK at registration demonstrates how the provider has worked with and involved LiNK participants in influencing the city wide strategy for improving mental health in Sheffield. An additional positive comment noted that people who use services, carers and foundation trust governors will be involved in visiting service areas, to talk to people who use services and staff about the quality and safety of care as part of the new quality checks process described in the ‘quality accounts’. People who use services have also carried out surveys of privacy and dignity on the wards during 2009/10 and “this will continue”.

Additional evidence was sought from the provider in the form of an annual team governance report for Rowan ward covering the period April 2009 to March 2010. We found the report to be a detailed and informative document containing a large range of information applicable to a number of outcomes for the location. The report contained a number of examples providing evidence of involvement and how feedback from people who use services and carers is obtained. Community meetings are held on a weekly basis which has allowed people who use services to discuss any issues or concerns and make suggestions. The ward had received positive feedback regarding the activity room and the report also explained how the activity coordinator role has remained popular with people who use services. Other examples of groups include a music group along with a health and wellbeing group.

A range of social inclusion partnership work has been continued, for example, a pedal ready cycle touring club. People who use services cultivate an ornamental vegetable garden within Hillsborough park walled garden and the group won a gold medal in the Sheffield in bloom awards. Other groups include a creative potters group which is a partnership between an independent potter, occupational therapy staff and people who use services from this location.

The governance report explained an initiative named “Star Wards”, which was started by a service user. The concept is that of providing people who use services with meaningful activities whilst on the wards. The meetings take place on the ward to allow staff members and people who use services to develop ideas and access them and have been found to be very positive. The report explained that morning planning meetings was one of the activities inspired by Star Wards. People who use services and staff members jointly share and plan the ward routine and activities for the day ahead and these are captured in a book to allow audit.

Other evidence

The provider declared compliance with this standard at this location at registration with CQC in April 2010. A provider level submission provided detailed explanatory notes regarding 'respecting and involving people who use services' , ‘how service users views are obtained and used to influence services’ and regarding the ‘promotion of equality, diversity and human rights’.

The current provider level Quality and Risk Profile (QRP) risk rating for this provider contained no negative individual information for this outcome or location. Overall the information contained showed the trust to be positively rated when compared with other NHS trusts nationally. The last MHA Commissioner reports were obtained for Pinecroft ward (visited 27/10/2009), Intensive Treatment Centre (visited 27/10/2009), Maple ward and Rowan Ward (visited 19/07/2010) that contained no negative feedback in relation to this outcome.

As part of the initial assessment of all outcomes a number of external stakeholders were contacted including, Sheffield LiNK (local involvement network), Sheffield OSC (overview and scrutiny committee), Health and Safety Executive, Yorkshire and the Humber SHA (strategic health authority), NHS Sheffield and Monitor (Foundation Trust regulatory body). None of these bodies raised any areas of concern specifically relating to this location or outcome.

As part of the assessment of this location the provider submitted a provider compliance assessment for this outcome. (This tool allows to the trust to perform a self assessment and explain how it is currently meeting each part of the outcome). A comprehensive amount of information was set out that explained in detail, with references to supporting evidence, how this outcome was being met. Examples are given below.

The provider stated that involving and respecting people who use services is fundamental to its approach and this is reflected in the “Service User Involvement Strategic Framework”, which was developed with people who use services. The provider reviews equal access to services through action planning linked to the “Single Equality Scheme” and application of equality impact assessment process to policy development and implementation. The Care Programme Approach (CPA) is used for people receiving mental health care and treatment. Older people have been treated under the CPA approach if their needs are complex, or the Single Assessment Process (SAP) is utilised if their needs are less complex. Training has been provided to staff across the organisation on CPA, which includes promoting the involvement of people in decision making.

The provider had systems and underpinning policy and procedures for accessing interpreting and translation services to ensure that people are able to engage fully in decision making irrespective of language or hearing barriers.

The provider had reviewed information that suggested some black and minority ethnic (BME) groups were either under or over-represented in different services, and so needed additional support or advocacy to make sure their needs were addressed and their voices heard. The provider holds a contract with the Pakistan Muslim Centre (PMC) which employs a link worker for inpatient areas across adult and older people inpatient mental health services. The role of this worker is to support communication and ensure that people are able to access appropriate services relevant to their cultural needs internally and on discharge. The Enhancing Pathways Link Worker post works primarily with south Asian people who use services. African and Caribbean people who use services have access to a similar service through an advocacy worker who is employed by the Sheffield African Caribbean Mental Health Association (SACHMA). Emotional wellbeing workers fulfil a community development role and support individuals, especially people from the Yemeni community and Pakistani women to have their care and treatment needs met.

People who use services have be