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 our last inspection we rated this key question good. At this inspection the rating has remained good.

Good: This meant people’s needs were met through good organisation and delivery.

This service scored 71 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to

Patients and their carers told us they felt their care was well coordinated and staff worked well with them. They were encouraged to be involved in their care and treatment plan and knew who they could approach to request information from if needed. Staff had a good understanding of patient’s individual needs, and these were respected. The family and carers we spoke with said they had specific support for their own needs. They also said they were involved in the care planning process through multi-disciplinary meetings.

We observed staff engaging with patients in a person-centred way and adjusting their approach according to the patient’s needs. Information was displayed informing patients of different treatment, care, and therapeutic options along with how to give feedback on care. Care and treatment plans we reviewed evidenced patient involvement.

There were options for activities on each of the wards we visited. These were rehabilitation focused and encouraged patients to build daily living skills that would help them to move on. This included money management, using public transport, road safety and cooking. There were also leisure activities such as board games, film nights and local walks, which patients told us they enjoyed.

Patients were, on the whole, involved in their care plans, although this was noted to be of differing levels. We saw records that evidenced patients had access to one to one time with a named nurse or key worker. We did however, find at Asket House that due to lower staffing levels than the establishment, staff did tell us they found it more difficult to make time for one to one sessions.

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

When appropriate, staff ensured that patients had access to education and work opportunities. As part of the occupational therapy assessment, each patient’s individual short and long-term goals were explored, including those around self-care,leisureand productivity. Productivity included courses,volunteeringor paid work,where this was valued and meaningful to the patient. The occupational therapy team worked closely with the community rehabilitation teams, recovery college and voluntary services as well as community-based third sector providers to support patients toidentifyand explore opportunities. Examples of this within the service included several patients taking part in paid coproduction work, volunteering at a local temple, and attending and completing college courses.

Staff supported patients to maintain contact with their families and carers. We received mostly positive feedback from family and carers we spoke with as part of the inspection. They generally found staff to be friendly and approachable and were informed of plans relating to their loved ones treatment and care where appropriate. Three raised that communication from the wards could have been better at times, but all felt confident they would be informed of any significant developments.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Although staff generally made notifications to external bodies as needed, we found that safeguarding concerns were not always reported to the local authority, as advised by the safeguarding specialist team when staff sought advice from them regarding safeguarding concerns.

Information governance systems included confidentiality of patient records.

The service complied with the Accessible Information Standard.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

Staff made information leaflets available in languages spoken by patients.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress.

Quality Statement Score: 2. We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

Whilst the trust data received told us there were no complaints made to any of the 3 wards in the last 12 months, we did note when reviewing governance and team meeting minutes that Asket House had received 2 complaints during this time and Newsam Ward 5 had received 1 complaint. It was unclear if these complaints were made informally rather than escalated formally, but we were nevertheless concerned that complaints were potentially not being captured in trust data in order to identify learning and take action.

There were 18 compliments received in the same timeframe. Themes from compliments included progress of patients, staff attitude and good teamwork.

Patients knew how to complain or raise concerns. Information on how to complain was displayed on all the wards we visited, as well as in patient information packs provided when they were admitted to the wards.

Staff knew how to handle complaints appropriately. Staff we interviewed as part of our inspection, understood the complaints process both informal and formal and knew where to signpost patients to and how to support them.

Quality Statement Score: 3. We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met – for example, wheelchair users were placed in bedrooms at ground level or had access to lifts.

Staff made reasonable adjustments for patients, such as providing those with mobility issues with equipment including walking aids and shower chairs.

There was adequate medical cover day and night, a doctor could attend the wards quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

Staff ensured patients had access to post-discharge care – for example, S117 aftercare, community mental health services and crisis services. This included access to the specialist community rehabilitation teams.

Staff planned for patients’ discharge, including good liaison with care co-ordinators.

Delayed discharges were monitored by the trust as a percentage figure. We requested the number of delayed discharges for the 12 months prior to our inspection. At the time of our inspection Newsam Ward 5 had the highest numbers of patients deemed clinically ready for discharge at 24%.Asket House and Asket Croft were below 1%. Staff and leaders we spoke with told us that the main reason for delays in patient discharge was due to difficulties in identifying the correct placement, and then if one was identified, awaiting a bed in that service/placement. We were able to see that when patients were clinically ready for discharge, staff worked hard to identify the correct onward placement, in collaboration with the patient and if appropriate, their family/carers.

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

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights and training compliance was at 100% across all 3 wards.

Quality Statement Score: 3. 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 patients and their families/carers to plan ahead and make important and informed decisions about their future care, treatment and support. Family members were encouraged and supported to take part in discussions and decisions that reflected patient’s wishes, needs and preferences.

Staff provided support to patient’s preparing for discharge, addressing their individual needs to ensure a smooth transition. They supported patients to access appropriate housing, and aftercare provision. Staff worked collaboratively with housing providers and escorted patients and their family members to view potential accommodation prior to discharge. This ensured patients who were approaching discharge were happy with the proposed accommodation, and could continue their recovery journey in a safe, and supportive environment which fostered the continued building of independence.

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