Sheffield Children's NHS Foundation Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

During this assessment we saw good interactions between staff and young people which took their individual needs into account, however staff were not following the trust search policy when young people returned from leave.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Carers told us staff were very kind and caring and respected their relative’s privacy and dignity. Young people felt in control regarding the amount of parental involvement in managing their care and support. Young people said that staff were kind and compassionate but that some new and temporary staff were not always introduced to them and that name badges were often tucked into their pockets, so they were not easily identifiable.

Several young people on Sapphire Lodge told us that they felt the staff spoke disrespectfully to them and arbitrarily picked up on things to chastise them for.

Staff we spoke to told us that caring and compassionate care is embedded in everything they do. We were told about one initiative whereby the estates department had worked with the clinical team to develop a sensory board to meet the specific needs of one young person.

Staff understood the individual needs of young people, including their personal, cultural, social and religious needs.

Independent advocates had witnessed staff members on Sapphire Lodgespeaking dismissively, coldly and rudely to young people on the ward. They told us that when young people had raised concerns during ward rounds or via emails to managers about how staff had treated them, they were not believed so their allegations were not investigated. The advocates also raised concerns of the increasingly hostile attitude towards them on Sapphire Lodge. They told us managers had ignored emails they had sent on behalf of young people they were representing.

We observed staff interacting with young people in a positive, caring and professional way. For example, on Ruby Lodge and the repurposed 136 suite, we witnessed excellent, caring, compassionate interactions between staff and young people. Staff had clear knowledge of the young people’ preferences and communication needs.

We received feedback from carers who told us that they were happy with the way staff within the service provided care that suited their carers member’s individual needs, and that staff knew them well.

Young people and carers were aware of the complaints process. However, some carers with family members on Sapphire lodge felt that complaints were not always dealt with in a timely and effective manner.

Staff treated young people as individuals with individual care plans tailored to their needs. This included the use of positive behaviour support plans and communication plans. Staff ensured young people had access to interpreters and external services to support physical health needs and dietary requirements.

We observed staff treating young people as individuals and delivering care according to their specific plans. We saw staff adapting their communication styles to meet young people’ individual communication needs.

We reviewed 7 care plans that were person-centred. Staff had developed individualised care plans dependent on the young person’s spiritual needs, physical health needs and mental health needs. Managers used feedback from young people and carers to ensure that plans were personalised to their needs. Minutes from community meetings and Your Voice meetings evidenced that staff asked young people their views about the safety of the ward environment, restrictions and other improvements that could be made to the service.

Young people and carers told us young people had access to a range of activities. Staff supported and encouraged young people to maintain relationships with the people who mattered to them. Staff supported young people to access cultural and spiritual support. One young person told us that staff had helped them progress to a point that they were able to attend their regular mixed martial arts gymnasium. Carers had an awareness of the complaints process. Carers could meet with the doctor and ask questions about their loved one’s medication.

There were 'Your Voice' meetings held within the service which gave young people an opportunity to discuss the activity schedules on each lodge and the wider hospital site to tailor them to everyone’s needs and preferences. These meetings were also an opportunity to discuss any restrictions, such as access to areas, restricted items and any other topics that were of interest on the lodges. There was suggestion boxes situated around the lodges and wider hospital complex, with ‘You said, we did’ display boards often posted alongside them.

Carers were involved in the young person’s care, where consent allowed. Carers told us they were invited to join multidisciplinary team meetings and received regular updates of the young person’s care on a daily or pre-agreed timescale via telephone calls, video calls as well as visiting, however we received feedback from carers regarding Sapphire Lodge, which stated communication from staff was poor and they didn’t receive regular updates regarding the on-going care of the young person.

Staff told us they could access a range of training appropriate to their role within the service, this included Oliver McGowan, non-violent resistance and eating disorder.

Staff promoted young people’s independence and enabled them to have choice and control over their own care, treatment, and activities. We observed staff supporting young people to stay connected with their carers and friends.

We observed information boards on the lodges with various posters, including how to access advocacy, therapies that were available, local services in the area, helpline numbers, how to make complaints posters and ward specific activities.

We observed there was a lack of activities available on the actual lodges themselves and a lack of flexibility with the times of activities, particularly at night time and weekends. However, young people had access to the activities off the lodges, such as art therapy suite, gymnasium, pool and an onsite school.

Managers undertook regular audits, reviews, and meetings to ensure oversight over young people’s care and treatment. These were not always effective as concerns raised by young people on Sapphire Lodge were not always believed and as such, not investigated.

Young people had access to a range of specialists. These included occupational therapists, psychologists, and a dietician.

We looked at 9 care and treatment records which included detailed and individualised positive behaviour support plans in order to support and maximise young people’ independence, choice, and control.

Carers felt that staff met the immediate needs of their relatives.

Young people felt that staff were visible on the lodges and were able to meet most of their immediate needs. However not all of the young people on Sapphire lodge felt staff meet their needs due to being too busy.

Staff used several techniques to identify young people’ needs and preferences. Staff told us they always knocked on young peoples’ bedroom doors, and ensured female staff were assigned to supporting female young people with their personal care. Staff demonstrated a strong understanding of restrictive interventions and practice, referencing both blanket and individual restrictions and individual care plans. Plans detailed what the risks were and why restrictions were needed, such as a lack of danger awareness. Restrictions were regularly reviewed to determine if they were still required.

Staff told us there were clear processes in place to deal with young people’s immediate needs, particularly when they were in pain, discomfort, or distress. Staff were trained and knowledgeable in the use of grounding techniques and coping strategies.

We observed some positive interactions between staff and young people.

Staff spoke with us about the young people they cared for in a caring, positive and professional manner.

On Ruby Lodge, staff were aware of each young person’s individual needs and preferences. The interactions we witnessed between staff and young people and their carers were very positive.

Records showed that staff undertook training in moving and handling, resuscitation, infection prevention and control, personal safety and conflict management, equality, diversity and human rights.

Managers told us they ensured staff had access to support for their own health and wellbeing; this was confirmed by staff we spoke with.

We were told about wellbeing sessions and how managers and leaders checked in with staff during team meetings and supervision.