Chesterfield Royal Hospital 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 – This means we looked for evidence that the service and its staff involved children, young people, parents and carers and treated them with compassion, kindness, dignity and respect. We rated this key question Good. This meant children and young people were respected and valued as individuals; and involved as partners in their care.

Staff demonstrated a consistent commitment to privacy, dignity, and person-centred care, responding sensitively to each child and young person’s individual needs. They empowered them to understand, manage, and make informed choices about their care and treatment, actively involving them in care planning, assessment of risk, and treatment decisions wherever possible. Staff also anticipated children and young people’s needs well and regularly sought feedback to improve care quality and treatment outcomes.

Parents and carers were fully engaged, informed, and supported, which promoted a culture of partnership, respect, and collaboration. Staff monitored and audited children, young people, parent and carer involvement, which ensured services strived to meet their expectations. Children, young people, parent and carer feedback demonstrated that staff provided care that was not only kind and empathetic but also measurable, responsive, and consistent in impact, reinforcing a positive culture throughout the service.

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.

Description: We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

We scored the service as 3. The evidence showed a good standard of care.

Children and young people were involved in their care and treatment planning. They felt staff saw them as individuals, with their own personal preferences, needs and wishes. One young person told us, “They’re very, very good. They’re genuinely kind and always give me the time I need. Everything is at my pace, and that’s important to me.”

Staff built relationships with children and young people which were based on openness, honesty and trust. Staff supported them when in distress, and they responded promptly, with kindness and compassion.

Staff were discreet, respectful, and responsive when caring for children and young people. They provided space for individuals to discuss any concerns, give their views and opinions and contribute to decisions about their care and treatment. Staff demonstrated an excellent understanding of the individual needs of the children and young people they supported, including their personal, cultural, social and religious needs. Staff were responsive to requests and questions that individuals had and provided information in an appropriate manner and accessible format.

Staff demonstrated a person-centred culture, and provided kind, compassionate and dignified care. Staff maintained a consistently caring approach and always acted with professionalism and empathy, reflecting a positive and caring culture. Children and young people’s information was treated confidentially and shared only when needed, and with their consent.

Observations, and feedback from staff, children, young people, parents and carers provided strong evidence of a culture in which kindness, compassion, and dignity were embedded across the service. Staff were motivated, empathetic, and proactive in their care and approach, which fostered trusting relationships and consistently met expectations.

Description: We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We scored the service as 3. The evidence showed a good standard of care.

Children and young people were encouraged, and supported to be actively involved in their care, and treatment, with information delivered in ways they could understand and was regularly reviewed with them.

Staff demonstrated an excellent understanding of the individual needs of the children and young people under their care, including their personal, cultural, social and religious needs.

Children, young people, parents and carers were positive about staff and felt that they treated them as individuals and sought to understand their specific circumstances and needs. They felt staff worked effectively to promote engagement and deliver care in a way that supported them. For example, one parent fed back that staff ‘had always planned sessions to accommodate their work and (child’s) school’ and that this had both encouraged and supported their engagement and the positive outcome they felt had been achieved with their child. The service had received positive feedback from parents around interventions within education settings. Parents felt this was a more personalised approach that recognised how the requirement to attend a hospital setting could create barriers to engagement.

The service promoted equality, diversity, and inclusion among staff. Equality, diversity and human rights mandatory training was completed in staff’s induction and repeated throughout their employment. Training and awareness fostered an inclusive and supportive culture. Equality, diversity and human rights principles were effectively embedded which enhanced the child or young person’s experience, promoted dignity, respect and understanding across the service.

Information about treatment, rights, and complaints were provided in accessible, personalised formats, including easy-read materials and information in different languages. Staff encouraged the involvement of advocates, and ensured children, young people, parents and carers had timely access to all required communication resources whenever needed.

Description: We promote people’s independence, so they know their rights and have choice and control over their own care, treatment. and wellbeing.

We scored the service as 3. The evidence showed a good standard of care.

Children, young people, parents and carers felt confident, informed, and empowered to make decisions, and choices about their care. Staff supported them to make their own decisions about their treatment and amended approaches to reflect individual needs and preferences. Children and young people’s care and treatments were explained effectively, using a range of communication methods, ensuring that children, young people, parents and carers, made informed decisions, and were fully involved.

Staff worked to ensure that children, young people, parents and carers had ownership of their care and treatment and were active participants in decisions and choices about it. They supported children, young people, parents and carers to understand diagnoses and to understand and manage their care, treatment and condition.

Children and young people were encouraged to contribute to discussions and decisions about their care and treatment. In addition, we spoke with 6 parents and carers. They also told us that they felt involved in their child’s care, were able to contribute to discussions about it and had a voice in decision making. One parent told us, “They really do involve me in decisions about my child’s care. I feel included, and my views and opinions always feel heard.”

