Bradford Teaching Hospitals NHS Foundation Trust

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained as good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff assessed the physical and mental health of all patients on admission or soon after. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team had access to the full range of specialists required to meet the needs of patients on the ward. Staff from different disciplines worked together as a team to benefit patients.

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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 9 care records as part of the inspection. Staff completed comprehensive assessments of individuals on admission to the unit, and their assessments covered potential risks for patients, including falls, pressure, skin integrity and nutrition. Specialist tools were used when appropriate. Staff then developed care plans that addressed the needs identified in the initial assessment.

Staff told us that patients were given clear information about their care and treatment plans, and informational leaflets to support this understanding. Most patients we spoke to understood their care and treatment.

Care records showed that staff regularly reviewed care plans and risk assessments and updated these when necessary.

We scored the service as 2. The evidence showed some shortfalls. The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff were competent and skilled to provide a range of care and treatment for their patients. Care was delivered in line with guidance from the National Institute for Health and Care Excellence. Staff also had good access to specialist when needed, staff were positive about their relationships with specialists, and we saw evidence of regular input from therapies, and dieticians as required.

Audits were completed monthly, facilitated by the Trust’s digital audit platform, which included pressure area care, nursing assessments and care planning, falls prevention, and nutrition. These audits were used to identify good practice as well as areas for service improvement. Both units also took part in a ward accreditation process carried out by the Chief Nurse team, which ensured care was clinically sound and aligned with Trust values of compassion, dignity and continuous learning. The process reviewed 11 key domains including medication management, safeguarding and leadership. Westwood Park and Westbourne Green were both at 99% compliance at the time of inspection.

The Trust were involved with the NHS England project ‘Hydration to Feel Great’, which aimed to maintain hydration, reduce urinary tract infections, and prevent falls by means of patients keeping a diary. However, we found that at both units there was a blanket approach to putting fluid balance charts in place for patients to monitor patient hydration, but no overall output was completed. This was raised with the Trust during the inspection. They confirmed that these were not formal fluid balance charts, which would be completed on the electronic patient record which would automatically calculate input, output and overall fluid balance. Although the Trust have shared this information with us, during the inspection staff did not highlight the ‘Hydration to Feel Great’ project. To ensure consistency, staff now recorded oral fluid intake in the food chart, and fluid balance charts would only be used when clinically indicated.

We also found that the care plan audits at Westwood Park did not record which care plans had been reviewed as part of the audit, so there was no way to assure that care plans were not being repeatedly reviewed.

We also found that one patient had been recommended snacks by dieticians, but it was not always recorded in their food chart if he had been offered and declined the snacks.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. The Trust had a target of 85% completion for mandatory training, and as of 30/10/2025, compliance was at 100% for both Westwood Park and Westbourne Green.

Both units had tailored local induction checklists for new staff whether they were permanent, bank, agency or locum.

Staff had regular team meetings, information from these meetings was shared when staff could not attend. At Westbourne Green staff were asked to sign or confirm that they had read and received information shared by the ward manager.

In the last 12 months 100% of staff at Westwood Park and Westbourne Green had completed an appraisal. The Trust did not have mandated supervision for registered nurses, but nursing staff received one to one meetings with their line managers and had access to Professional Nurse Advocates who could offer formalised clinical supervision. The average attendance for these sessions was not provided by the Trust.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had regular and effective multidisciplinary meetings, staff we spoke to said they felt able to raise concerns and felt listened to when concerns were raised. Staff also told us that patient handovers were comprehensive and effective, so that information about patients was shared between shifts to ensure effective monitoring and care.

The teams regularly engaged with other teams in the Trust to ensure their patients could access additional support when needed. They also had effective working relationships with external organisations such as the local authority and GPs to support discharge and safeguarding concerns.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported patients to live healthier lives, information about healthy living and support was available around the ward areas, on display boards as well as leaflets.

On both wards we observed that patients were encouraged to be out of their beds, and at Westwood Park there was a supply of clothes available to support with the prevention of ‘pajama paralysis’ for patients who could not easily access other clothing.

Staff encouraged patients to be mobile, at Westwood Park they had used the circular design of the ward as way to encourage patients to walk with measures of how far they had walked and encouraging phrases on the wall.

At Westbourne Green, the ward manager arranged for a Thursday exercise class on the day that therapies could not attend the unit. This encouraged patients to engage with rehabilitation exercises on a basic group level that was inclusive of all skill levels.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service completed monthly audits as part of an agreed schedule to ensure that care and treatment was continuously monitored and when areas of concerns were identified each unit could respond. This process was supported with the ward accreditation process, which was used to identify and make further improvements. Both wards had completed this accreditation and had recommendations for improvement with action plans in place to ensure they were addressed and there was consistency across wards.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. When a patient had impaired mental capacity, they were appropriately assessed, and capacity to consent was recorded appropriately. Staff understood consent was decision specific and they had access to support if they had any concerns.

During admission to the units, staff took social histories of patients, so that when best interest decisions were required, the person’s wishes, history and culture could be considered.