Leeds and York Partnership 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 inspection we rated this key question good. At this inspection the rating has remained good.

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. We found that staff knew patients well, took an interest in them in a genuine way and listened to their thoughts and opinions.

Staff supported patients to understand and manage their care, treatment or condition. This included patients chairing their own multidisciplinary meetings where they felt comfortable to do so, or staff supporting them with this if not.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. This included substance misuse services, local volunteering opportunities and local colleges for education.

Patients said staff treated them well and behaved appropriately towards them. Patients gave positive feedback regarding the staff on all 3 wards we visited. Patients told us that staff were kind, caring and treated them well.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. Staff ensured that patients had access to appropriate spiritual support. We saw evidence of celebrations of different cultures such as Chinese New Year, Ramadan and Easter. Events were planned around these celebrations and photos were displayed on the wards of patients and staff celebrating together. There was access to local religious leaders if patients wished to speak to them and staff were able to facilitate visits either to the ward or local community if patients had leave from the wards.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences. Staff we spoke with told us they felt confident to do this, and felt that when they had done this, they had been listened to and appropriate action taken.

Staff maintained the confidentiality of information about patients.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure 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 made adjustments for disabled patients – for example, by ensuring disabled people’s access to premises and by meeting patients’ specific communication needs. They had developed an easy read document for patients to complete in relation to patient reported experience measures (PREMS). This allowed more patients to be involved in providing feedback on their experience of the service.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. We saw information on how to complain was displayed on the wards and was also in the welcome packs given to patients prior to, or on admission.

Staff made information leaflets available in languages spoken by patients and staff told us they had easy access to interpreters and/or signers.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients we spoke with, and their carers/family felt very well informed about their care and treatment. Patients described that they had received information about their medicines and said they were involved in reviews about their care and treatment. Patients reported that, where appropriate, their family, carers or loved ones were involved in meetings about their care.

As part of our data request following our on-site inspection we requested the minutes of the last 3 community meetings on each ward and patient and carer feedback received in the 6 months preceding our inspection. We also requested 5 examples of changes made as a result of patient feedback on the rehab wards in the 12 months prior to our inspection. In the main, community meetings appeared to be happening on a regular basis. The meeting minutes reflected patient views and suggestions, but the outcomes and actions were not always documented, and some suggestions were noted but no follow-up or actions were documented at the next meeting. Examples of suggestions included trips to local parks, a request for a radiator and Easter celebrations. We did, however, see lots of good examples of changes made as a result of patient feedback across all 3 wards. Examples included, improved hot water flasks for patient drinks, improvements to the patient dining room to improve mealtime, and the purchase of board games that patients had shown an interest in.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. 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.

All patients we spoke with told us that staff quickly responded to them when they needed something. They told us staff always listened to them and tried to reduce any distress they may have experienced.

Staff identified and responded to changing risks to, or posed by, patients. We saw that patients had person centred care plans that supported staff to understand how best to respond to their needs. Although these were not always updated. Staff on all 3 wards were familiar with the patients they were caring for and were able to tell us about their specific needs and how to manage these.

The service had access to the on-call rota that clearly showed medical support, senior management, and ward management availability. We discussed handovers and safety huddles with ward staff and managers and found that peoples’ immediate risks and needs were addressed and discussed.

Patients on the wards had access to call bells when they needed immediate assistance.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. Staff received de-escalation training as part of their prevention and management of violence and aggression training. The staff we spoke with told us that they would always attempt to verbally de-escalate an incident before resorting to physical restraint. Physical restraint had not been used in the service in the 12 months preceding our inspection, although we would not expect to see high levels of restraint in this type of service.

Quality Statement Score:3. We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported and valued. We received positive feedback from staff and leaders about the wards and the trust being a supportive place to work, with good access to staff well-being initiatives and flexible working arrangements. Staff we spoke with confirmed their workload was manageable and they felt safe in their place of work.

Staff had access to support for their own physical and emotional health needs through an occupational health service.

Staff appraisals included conversations about career development and how it could be supported. Although we found staff appraisals were not always completed.