Dorset Healthcare University 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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question as good. At this assessment the rating has remained the same.
Patients were treated with kindness, compassion and respect. Staff promoted patients' privacy, dignity and human rights and took time to understand what was important to them. Care and treatment reflected patients' individual needs, preferences and circumstances. Patients, families and carers were involved in decisions about care and treatment and were supported to maintain independence, choice and control wherever possible. Staff responded to people's needs with empathy and worked collaboratively to support positive experiences and outcomes.

This service scored 85 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

The service demonstrated a strong caring culture where people were treated with kindness, compassion and respect. Throughout interviews, case discussions and record reviews, staff consistently spoke about people in a warm, respectful and person-centred way. Staff demonstrated detailed knowledge of the people they supported and many had developed long-standing professional relationships with individuals and their families. This enabled them to understand people's histories, preferences, aspirations and support needs.
During the inspection, we observed a discharge planning meeting involving a person preparing to move from inpatient care into supported living. We observed interactions between staff and people and saw that staff engaged with them in a supportive and respectful manner. Staff ensured the person was introduced to attendees, supported to understand the purpose of the meeting and encouraged to participate in discussions. Risks, restrictions and support arrangements were explained clearly, and staff demonstrated a commitment to ensuring the person remained central to decisions about their future care and support.
Staff described examples of going beyond expected service boundaries to ensure people received the support they needed. This included supporting people to attend healthcare appointments, maintaining engagement with people who were reluctant to access healthcare interventions and working flexibly with families during periods of crisis. One practitioner spent more than two years building trust with a person who was unable to tolerate blood tests, enabling them to eventually access essential healthcare monitoring.
Carers consistently provided highly positive feedback about the service. Families described staff as caring, approachable, responsive and compassionate. Carers reported that staff listened to their concerns, involved them in decision-making and worked alongside them to achieve the best outcomes for their relatives. Several carers stated that they had never needed to make a complaint about the service and spoke positively about the relationships they had developed with team members. Families frequently described staff as "wonderful", "supportive" and "always there when needed". One carer described the learning disability nurse supporting their family member as "incredible", whilst another stated they could "only speak highly" of the support they had received from the team. The teams produced detailed and comprehensive end of life plans so people could be assured their wishes would be met.
Staff demonstrated respect for people's dignity, privacy and beliefs. They described always seeking permission before entering people's homes and adapting support to reflect individual values, culture and religious beliefs. For example, staff were mindful of the wishes of a person religious beliefs and adapted their communication and engagement accordingly.

The service treated people as individuals and made sure young 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.

The service demonstrated a strong commitment to delivering personalised care. Care records reviewed reflected people's individual histories, communication needs, strengths, preferences and support requirements. Records included personalised documents such as wellbeing plans, care passports and "All About Me" profiles, supporting staff to understand the person beyond their diagnosis.
The quality of care planning reviewed within the Dorchester team was particularly strong. Care plans included detailed life histories, personalised interventions, comprehensive risk formulations and evidence of family involvement. Staff consistently demonstrated a detailed understanding of the people they supported and were able to describe how individual experiences, relationships and life events influenced current needs and goals.
Staff adapted their approaches to reflect individual interests and preferences. Examples included using a person's interest in rollercoasters to support engagement with care planning, incorporating music and dance into physiotherapy interventions and developing personalised communication approaches. A "This Is Me Day" had been arranged for one person, bringing together professionals and care providers to improve understanding of their communication style, preferences and support needs.
Carers reported that staff took time to get to know people as individuals and understood what was important to them. Families described support as personalised, flexible and responsive, with staff adapting interventions to meet changing needs and preferences.
 

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.
The service actively promoted independence, choice and control. Staff worked collaboratively with people and their families to identify goals, develop skills and support greater independence whilst balancing safety and risk management.
People were offered choice regarding how they engaged with services, including appointment times, locations and methods of communication. Care planning was completed through the My Wellbeing Plan, which incorporated the views of the individual, carers and professionals and focused on outcomes that were important to the person.
We spoke with 11 staff members ,9 carers and reviewed 9 patient files There was evidence of positive risk-taking throughout records reviewed and during discussions with staff. Examples included supporting people to learn bus routes, access community activities, develop healthy living skills, manage daily routines and move into more independent living arrangements.
The service worked closely with social care to support young adults transitioning from family homes into more independent living through dedicated transition houses. These services focused on developing practical skills, confidence and independence whilst ensuring appropriate support remained available.
Carers described positive outcomes resulting from this approach. Families reported improvements in independence, community participation, social opportunities and quality of life. Examples included individuals becoming more involved in shopping, preparing drinks, attending activities, developing routines and accessing day opportunities. Carers described staff as working hard to ensure people remained connected to their communities and support networks.
Where people lacked capacity to make specific decisions, staff described using Mental Capacity Act principles and Best Interest processes to ensure decision-making remained person-centred and least restrictive.
 