Staff promoted independence and recovery, providing opportunities for children and young people to take part in activities that built skills, confidence, and resilience. Day services delivered one to one or group confidence building sessions. The intensive home treatment team completed community engagement assessments which were designed to gauge how children and young people coped and interacted in community situations. Community assessments were repeated and young people, parents and carers had a debrief and progress update following each assessment. This supported and promoted independence and long-term treatment and recovery goals.

Description: We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

We scored the service as 3. The evidence showed a good standard of care.

CAMHS services had a crisis and urgent pathway for referrals that met the criteria and the child or young person could not be supported effectively by the core CAMHS team. This meant that children and young people identified as needing the urgent pathway were supported by the urgent care team. The urgent care team provided assessment and brief intervention to children and young people who presented with an acute mental health crisis. The urgent care team provided support between the hours of 0800 – 2200, 7 days per week, 365 days per year, an on-call medic was available to assess where needed following discussion with an on-call psychiatrist. Children and young people also had access to a dedicated mental health support line which was available 24/7, and a text support service.

CAMHS provided an intensive home treatment team (IHTT). The intensive home treatment team provided a more intensive and flexible service to children and young people who presented with high levels of risk, and who may find it hard to engage with the core CAMHS team and who may otherwise have required admission to Tier 4 (inpatient) placement. The intensive home treatment team could be offered as a ‘step-up’ from core CAMHS, or a step down from urgent care or specialist mental health inpatient bed to provide intensive mental health support.

Intensive home treatment was delivered by a multidisciplinary team, such as, mental health practitioners, therapists, psychologists, psychiatrists and specialist support workers, and included the child or young person’s current care team. This promoted best practice by ensuring consistency of practitioner working with the child, young person and their family. Appointments and interventions were delivered weekly, but this could be increased dependant on need.

CAMHS provided a day service which was directly commissioned by the East Midlands Provider Collaborative and funded through children’s mental health bed capacity funding. Day service staff provided an environment for young people to access as an alternative to admission to hospital. Children and young people who attended day services accessed a wide range of therapeutically informed sessions and received ongoing care with their CAMHS clinician whilst on site. Appointments, interventions and sessions were delivered multiple times throughout the week, and the service also offered enhanced staffing support for children and young people who presented with increased risk or complexities. This ensured that children and young people with more complexed needs could also access the service and receive much needed support.

Post initial assessment, the service had clearly defined referral pathways and support provision for children and young people diagnosed with a learning disability, eating disorder, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Staff were trained in conflict resolution and de-escalation techniques, calm, supportive approaches that reduced stress, anxiety, and distress. Staff supported children and young people to manage challenges independently and encouraged them to use coping skills, strategies and self-regulation. We reviewed 8 care records, and found evidence of up to date hospital, and communication passports for children and young people who needed them.

Description: We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

We scored the service as 3. The evidence showed a good standard of care.

Staff felt respected, supported and valued. They were positive about the service as a place to work and were proud about working for CAMHS. Staff described a caring and supportive culture. They praised managers and senior leaders within the service and gave multiple examples of how they had been supported through both personal and professional issues. One staff member told us, “You can go to managers at any time and they’re always there for you, they’re genuinely caring and can’t do enough for you. We’re all part of one big team; it’s a great place to work!”

Staff morale was positive. Staff acknowledged the pressures of their role but felt supported and empowered to deliver high quality care. Supervision and appraisal processes reviewed workload, caseload management and wellbeing. Staff appraisals included conversations about career development and development pathways were in place to support training opportunities. Appraisals and supervisions included discussions about career progression, and staff had opportunities to take on new responsibilities and apply for training. Staff received training focused on recovery orientated practice and trauma informed approaches. Staff sickness and absence rates varied across teams and staff groups but averaged at 5.83%.

Staff were supported and kept safe when they were lone working in the community. There were lone working policies and procedures to support this process including the use of risk assessments before carrying out home visits. Staff had access to a shared working app which meant that managers were always aware of where they were and check-ins completed. Staff carried personal alarms, and GPS tracking technology which supported safer community visits.

Leaders supported their staff and ensured they had access to a comprehensive range of wellbeing resources to ensure the safe and effective delivery of person-centred care. These included access to a 24/7 employee assistance programme, counselling and bereavement support, menopause support and men’s health groups, a dedicated organisational wellbeing team, occupational health, freedom to speak up service and human resource team. The psychology team supported staff with reflective practice sessions and debriefs and were also available on an ad-hoc basis when required. Managers facilitated flexible working patterns for staff, around health needs, or caring responsibilities.

Leaders encouraged regular breaks and promoted a culture where staff felt valued, supported and able to speak freely. Staff described leaders as visible, available and approachable. Staff had access to a purpose built health and wellbeing hub which included a gymnasium, changing and shower facilities. Therapists also provided massages for staff across the sites we visited. Managers supported staff to develop their skills and careers and encouraged and supported staff to access a band 5 development and talent management programme.

Managers demonstrated a strong commitment to supporting and enabling their workforce. By looking after staff health and wellbeing, making every effort in maintaining safe staffing levels, and recognising and developing staff, leaders enabled them to confidently deliver high-quality person-centred care.