North London NHS Foundation Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment of this newly merged trust. However, these wards were inspected under their previous trusts. At our last comprehensive assessment, we rated this key question good. At this assessment the rating has remained good.

This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Most patients told us staff treated them well and behaved appropriately towards them. The majority of carers told us staff were kind and helpful. At Highgate West Mental Health Centre, an LGBTQ+ group for patients had recently started. There was also a women’s forum which staff and patients could attend. Patients we spoke with told us they felt able to raise any concerns they had with the ward staff or managers. Staff told us they felt respected, supported and valued by their colleagues and managers. They spoke positively about working at the service and proud of the work of their team. However, some patients told us they were not given information about the ward on their admission. Some patients told us staff were not respectful of their privacy, such as not knocking before entering their bedroom. Some patients told us staff were not always available when they needed support.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff attitudes and behaviours when interacting with patients showed that they were mostly respectful. We saw examples where staff were kind and supportive to patients. However, there were also times when staff were not visible on the ward to support patients.

A few staff did not talk about patients with respect. For example, at a handover on Suffolk Ward, staff referred to a number of patients as ‘bizarre’. When reviewing incident reports at Blossom Court, we also noted two examples where staff could have spoken with more compassion. For example, staff said a patient was ‘counselled about their behaviour’ after a self-harm incident.

We spoke with 56 patients and 32 carers.

Most patients told us staff treated them well and behaved appropriately towards them. However, 11 patients across the trust were not happy with how staff treated them. Two patients at the Dennis Scott Unit told us staff mocked them and were disrespectful. One patient on Devon Ward told us staff often spoke in different languages in front of them, this made them feel uneasy and paranoid.

The trust collected feedback from patients about their care. Most patients rated the service ‘very good’ and ‘good’. However, not all wards completed patient surveys. In February 2025, three wards did not complete any surveys and in January 2025, five wards did not complete any surveys.

Twelve patients said they were not given information about the ward or shown around when admitted, which would have been helpful. One patient on Trent Ward told us the information booklet on admission was not easy to read or inclusive.

The majority of carers told us staff were kind and helpful. Three carers told us staff were dismissive and lacked an understanding of their relative’s needs.

Staff maintained the confidentiality of information about patients. However, a patient told us they could hear information being discussed about them from outside of the nursing office.

Some patients told us staff were not respectful of their privacy, such as not knocking before entering their bedroom. We saw examples of staff not asking permission before entering patient’s bedrooms.

Staff made adjustments to support patients where needed. Staff gave us examples of how they supported autistic patients on the ward. They were aware of some of the challenges being on an acute ward could have for some autistic people and spoke of adjustments, such as providing ear plugs and music to reduce the volume of the ward alarms. Staff completed mandatory training on how to support autistic people. Overall, 91% of staff had completed this training. However, a patient told us their room was painted whilst they were out, without their knowledge, which was upsetting. Another patient told us staff were not using their autism passport, which had helpful strategies to support the patient.

Staff took into consideration relevant protected characteristics when providing care. For example, creating safety plans with patients, detailing their preferred pronouns.

The service provided a variety of food to meet the dietary and cultural needs of individual patients, for example, halal, kosher and vegetarian options. However, many patients we spoke with said the food was of poor quality and there was not enough choice. St Ann’s Hospital had close links with the local Jewish community. They had a community who brought in fresh kosher snacks and bread each day for those requesting a kosher diet.

Most patients had access to spiritual, religious and cultural support. For example, staff had recently supported patients to observe Ramadan. We also observed a priest visiting a ward whilst we were onsite. However, not all wards had access to a multifaith room. Shannon Ward created a multifaith room as part of a quality improvement project. This project had been going well and there were hopes to roll this out to the other wards at the Dennis Scott Unit.

Managers made sure patients could get help from interpreters or signers when needed for ward round meetings. Some staff told us interpreters often cancelled their booking last minute. Staff would then attempt to rebook an interpreter for phone support or use translation apps.

At Highgate West Mental Health Centre, an LGBTQ+ group for patients had recently started. There was also a women’s forum which staff and patients could attend.

Staff involved most patients in discussions about their care and treatment, however 16 patients we spoke with told us where were not involved in planning their care.

Most patients said staff explained their rights under the Mental Health Act. However, four patients at Chase Farm Hospital and three from Blossom Court said staff had not explained their rights.

Patients were aware of their ward rounds and met with doctors to discuss their treatment regularly.

Where appropriate, carers attended ward rounds. One carer told us they could not attend a ward round meeting so was asked to complete a questionnaire. However, the ward said they did not receive this paperwork, and the carer felt this affected their relatives discharge plans.

The trust employed lived experience peer support workers. They were available on some wards to engage with and support patients. However, on Trent Ward the peer support worker was included in nursing shift numbers. This could impact the amount of peer support they were able to offer, due to regular shift pressures.

The trust asked patients to join their involvement register as experts by experience. We saw evidence of this in complaint response letters.

Patients were encouraged to provide feedback about the ward. Patients were able to provide feedback in community meetings, ward rounds and patient surveys.

Most patients told us staff gave them emotional support and advice when they needed it. However, six patients told us staff were not available when they needed support.

Patients we spoke with told us they felt able to raise any concerns they had with the ward staff or ward manager. Patients also had access to community meetings where they could raise their concerns about issues on the wards. However, community meeting minutes often did not have action plans or provide updates following a patient raising a concern. These meetings did not always happen weekly on all wards.

The trust had policies and procedures in place for searching patients and their bedrooms. All patients were searched on their return from leave; however, a carer told us their relative was not searched properly and was able to bring materials onto the ward to self-harm.

The trust used technology to assist patients. For example, they had invested in search equipment, that was non-invasive, to identify contraband materials, reducing the need for hand on personal searches.

The wards at Chase Farm Hospital had a quality improvement project, called the perfect day initiative. This project looked at having more of a structured routine to key meetings and session throughout each day. This ensured patients and carers knew what times meetings, such as formulation meetings and handovers, would occur in advance. This ensured patients and carers had clearer expectations, improving communication.

The trust also had a patient flow improvement project, which looked at reducing the number of out of area placements. Following their initiatives, the project found there was a greater involvement of carers in care formulation and discharge planning. At the time of inspection here had been a 23% reduction in out of area placements.

Staff told us they felt respected, supported and valued by their colleagues and managers. They spoke positively about working at the service and proud of the work of their team.

However, a staff member told us they were often expected to work longer hours to support short staffing in the next shift. They often had to do this with no recognition from managers.

Staff had access to support for their own physical and emotional health needs through the trust’s occupational health service. Staff told us they received support from managers when they were off sick.

Some staff told us they often had to deal with verbal or racial abuse on the wards. Despite this, staff told us they felt supported by their managers when this happened. One staff member told us they did not feel supported by managers following racial abuse. Staff were supported to report abuse to the police. One staff member told us they were offered occupational therapy and physiotherapy following a physical assault on a ward.

The trust recognised staff success within the service, for example, through staff awards. Some wards also had an employee of the month award.

Staff appraisals included conversations about career development and how it could be supported.

Staff across hospital sites told us they had recent team away days, where they focused on improving patient care and team bonding.