The service 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.

The service demonstrated flexibility and responsiveness when people's needs changed or additional support was required. The Intensive Support Team provided crisis support across Dorset and staff described responding rapidly to people experiencing emotional distress, escalating risks or potential placement breakdowns.
The service ensured people had access to support outside normal operating hours. The Intensive Support Team operated between 8am and 8pm, seven days a week, providing rapid assessment and intervention for people experiencing increased distress, deteriorating mental health or potential placement breakdown. Outside these hours, people could access NHS 111, the Trust's 24-hour mental health crisis service, The Retreat and Front Room services across Dorset. These services provided safe and supportive environments where people could access support from mental health practitioners and Experts by Experience during periods of emotional distress or crisis. Staff described working closely with these services to ensure people with learning disabilities were able to access support when required and were not excluded from mainstream mental health pathways.
Carers were particularly positive about the availability of support during periods of crisis. One carer explained that their relative no longer contacted emergency services when distressed and instead contacted the Community Learning Disability Team directly because they knew support would be available. Families described staff as accessible, responsive and proactive in preventing situations from escalating. Carers valued knowing that support could be accessed both during the day and through out-of-hours services when required, providing reassurance and helping people remain safely within their communities.
Families consistently described the service as responsive during periods of difficulty. Carers reported that concerns were acted upon quickly and that staff coordinated effectively with providers, commissioners, hospitals and other agencies to maintain safety and stability. Staff also remained involved during hospital admissions and discharge planning, helping to ensure continuity of care and smooth transitions back into the community. For example, they ensured patients in a local hospital had easy read information and menus so they could make real choices about their care and treatment.
The service demonstrated a commitment to reducing barriers to healthcare. Staff supported people to attend appointments, engage with treatment and access specialist services. Examples included supporting attendance at hospital appointments, implementing reasonable adjustments and undertaking long-term engagement work to enable people to access essential healthcare interventions.
Overall, evidence demonstrated a responsive service that adapted to people's changing needs, promoted accessibility and inclusion, involved people and carers in decisions about their care and provided coordinated support to help people achieve positive outcomes.
 

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.
Staff consistently described feeling supported by their managers and colleagues and spoke positively about the culture within the service. During discussions and staff forums, staff reported good management support, approachable leaders and an open culture where they felt able to raise concerns, seek advice and discuss challenges within their work.
The inspection identified a stable and experienced workforce. Community teams reported low staff turnover, with many staff remaining in post for over ten years. All staff we spoke with told us of their high levels of satisfaction working at the service.

Leaders demonstrated a commitment to supporting staff wellbeing. Teams were provided with two hours of protected wellbeing time each month which staff could use for activities chosen by the team. Examples included team breakfasts, bird bingo and wreath making. Staff reported positive engagement with these activities and advised that medical staff also participated, helping to strengthen team relationships and morale.

Staff had access to regular supervision arrangements. Clinical supervision was provided every two months and management supervision every six weeks. Staff described supervision as supportive and valued opportunities to discuss clinical practice, complex cases and professional development.
The service supported staff to develop and maintain specialist skills through access to a wide range of training. Staff described receiving training in areas including epilepsy, postural management, autism, trauma-informed practice, personality disorders, positive behaviour support, conflict resolution and breakaway techniques. Seven members of staff had completed safe holding training to support safe practice where restrictive interventions may be required.
Robust arrangements were in place to support staff safety and wellbeing whilst lone working. Staff described the use of technology, staff safety checklists, designated contact arrangements, safety words, dynamic risk assessments and escalation to joint visits where risks were identified. Staff advised they would not routinely undertake visits alone where risks were known and additional support could be arranged where required.
Staff demonstrated pride in their work and passion for supporting people with learning disabilities. During the inspection, teams were observed to be collaborative, supportive and committed to achieving positive outcomes. Staff described themselves as a close team of experienced practitioners who demonstrated confidence in their roles whilst remaining open to challenge and learning. Staff consistently spoke positively about colleagues and described feeling valued within their teams.

leaders demonstrated active recruitment efforts and described how they were attracting applicants from other services. Staffing levels were managed through oversight of caseloads, allocation processes and multidisciplinary working, helping to ensure staff were supported to meet the needs of people receiving care.