North East London NHS Foundation Trust

On this page

• 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

Responsive – this means we looked for evidence that the trust met people’s needs. At our last assessment we rated this key question good. At this assessment the rating remained good. This meant people’s needs were met through good organisation and delivery.

The average length of stay at the service in October 2024 was highest on Kahlo and Titian wards, and lowest on Ogura and Picasso wards (the clinical decision units). Overall, there were 347 days of delayed transfers of care in the last 12 months across the wards, the highest on Monet ward. Managers noted that pressure on beds was very high, with out of area placements rising in the months prior to our inspection. Managers regularly reviewed length of stay for patients to ensure they did not stay longer than they needed to and work was underway to develop crisis houses to help support patients in the community. Patient transfers to acute and PICU wards were planned and at times that were appropriate for the patient and team.

Care plans generally reflected patients’ assessed needs, were personalised, holistic and recovery oriented. We found the care plans we sampled on Kahlo ward to be particularly holistic. Many patients told us that they did not feel involved in their care and treatment, and did not have copies of their care plans.

Although the trust provided patients with food to meet their dietary requirements, a significant number of patients interviewed across the wards expressed concerns about the quality and quantity of food.

The service could support and make some adjustments for disabled people and those with communication or other specific needs. For example, wards had rooms with wider doors which were more accessible for those in a wheelchair and easy read information was available if needed. Managers made sure staff and patients could get help from interpreters or signers when needed. Staff were clear about the need to be sensitive in respecting the needs of transgender patients ensuring they used the correct pronouns when referring to them.

Staff supported patients with activities outside the service, such as work, education and family relationships. The wards offered weekly programmes of activities provided by occupational therapists and other staff.

Most patients and carers told us that they did not know how to make a complaint about the service. However, many said that they would find out if they needed to. In the last 12 months, across the wards 32 formal complaints had been received, with the most common issues complained about being care, and staff attitude.

Staff carefully planned patients’ discharge and worked with care managers and coordinators to make sure this went well. Community care coordinators were invited to all ward rounds, either in person, or via video conferencing facilities. Home treatment team coordinators worked across the wards. They attended multidisciplinary team meetings and worked closely with the ward teams, community mental health teams and local authorities to ensure that there were no barriers for when the patient was ready to be discharged.

Relatives were invited to ward rounds when patients consented. Some relatives/carers said they wanted to be more involved in planning for discharge and after discharge.

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.

Staff developed individual care plans with patients which were reviewed regularly through multidisciplinary discussion and updated as needed. Care plans generally reflected patients’ assessed needs, were personalised, holistic and recovery oriented. We found the care plans we sampled on Kahlo ward to be particularly holistic.

Staff said that they involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. However, patients gave a mixed picture of being involved in their individual care plans. On some care records it was clear that patients’ views were included in their care plans using their own words. However, this was not always the case. Many patients told us that they did not feel involved in their care and treatment, and did not have copies of their care plans.

The service could support and make some adjustments for disabled people and those with communication or other specific needs. For example, wards had rooms with wider doors which were more accessible for those in a wheelchair and easy read information was available if needed. Managers made sure staff and patients could get help from interpreters or signers when needed.

The service provided a variety of food to meet the dietary and cultural needs of individual patients, for example halal and vegan options. Patients had access to spiritual and religious support, including support to observe festivals such as Ramadan.

Staff were clear about the need to be sensitive in respecting the needs of transgender patients. Staff were respectful in supporting patients and ensured they used the correct pronouns when referring to them.

The average length of stay at the service in October 2024 was highest on Kahlo ward at 171 days, and Titian ward at 162 days, and lowest on Ogura ward at 12 days and Picasso at 23 days.

Overall, there were 347 days of delayed transfers of care in the last 12 months across the wards. The highest was Monet ward with 197 days, and then Turner ward at 57 days. The trust advised that work was underway to develop crisis houses to help support patients in the community to improve flow. There was also a digital transformation programme aimed at improving inpatient flow. A review of the clinical decision unit model was also underway.

Staff supported patients with activities outside the service, such as work, education and family relationships. The wards offered weekly programmes of activities provided by occupational therapists and other staff. These included arts and crafts groups, exercise, and access to computers. On most wards patients said they would like to have more activities available to them.

Staff supported patients to stay in contact with family members, including visits to the service, and involvement in relevant meetings about their care.

Staff provided patients and relatives/carers with relevant information about the wards. Staff were able to provide easy read care plans and documents, and translations into other languages, for those who needed this. Some patients and relatives said that they would like to have more information about their care, and that it could be difficult getting accurate information from the ward especially when contacting wards by phone.

Most patients and carers told us that they did not know how to make a complaint about the service. However, many said that they would find out if they needed to. Information on how to complain was displayed in communal spaces and included in welcome packs.

In the last 12 months, across the wards 32 formal complaints had been received, highest on Picasso and Turner wards with 7 complaints each, and lowest on Knight with 2 received. Rodney ward had not received any complaints but had not been open for a full year. Of the 32 complaints, 12 were upheld, 15 were partially upheld, and 5 were not upheld. The most common issues complained about were care, and staff attitude. 86 informal complaints were received in the last 12 months, highest on Picasso with 22, and Ogura with 18, and lowest on Rodney and Knight wards with 4 received.

Managers noted that pressure on beds was very high. Out of area placements in October 2024 were at 51. At their highest they were at 52 in July 2024, and lowest in March 2024 at 15 and September 2024 at 16. There was no female psychiatric intensive care unit (PICU) ward available within the trust, but the trust worked with their immediate neighbour to access beds when needed.

Patients were moved between wards only when there were clear clinical reasons, or it was in the best interest of the patient. Staff did not move or discharge patients at night or very early in the morning. Patient transfers were planned and took place at times that were appropriate for the patient and team.

The wards had facilities to support patients with mobility needs, including wheelchair users.

Although the trust provided patients with food to meet their dietary requirements, patients across the wards expressed concerns about the quality and quantity of food.

Managers monitored the number of patients whose discharge was delayed, knew which wards had the most delays, and took action to reduce them. Patients did not have to stay in hospital when they were well enough to leave unless this was due to awaiting appropriate supported accommodation and residential placements.

Staff sought feedback from patients on the ward through questionnaires and regular meetings but acknowledged that they could do more to involve patients in the running of the service, to ensure that people most likely to experience inequality, had the best outcomes possible.

There was high compliance in staff training in equality, diversity and human rights across the wards.

Staff carefully planned patients’ discharge and worked with care managers and coordinators to make sure this went well. Community care coordinators were invited to all ward rounds, either in person, or via video conferencing facilities.

Home treatment team coordinators worked across the wards. They attended multidisciplinary team meetings and worked closely with the ward teams, community mental health teams and local authorities to ensure that there were no barriers for when the patient was ready to be discharged.

Relatives were invited to ward rounds when patients consented. Some relatives/carers said they wanted to be more involved in planning for discharge and after discharge.