Manchester University NHS Foundation Trust

On this page

• 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.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

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

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.

We scored the service as 2. The evidence showed some shortfalls. The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. However staff treated colleagues from other organisations with kindness and respect.

Several young people were on foot in the door observations when using the toilet or bathroom, which meant staff stood at the door with their foot in the door, with the aim of reducing the risk of young people vomiting. Young people told us this was very intrusive, and they did not feel comfortable using the bathroom. All toilets and bathrooms were on communal corridors which meant their privacy and dignity was compromised, young people told us, and we observed, that the toilets were not soundproofed, which meant when in the sensory room next to the toilet, it was not very relaxing. Young people also did not fully understand the reason for the restriction.

Staff attitudes and behaviours when interacting with young people showed that they were discreet, respectful and responsive, providing young people with help, emotional support and advice at the time they needed it.

Staff supported young people to understand and manage their care, treatment or condition.

Staff directed young people to other services when appropriate and, if required, supported them to access those services. Liaison took place with schools, to assist young people to transition back to their school.

Young people said staff mostly treated them well and behaved appropriately towards them. This included using grounding techniques and listening to young people. However, on occasion, young people told us that staff told them to eat faster and told them to “pull themselves together” when crying.

Staff understood the individual needs of young people, including their personal, cultural, social and religious needs.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards young people without fear of the consequences.

Staff maintained the confidentiality of information about young people. Information was stored in the electronic care records which were password protected and the paper records were stored in the locked nurse’s office.

We scored the service as 2. The evidence showed some shortfalls. The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service did not always make adjustments for disabled young people – for example, 4 young people were autistic and told us of the difficulties they experienced on the ward, for example lighting levels, noise levels and having to move bedrooms which they found disruptive.

Staff ensured that young people could obtain information on treatments, local services, young peoples’ rights, how to complain and so on. There was an accessible welcome pack that had been created in conjunction with young people.

Staff made information leaflets available in languages spoken by young people. We saw rights leaflets available in different languages. There was an interpretation service which included the translation of written documents.

Managers ensured that staff and young people had easy access to interpreters and/or signers. The Trust had a tip sheet regarding communicating with people who use British Sign Language (BSL) and included the alphabet as part of this. Staff could access face to face interpretation, video interpretation, telephone interpretation and written translations.

There had been challenges with the food provision of the service. This had been raised at the community meetings and included food not turning up on time and items not being delivered. Leaders had developed a project with the catering service to resolve the food challenges. This involved logging incidents, regular meetings and a plan for the head of catering to attend a community meeting and ward staff to meet with the new chefs to ensure they understood the service and the importance of food orders being correct.

Staff ensured that young people had access to appropriate spiritual support. Young people could access the chaplaincy service. The sanctuary room had a cupboard with faith and spiritual resources including a bible, prayer mat, religious scriptures, multifaith calendar and mindfulness activities.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Young people were involved in their care. We saw young people involved in their reviews; they were invited to ask questions and provide feedback about their experiences of the service.

Young people detained under the Mental Health Act had their rights explained to them and had access to an advocate, we saw the advocate had met with young people prior to their reviews to explore what they wanted to raise in the meeting.

Young people were involved in weekly community meetings where they provided feedback about the service. Feedback about the food had resulted in the service meeting with the head of catering to address the concerns.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were aware of and dealt with any specific risk issues, these included young people’s risk of secreting food and purging following meals. Staff care planned for these accordingly.

Staff identified and responded to changing risks to, or posed by, young people. Risk updates were included in the handover and any young person on enhanced observations was discussed. However, risks and observation levels of all young people were not included in the handover.

Staff used de-escalation techniques to reduce the need for physical interventions when young peoples’ behaviours became heightened. Young people told us that staff helping them when they became distressed, including sitting with the young person to help ground them and feel calmer.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported and valued. The majority of the staff had worked in the service for several years and were happy in their role.

Staff felt positive and proud about working for the provider and their team. Staff were involved in delivering training externally in Pervasive Arousal Withdrawal Syndrome (PAWS). Staff had had the opportunity to contribute to a practice considerations document created with colleagues from other NHS Trusts in England and experts by experience regarding PAWS and valued being able to share their knowledge and expertise with others.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Reflective practice sessions also took place which staff spoke positively about attending.

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