Leeds and York Partnership NHS Foundation Trust

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• 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

This means we looked for evidence that the service met people’s needs.

At this assessment we rated this key question as good.

At this assessment we rated responsive as good. Staff managed beds well. A bed was available when a patient needed one. Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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 service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

All young people had a care plan. Care plans were individualised and showed evidence they had been written with the young person’s input. We saw more specialised care plans were created by the relevant teams where required, such as speech and language therapy, psychology, and occupational therapy. Young people had access to art therapy at Red Kite View and drama therapy at Mill Lodge.

We also saw carers being supported through family therapy sessions.

Those young people who required them had nasogastric feeding care plans.

Staff carried out capacity assessments when required and supported young people to make decisions. They held community meetings which supported young people to have a say in the day to day running of the ward.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Young people had access to education facilities. Education happened during school term time only which resulted in some of the young people feeling there was less to do in the holidays. At the time of our assessment, it was half term, but young people and carers gave positive feedback about the education provided. We saw examples where young people were still completing work set by their own school and working towards qualifications.

Staff supported and encouraged young people to maintain contact with their families and carers. Family contact could be facilitated on the ward in a designated visiting room or young people with escorted or unescorted Section 17 leave could access local community facilities.

We did not see evidence of young people accessing spiritual support, but the provider had a chaplaincy provision which was available through self-referral or referral by staff.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed, including local authority safeguarding alerts, and to commissioners. CQC received appropriate notifications where necessary from the service. Staff ensured carers, families and commissioners were regularly updated about the young person’s progress.

Staff ensured that young people could obtain information, for example, on treatments, local services, their rights and how to complain. This information was available throughout the service on notice boards. Staff made information leaflets available in languages spoken by a young person and access to translation and interpretation services was provided if this need was identified.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

There were 9 formal complaints made to the service in the 12 months prior to assessment. The main themes identified in those complaints were poor communication (6 complaints) and poor care (6 complaints). One complaint had been withdrawn, 1 was partly upheld, 1 had not been upheld and the others were still being investigated at the time of our assessment. Red Kite View had received 7 complaints and Mill Lodge 2. No complaints were referred to the Ombudsman.

Most young people and their carers told us they knew how to complain or raise concerns and did so mostly verbally, at the time the issue occurred, and these were resolved quickly. They told us they felt complaints would be taken seriously. When young people and their carers complained or raised concerns, they received feedback, and most people felt that their concerns had been resolved by staff.

Staff knew how to handle complaints appropriately and protected young people who raised concerns or complaints from discrimination and harassment.

The service recorded 47 compliments in the same time period. 26 of these were related to the general adolescent ward at Red Kite View, 5 related to the PICU and Mill Lodge received 9 compliments. Most of these were in the form of cards from young people, carers and staff who had previously been on the wards.

The service made sure that people could access the care, support and treatment they needed when they needed it.

The trust ensured young people could expect their care, treatment and support to be accessible, timely and in line with best practice, quality standards and legal requirements, including those on equality and human rights. This included making reasonable adjustments for disabled people, addressing communication barriers and having accessible premises.

Staff supported young people to access specific cultural and spiritual support where this was relevant, and made reasonable adjustments for people, for example those with mobility issues were assessed and provided with walking aids and shower chairs.

Staff ensured young people had access to post-discharge care. Staff planned for young peoples’ discharge, including liaison with community teams. There was also evidence that staff had planned gradual discharges to ensure the young people were ready for discharge prior to leaving and that ongoing support was provided after the young person had left. For example, we saw one meeting with carers where a discharge was agreed but the young person was already on home leave, community teams had engaged with the family and the young person would remain on leave until their formal discharge date. Staff and carers agreed this would provide them flexibility for the young person to return quickly if a discharge became unsuitable.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

All the young people we spoke with felt they were treated fairly, and they were actively involved in planning their care. No concerns were raised regarding discrimination and staff made every effort to ensure reasonable adjustments were in place to support equity in experience and outcomes.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Young people could attend community meetings to share their views and there were advocates for young people. Young people told us they felt they could raise concerns.

Staff were 98.5% compliant in mandatory equality and diversity training.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported young people to make decisions about their care and treatment and their future. Staff created personalised care plans to account for the young person’s needs, wishes and feelings. However, we found two instances where care plans did not reflect actions arising from risk assessments.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of young people with complex needs.