North London NHS Foundation Trust

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

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’s needs were met through good organisation and delivery.

Staff worked with external organisations which allowed patients to engage with activities in the community. The complaint responses we reviewed were detailed with clear outcomes and were apologetic. Staff planned for patients’ discharge, including liaison with community teams and housing when appropriate. The trust was engaged with the NHS England Patient and Carer Race Equality Framework (PCREF).

However, whilst the service displayed information about how to raise a concern in patient areas, some patients and carers told us they did not know the complaints procedure. Some staff told us there was pressure to discharge patients. In February 2025 were 64 delayed discharges across the 20 inpatient wards.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Each patient had their own bedroom and privacy windows they could adjust. Some bedrooms had ensuites, others had shared toilet and showers.

Patients could keep possessions in their bedrooms or secure lockers in the nursing office. Patients could use mobile phones to make phone calls in private and could also access a ward phone.

Most wards had a quiet space with sensory equipment for patients to use. We spoke with staff who had completed sensory integration training and were involved in creating these sensory spaces on the ward.

The service could support and make some adjustments for disabled people. Each ward had a larger accessible room to support those who need these adjustments. There were lifts to get to wards on higher levels.

We saw patient centred discussions in multidisciplinary team meetings at Chase Farm Hospital and St Ann’s Hospital.

Twenty-five carers told us they were happy with the service their relative’s received, and they felt involved in decision around their care. These carers told us they felt the trust provided patient-centred care and any complaints they raised were resolved quickly.

Patients did not always have care plans in place to reflect their individual needs. For example, we did not see care plans to support a patient’s communication or religious needs. A Personal emergency evacuation plan (PEEP) was not in place for a patient who was using a wheelchair. A PEEP is a personalised plan to support a patient who may need assistance evacuating a building during an emergency, ensuring their safe and timely evacuation.

Staff worked with external organisations which allowed patients to engage with activities in the community. Staff told us they had referred patients to community groups run by charities, community links and recovery colleges. They also attempted to source courses for individual interests, such as Japanese classes for a patient.

Staff supported patients to maintain contact with their families and carers.

Staff communicated with external services when someone was being discharged

Staff supported patients to access their chosen place of worship within the community. Staff told us they had supported patients to attend a mosque on Fridays, and to attend church services on Sundays.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain. This could be provided in different languages if needed.

Information was available on noticeboards on each ward. However, there was some outdated information on Thames Ward.

Information governance systems included confidentiality of patient records.

Staff supported, informed and involved families or carers. Families or carers were invited to ward rounds, where appropriate. At Highgate West Mental Health Centre, there was a fortnightly carers group, however attendance was low, with only 1 carer attending recently.

We spoke with 32 carers across the trust. Most carers spoke positively about their interactions with staff. However, four carers reported they found it difficult getting through to the ward when they call. Three carers told us their relative’s discharges were not managed well, with little communication from the ward. Six carers told us the ward did not keep them informed of their relatives progress or involve them in their care planning.

The service displayed information about how to raise a concern in patient areas. Staff understood the policy on complaints and knew how to handle them.

However, seven patients and 11 carers told us they were not aware of the complaint’s procedure. Some other patients and carers said they weren’t explicitly aware of the procedure, but they would speak to ward staff with any concerns.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results. In the examples we looked at, we saw complaints were reported, escalated and dealt with appropriately.

From September 2024 to February 2025, the wards received 48 complaints. All of the complaints were acknowledged within 5 days. Of those complaints, 23 were still in progress. Four of the ongoing complaints were originally submitted towards the end of 2024.

The complaint responses we reviewed were detailed with clear outcomes and were apologetic. However, the response letters were often very long and difficult to read, with the pages moving between landscape and portrait. Some responses were poorly written with spelling and grammatical errors. Some of those responses also switched between first and second person and used complicated language which made it difficult to follow.

Two patients and 2 carers said they had made complaints to the wards but had not had a response.

One patient told us they did not feel comfortable complaining in case it negatively impacted their care.

The service used compliments to learn, celebrate success and improve the quality of care. Compliments were displayed on noticeboards and in nursing offices. Managers shared feedback from compliments and complaints with staff, and learning was used to improve the service. For example, staff at Blossom Court were informed they were able to review CCTV footage out of hours to resolve complaints where necessary.

The service was accessible to patients who needed inpatient care, although at the time of inspection, there was a lot of pressure on the wider mental health system, impacting on the length of time a number of patients were waiting to access an inpatient bed. The trust had systems and processes in place, which were overseen by a bed management team, who monitored and addressed delays.

Staff ensured the needs of patients with mobility issues were met. For example, wheelchair users were placed in larger accessible bedrooms.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospitals were within a reasonable travelling distance to the local acute hospital.

Staff planned for patients’ discharge, including liaison with community teams and housing when appropriate.

Staff told us discharges were often delayed for reasons other than clinical reasons, such as awaiting appropriate social care. Staff told us there was often long waits for supported accommodation or rehabilitation wards, meaning patients were awaiting transfer on the acute wards.

In February 2025, there were 64 delayed discharges across the 20 inpatient wards. The wards with the highest number of delayed discharges were Jade Ward and Amber Ward, where there were 8 delayed discharged on each ward.

Some staff told us there was pressure to discharge patients. Some managers told us they were asked to discharge three patients each week. All managers told us they did not discharge someone if they were not clinically well enough. However, we observed a meeting where it appeared staff were being pressured to discharge patients despite telling the managers they were not fit for discharge.

When patients went on leave for more than one night, a new patient usually filled their bed. This meant, if a patient required their bed back because they are not ready to be discharged, they often needed to be admitted to another ward, sometimes even another hospital.

Staff received training in equality, diversity, inclusion and human rights. Overall, 95% of staff had completed this training.

The trust had 2 equality and diversity strategies ongoing at the time of inspection. Their equality, diversity and inclusion strategy from 2022 to 2025, which primarily focused on patient care, and their people and organisational development strategy, running from 2023 to 2026, which primarily focused on supporting staff.

The trust was engaged with the NHS England Patient and Carer Race Equality Framework (PCREF), which is a mandatory framework aiming to support providers to become actively anti-racist organisations and reduce racial inequalities experienced in mental health services. This ongoing work involved engaging with communities and supporting services to embed the voices of people with lived experience.

Where appropriate, staff supported patients to consider longer term decisions about their care, treatment and discharge

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. For example, ward staff liaised with personality disorder teams and substance misuse services when appropriate.