North East London 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

Caring

Caring – this means we looked for evidence that the trust 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 remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Staff were passionate about delivering high quality care to patients. Staff were discreet and responsive when caring for patients, respecting their privacy and dignity. Most staff took time to interact with patients and those close to them in a respectful and considerate way.

People we spoke to felt involved in their care planning. Many appreciated that the nurses discussed treatment options with them and adapted care plans to suit their needs. Staff we spoke to understood peoples’ strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Staff considered equality, diversity and inclusion matters affecting their local population regularly during their team meetings.

Staff demonstrated a clear and detailed understanding of the individual needs of the patient and potential risks and how these should be managed or mitigated.

Staff wellbeing was frequently discussed in team meetings. All senior managers were aware of the need to promote staff wellbeing.

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.

The trust was exceptional at treating people with kindness, empathy and compassion and respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

We spoke to 38 patients, and 7 carers/relatives and received 22 comment cards. The district nursing and specialist teams were widely appreciated by the people we spoke with. They commented that staff treated them with kindness, dignity, and respect. The majority of patients, families and carers we spoke with were very satisfied. The service was generally seen as excellent, with nurses who demonstrated high levels of professionalism. The majority of people using the service praised the compassion and helpful nature of the nurses.

Staff were passionate about delivering high quality care to patients. Staff were discreet and responsive when caring for patients, respecting their privacy and dignity. Most staff took time to interact with patients and those close to them in a respectful and considerate way. Staff supported patients to access other speciality teams. The majority of staff knew patients well and could describe their needs and preferences. Staff were committed to helping patients recover or manage long term conditions.

We observed staff delivering care. Staff had a clear and very detailed understanding of the individual needs of the persons and a good understanding of potential risks. We observed district nurses speaking kindly and respectfully to patients while carrying out their treatment. They engaged with patients around their wider health and social needs, listening and encouraging people to tell their life stories and share personal histories. For example, we observed a Tissue Viability Nurse (TVN) consider their patients holistic needs outside the ‘task’ at hand by engaging in conversation about other aspects of their life and other health appointments. Staff had a holistic view of their patients, not confined to their current clinical treatment.

Overall, the trust treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People we spoke to felt involved in their care plans. Many appreciated that the nurses discussed treatment options and adapted care plans to suit their needs. People told us they knew how to give feedback about their care and were involved in planning their care, support and treatment needs. For example, people who used services in Basildon, Brentwood and Thurrock teams felt they were supported to have choices and to make decisions about their care, treatment and wellbeing. People felt included ‘all the way’, with some giving examples of how nurses had discussed with them the different methods of treating their wounds.

However, just over 15% of the people we received feedback from commented that communication in some teams could be improved. Some patients in the London teams reported there was an ongoing language barrier between them and their nurse as they did not share a language. This meant they could not always understand each other. Staff did not always book interpreters for appointments and had to reply on relatives. Some staff confirmed that they did not always use language services or interpreters. Following our inspection the trust introduced measures to monitor and improve the use of language services.

Some people reported a lack of consistency in care in the Havering district nursing teams, with patients, at times, having to remind staff what was in their care plan. We shared this feedback with the trust. They told us that some people had multiple care plans for different conditions and a handover document was being developed to simplify information sharing and to ensure clinicians had access to the most up to date care information for their patients.

Staff we spoke to understood peoples strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Staff considered equality, diversity and inclusion matters affecting their local population regularly during their team meetings. Staff were also able to consider how equality, diversity and inclusion might impact on their interactions with individual clients. We saw staff share information and discuss how they might respond, depending on culture or religion when in attendance after a death.

We observed consistently meaningful interactions between staff and the people they were caring for.

The trust promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People commented that they were well-informed about their care. Many patients expressed satisfaction with the information they were given about their treatment, progress and prognosis. Many appreciated that the nurses adapted care and treatment to suit their needs, highlighting a collaborative, personalised approach to care.

People’s care plans reflected their personal, cultural, social and religious needs.

The trust 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.

We observed home visits and specialist clinic appointments. Staff treated patients and their families with compassion, respect and kindness. Staff demonstrated a clear and detailed understanding of the individual needs of the patient and potential risks and how these should be managed or mitigated.

Specialist teams and services worked well with district nurses to provide holistic care.

The trust cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff wellbeing was regularly discussed in team meetings. Havering and Barking teams had access to a psychologist to support staff resilience and wellbeing. All senior managers were aware of the need to promote staff wellbeing. Senior managers in the Essex teams used their mental health clinical experience to facilitate debriefing for complex cases.

Patients and carers were aware of nurses and clinics busy schedules. They appreciated staffs’ kind, helpful approach and positive attitudes.

Staff at the Cranbrook and Loxford district nursing team felt that senior leaders had not listened to their concerns regarding recent service changes. Staff raised concerns that they often worked out of hours to complete their documentation and felt stressed. There were also difficulties in accessing appropriate and affordable parking at the team base. Following our inspection the trust put additional measures in place to engage and listen to staff including a regular leadership meeting for staff to be able to raise concerns, a nursing improvement group and a demand and capacity review to report by April 2025.