Cornwall 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

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

Good: Staff treated people who used services with compassion and kindness. They respected people’s privacy and dignity. They understood the individual needs of people who used services and supported them to understand and manage their care, treatment or condition. Staff involved people in care planning and risk assessment and supported people to increase their independence.

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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. They treated colleagues from other organisations with kindness and respect.

We spoke to 14 people who used services. All of them spoke positively about the staff and told us staff were kind, empathetic and friendly. Some people named individual staff members as being particularly helpful, supportive and caring.

We observed several staff interactions with people who used services, including a first assessment, clinic appointments and checking in at reception. In all instances, staff were caring, professional, and kind. Staff put people at ease, gave them information about their care and answered any questions supportively.

We observed an initial assessment that took place over the telephone. Initially the person being assessed was distressed. The assessing staff member asked if it was an appropriate time for the assessment to take place and explained what was involved. They were patient and gave the person time to speak and full answer questions, leading to the person being assessed feeling calmer. Staff displayed empathy and strong active listening skills.

During 4 depot clinic appointments we observed, staff engaged positively with people who used services. They communicated clearly and interacted in a professional and supportive manner.

We observed staff in the adult community mental health service spoke respectfully and compassionately about people who used services, and their families. We reviewed 20 care records and in each one, staff used non-judgmental language.

In the 12 months prior to our inspection, staff in the adult community mental health service received 206 nominations for the trust’s Living Our Values Awards. Of the 206 nominations, 114 were for staff allocated to ‘countywide community mental health’.

All staff, managers and senior leaders spoke about colleagues and staff from other organisations with kindness and empathy about the pressures different teams and services faced.

The service treated people as individuals and made sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service delivered care and treatment in ways that met people’s individual needs and preferences. Most staff told us they planned visits at times and locations that best suited the people they supported. One person we spoke to told us their key worker often took them out in the car as they had limited mobility, and their key worker knew they benefitted from time outside their home.

Care was planned to meet people’s individual goals and aspirations. In the early intervention team (EIT) East, some staff told us about how they supported people with opportunities that were related to their previous careers which they hoped to return to once well enough.

We spoke to 14 people who used services and 3 carers. Two people told us reception staff knew them by name, which made them feel less anxious when attending appointments. Most people told us they had helpful keyworkers who tailored support for them.

The service promoted people’s independence, so they knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff in the adult community mental health service empowered people to be as independent as possible. There was a range of activities and interventions staff supported people to access, which increased people’s independence. For example, people were supported to access employment support through the individual placement and support service (IPS). IPS is a model of supported employment specifically tailored for people with serious mental illness that helps promote recovery through obtaining jobs that align with someone’s strengths and preferences.

Staff supported people who used services to identify what they felt they would like help and support with. Some staff told us this could mean anything from supporting someone to brush their teeth every day, to being able to walk their dog or return to employment. They told us they were led by whatever the person wanted to achieve. Some staff told us about work they had done with someone who lived on the Isles of Scilly and wanted to be able to use the ferry to get to the mainland. Staff worked with them to slowly increase their confidence with travelling, and they could now use the ferry.

The service gave people choices about the care and treatment they received. For example, we saw in one person’s care record that medical staff had advised medicines to help them. However, it was noted that the person wanted to try non-pharmaceutical options first. Therefore, staff supported them with other treatment options to help them successfully manage their condition.

The service encouraged people to take control of their wellbeing. People we spoke to who used services told us staff always made it clear it was their choice to attend appointments and would gently encourage them to engage in their care and treatment without making them feel forced to engage.

The service listened to and understood people’s needs, views and wishes. They responded to these in that moment and acted to minimise any discomfort, concern or distress.

We observed reception staff in a community mental health team (CMHT) interact in a friendly and professional manner with everyone who attended for an appointment. They noticed one person was early for their appointment and seemed distressed. They contacted the person’s key worker, who immediately attended reception and supported the person discretely, to make them feel less distressed.

We observed a phone call to a CMHT duty worker, in which staff displayed an empathetic and compassionate approach when supporting someone experiencing a decline in their mental state. Staff were able to successfully support the person in a caring and compassionate manner, including discussing any current risks and how to reduce them.

Daily huddles enabled staff to identify and respond to people’s changing needs or risks. Most staff told us they were encouraged to discuss anyone on their caseload during multidisciplinary meetings, not only those presenting a higher level of risk. This meant staff could agree any necessary actions to support people in a timely manner rather than waiting until someone’s mental state declined.

We spoke to 14 people who used services. One person told us their key worker increased the frequency of visits when their mental health declined and had recently requested a medical review for them after identifying they were struggling more than usual. Most people who used services told us they were able to seek additional help or support when needed and found the duty workers useful. However, 1 person told us they did not find duty staff helpful.

The service cared about and promoted the wellbeing of their staff. Some teams in the adult community mental health service had experienced staffing challenges and managers and senior leaders focused on supporting staff wellbeing to enable them to continue to deliver person-centred care.

Staff told us they felt respected and supported in their roles. Community mental health teams (CMHT) and the mental health access and brief treatment team (MHABTT) had clinical leads who provided clinical expertise and oversight, whilst the team managers focused more on staff wellbeing, training and supervision. Team managers all told us how important they felt their team’s wellbeing and happiness was. All staff spoke positively about their managers, and how supportive they found them.

Most staff and managers told us about a range of wellbeing support they could access such as occupational health support and wellbeing assessments. We observed wellbeing posters on staff notice boards that had QR codes for staff to access wellbeing conversations, financial wellbeing support, confidential counselling, healthy lifestyle support and mindfulness and meditation.

Improving and maintaining staff wellbeing was a focus that managers and senior leaders told us about. Some staff and managers told us about team away days they held annually. The away days combined professional development with team building activities. Some staff also told us about wellbeing activities such as wellbeing walks and fortnightly wellbeing hours. Some staff told us about ‘reboot days’ that happened every 4 to 6 weeks and supported staff to complete training, update people’s paperwork and participate in team building. In some teams, there were monthly shared lunches and wellbeing activities that related to the most recent business meeting topics.

Staff were recognised for their efforts by ‘applause awards’, in which staff nominated colleagues they felt had done a good job. Staff could also be nominated for awards from an externally judged employee recognition programme. We saw staff award certificates on staff notice boards and office walls.

At the time of our inspection, senior leaders told us they were in the process of rolling out post event team reflection (PETR) training to all staff, to support staff wellbeing. They told us they hoped PETR would help teams to come together to discuss their thoughts and feelings about things. Staff also had access to debriefs following any incidents, which were supported by psychology staff.

Some staff and managers told us they continually tried to set up reflective practice as a supportive space for staff. However, they told us that staffing pressures and the geographical spread of teams made this difficult to achieve.