Bradford Teaching Hospitals 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 good. At this assessment the rating has remained as good.

The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Patients were supported to mobilise on the ward, and the staff used feedback to develop and improve the service they provided. Patients were confident in the care that was being provided and felt able to raise concerns or share compliments when they wanted to. The service met the needs of all patients – including those with a protected characteristic. However, the patient voice was not always present in the care records we reviewed during the inspection.

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 2. The evidence showed some shortfalls. The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

In the care records that we reviewed, there was limited involvement of the patient in the care plan, particularly regarding specific individual risk. Although there was evidence of the patient being informed of their care and treatment plan, there was limited patient voice in creating their risk plans and care plans.

However, most patients and carers felt that they were involved and informed about their care. Staff told us they would discuss treatment with patients and provide information leaflets to support understanding.

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.

The service had implemented John’s Campaign, which aimed to encourage carers to attend outside of normal visiting hours to better support patients with dementia. Families and carers were encouraged to attend the ward to provide familiarity and reassurance to their loved ones. Staff told us they found carers coming in at mealtimes would help to encourage patients to eat as they felt less anxious around a family member.

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.

In the reception areas of both units there were information leaflets providing a range of information, including support available to carers, complaints and care and treatment. At Westbourne Green, these leaflets were also readily available in other languages, however staff at Westwood Park confirmed they had access to translation service when required.

Around the units there were also information boards about the importance of hydration, falls and pressure risks. At Westbourne Green there was also a ‘You Said, We Did’ display which had actions taken following feedback the ward had received.

Patient records were all electronic and laptops were used securely, always locked when a staff member moved away.

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.

In the 12-months prior to inspection, neither Westwood Park nor Westbourne Green received any formal complaints. Staff were responsive to feedback that they received from patients, families and carers and would use this to drive continuous improvement of the service. For example, at Westwood Park patients shared that they would like more access to outdoor areas, and funding was secured to develop a dedicated garden that was accessible for wheelchair users and those using mobility aids, with seating and flowerbeds. Similarly at Westbourne Green, in 2022 patients had raised that there was a lack of physiotherapy input, and the ward manager worked to recruit 3 new rehabilitation support workers and implemented additional therapies input on days where there were none.

Staff told us they knew how to escalate complaints appropriately, and we saw evidence that staff had responded to and received feedback from previous complaints. The units also completed friend and family test surveys and the results of these were displayed for staff and patients to read.

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.

Both units were accessible for patients with mobility issues. Westwood Park’s ward was on the ground floor and included an outdoor space which had been designed specifically to ensure access for all patients. Westbourne Green’s ward was on the top floor of the building, patients still had access to an outdoor space, and lift access to the ward, including during an emergency. Both wards had good access to mobility aids, and patients were encouraged to use them when appropriate.

The units had adequate access to medical cover and staff told us that they had good working relationships with the doctors, who were approachable and responsive.

In a review of delayed discharges in the last 6 months, it was found that most discharges were caused by therapy related delays for onward referrals and equipment, adult social care delays, and complex discharges. The same issues were faced by all three units in the under the Trust’s Intermediate Care bed base, which included St Luke’s Hospital which was not inspected as part of this assessment. The Trust was working with local authorities and the local integrated care board (ICB) to address these issues, review discharge pathways and the development of a step-down model to reduce delays.

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 had 100% compliance in their equality and diversity training at both units, and staff were aware of the importance of empowering individuals with protected characteristics. People working in services reflected the diversity of the communities they worked in.

Staff had a clear understanding of the individual needs of their patients, and records showed regular and detailed one to one time with their named nurse. When required they had access to specialist input for their patients.

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.

Staff supported patients to make decisions about their care and treatment, and their future, families and carers were also involved in these discussions, so that they were informed. If families had any concerns, staff worked to address these and support the patient.

The care records showed that patients had individualised goals in their treatment to ensure that discharge was achieved. While there was estimated timelines for patient’s stays on the wards, this was flexible and changed depending on patient need. There was also evidence of good communication with patients when do not attempt cardiopulmonary resuscitation (DNACPR) decisions were put in place.

Staff worked with other teams and organisations when needed, such as local authorities and social workers to ensure safe discharge for their patients.