Essex Partnership University NHS Foundation Trust

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• 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating had changed to good. This meant patient’s needs were met through good organisation and delivery. Staff managed beds well. A bed was available when a patient needed one. Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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.

We scored the service as 3. The evidence showed a good standard. 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.

Staff regularly met with young people to understand their views on care and treatment. These discussions took place in one-to-one meetings with nurses and in multidisciplinary team meetings. Staff monitored young people’s conditions and discussed any changes at handover meetings.

The service provided therapeutic and recreational activities. Young people had access to groups such as garden life group, self-care group and sensory group. OT provided an evening timetable of mindfulness and relaxation, book club and yoga. Young people had individual timetables which included art, community trips, English, nurture farm, PAT dogs, culture group, cooking, trampolining, music, science, and driving theory.

Young people had access to psychology input either in groups or 1-1 sessions. Psychology groups were based around therapies such as, eye movement desensitisation and reprocessing (EMDR), dialectical behavioural therapy (DBT) and counselling sessions, providing young people support with emotional management and coping strategies.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported young people to maintain contact with their families and carers. All young people we spoke to told us they were supported to maintain contact with the people who were important to them. Staff told us they were able to support visits from children in an area away from the ward environment.

Staff supported young people to maintain contact with people in their local area. Staff ensured family members and care co-ordinators were invited to multidisciplinary team meetings. The service facilitated attendance by video link, if people were unable to attend the ward in person.

Young people had access to appropriate spiritual support. The wards had access to the trust’s chaplaincy service, the chaplain regularly visited the wards and supported with activities.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made sure young people could access information on treatment and local services. Staff explained that information was provided for young people if it was needed. Staff displayed information about safeguarding, infection control, the Mental Health Act and the independent mental health advocacy service.

The service had a variety of easy read documents for young people, including, consent to admission, welcome booklet, and what young people can expect from the service. There was also individualised easy read information for young people, for things such as specific medications, blood tests, changing clothes and cleaning.

Staff had access to equipment and information technology needed to do their work, the nurse’s stations had enough room and access to computers for staff to be able to sit and do their work.

Leaders had access to information to support them with their management role. This included information on the performance of the service, staffing and young people’s care. This information was presented and discussed in clinical governance meetings.

Staff made notifications to external bodies as needed. The service submitted notifications to the Care Quality Commission in accordance with requirements. The service submitted safeguarding referrals to the local authority.

We scored the service as 3. The evidence showed a good standard. 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.

During the last year there had been 3 complaints made to the wards, 2 for Poplar Unit and 1 for Longview, 1 complaint had been upheld and 1 was under investigation. There were also 2 complaints that were under investigation with PALS, no complaints had been referred to the Ombudsman. Young people, relatives and carers knew how to complain or raise concerns. Young people said if they had any complaints, they would speak to staff or the ward manager in the first instance, there was information on the wards about how to make a complaint and how to access advocacy. Young people told us they knew how to access an independent advocate. The service also had peer support workers and family ambassadors that provided support to young people and their families.

Staff understood the policy on complaints and knew how to handle them. Staff and leaders told us people received feedback after investigations into complaints. Staff received feedback on the outcome of investigations into complaints and acted on the findings.

During the last year the wards had received 39 compliments, these were from young people, their families and student nurses.

Young people and staff participated in regular community meetings on the wards. Community meetings had a good uptake from young people, and a range of staff attended. Feedback on items discussed during previous meetings were given.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service had adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the wards were within a reasonable travelling distance to the local acute hospitals.

The service had clear criteria for accepting young people on to the wards and did not accept anyone whose physical health needs could not be met. The ward’s had an accessible bedroom, equipped for people who may have a physical disability and may require a hoist, profiling bed or use of a commode. Poplar Unit also had a lift to access the ward where required.

Staff planned young people’s discharge from the wards and had effective liaison with care co-ordinators. Staff supported young people during transfers between services. There had been 1 delayed discharge in the last 12 months. Staff ensured young people had access to post-discharge care, including section 117 aftercare, community mental health services and crisis services.

Young people had access to chaplains, who worked alongside other health professionals to provide religious and spiritual care for people regardless of faith, belief or philosophy. Chaplains assisted with the practice of religious observance or through listening and dialogue.

Young people had access to interpreting and translation services, through the trust’s contracted provider. Where needed this provided people with interpreters face-to-face, via telephone or video calls based on their needs and preferences.

We scored the service as 3. The evidence showed a good standard. 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 within the service promoted a culture in which young people using the service felt empowered to give their views.

The service admitted young people from diverse religious and cultural backgrounds. Staff asked young people about their religious and cultural needs when they were admitted to the ward. The service provided culturally appropriate food.

Staff shared adjustments that had been made to accommodate young people with diverse needs. Information was also made available in various formats and languages upon request to ensure accessibility.

The service had an equity, diversity and inclusion policy in place to guide staff in ensuring that people were treated fairly. Staff had access to the trust’s identifying and supporting protected characteristics toolkit. This supported staff to recognise and understand protected characteristics and to provide person-centred care for people from those groups. The toolkit included checklists to prompt staff and contact details for the freedom to speak up guardian, staff engagement team, patient advice and liaison service and the chaplaincy service. All staff completed training in equality, diversity and human rights. Staff compliance with this training was 100% on Larkwood and Poplar Unit and 97% on Longview.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of young people with complex needs. The multi-disciplinary teams within the service were made up of consultant psychiatrists, specialty doctors, nurses, healthcare support workers, psychologists, occupational therapists and other support staff.

Discharge planning was led by the Multi-Disciplinary Team (MDT), onwards referrals were made in advance to services such as care co-ordination, community teams and voluntary organisations. Occupational therapists and activity co-ordinators supported young people to plan for the future through life-skills groups, meaningful activities and engagement in hobbies or community resources. Through education services young people had access to careers advisers and employment specialists. Young people were encouraged to work towards achievable and meaningful qualifications to support their future goals.