North Staffordshire Combined Healthcare NHS Trust

On this page

• 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 assessment we rated this key question outstanding. At this assessment the rating has changed to good.

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

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff gave patients choice about where they could be seen, such as at home or at the crisis centre and the gender of the clinician visiting, if safe to do so.

Care plans were individualised and personalised. One patient told us how staff had enabled her to remain at home as she had previously been treated in hospital. All patients and carers we spoke with had a good understanding of how their care and treatment would enable them to recover.

Support staff worked closely with patients to enable them to access community services that would benefit them. For example, 1 patient said a support worker had helped her get back into education by encouraging her to apply for a course at college and escorted her to the interview. They had helped her with debt management and had supported her with practical help with her housing needs.

Staff worked closely with family and carers when patients were happy for them to do so. One carer told us staff had given them the information and support they needed to ensure their family member stayed at home and avoided a hospital admission. Staff considered carers needs as part of the initial assessment.

Staff made notifications to external bodies as needed and information governance systems ensured confidentiality of patient records.

Staff told us information was shared in a format that was accessible and met patients’ communication needs. Staff were able to get support from interpreters or signers when required. Staff made information leaflets available in languages spoken by patients.

We spoke with 2 family members. They said staff had provided with them with all the information they needed to help their family member whilst they were unwell and all knew how to contact the team when required. They said staff were approachable and friendly. They knew how to complain if they needed to.

In the 12 months prior to our assessment, the service had received 7 formal complaints. None had been upheld. Twenty-two concerns had been raised through the patient advice and liaison service (PALS). Most of the concerns related to staff attitude or behaviour and access to the team, mostly for a long wait on the telephone.

In the same period the team received 15 compliments and 11 friends and family test comments. Most of the feedback was positive although 3 comments described the service and experience they received as poor or very poor and staff had not been helpful.

The trust had processes in place to manage complaints. Patients said they knew how to raise a complaint or who to speak to if they were not happy. Staff said they knew how to handle complaints appropriately and efficiently and managers provided feedback on the outcome of investigations to staff and patients and acted on any findings.

The crisis centre and the health-based place of safety were on the ground floor and accessible for patients with mobility issues. The health-based place of safety had 2 assessment rooms but was only commissioned for 1, therefore when it was full, people would be taken to other local places of safety in neighbouring trusts.

The trust used a duty doctor system therefore a doctor was available for the crisis centre and health-based place of safety in an emergency and the hospital was situated close to the local acute hospital. However, staff told us it was sometimes difficult to get a Section 12 approved doctor to attend the health-based place of safety for the Mental Health Act assessment in a timely manner, especially out of hours. This often led to delays and people had to wait for a longer period for assessment. Managers told us it had been escalated to the senior medical leadership team.

The home treatment operational policy stated that following a referral, a face-to-face assessment would be arranged within 24 hours, unless the patient chose to have their first contact by telephone. The trust monitored its initial response to referrals received. In the 12 months prior to our assessment, the average initial response time was 2 hours and for referral to assessment it was 4 hours. For urgent assessments, the trust response target was 4 hours. In the 12 months prior to our assessment, the crisis resolution and home treatment team responded to referrals within 4 hours 88% of the time, and the single point of access was 78%.

In the health-based place of safety, the trust monitored its response time following detention under Section 136 to assessment. From 1 December 2024 to 1 May 2025 there were 63 people detained under Section 136. None of them were detained over 24 hours. From 1 April 2024 to 31 March 2025, for adults the average time was 12 hours and 16 minutes. For those under 18 years old, it was a longer wait at 14 hours and 49 minutes due to less availability of specialist children and adolescent mental health specialist doctors.

The trust were unable to monitor unanswered calls due to the current telephone system. However, they were able to monitor peak demand times and modify staffing as required, such as the twilight shift for crisis call operatives.

Staff planned for patients’ discharge and liaised with relevant health care professionals or teams to ensure good continuity of care. Staff ensured patients had access to post-discharge care such primary care or community mental health services. However, staff told us there were often long waits for patients to be allocated a care coordinator, which delayed their discharge from the team. The nurse practitioners had created a sub caseload for patients who no longer required home treatment but had not been allocated a care coordinator which ensured they received appropriate care whilst waiting.

Patients and carers were able to feedback about the service they received through friends and family surveys, comments boxes and were invited to provide feedback post discharge. The trust collated patient experience and fed back to the individual teams. The patient experience team produced a monthly report.

Staff received training in diversity and inclusion. At the time of our assessment, 97% were compliant.

The trust had implemented and monitored the Patient and Carer Race Equality Framework (PCREF) developed by NHS England, which set out to improve the experience and outcome of people from ethnic minorities who were on mental health pathways. The service 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 supported patients to make decisions about their care and treatment and their future. We saw discharge planning with goals listed in patient care records and safety intervention plans which were personalised.

Staff made referrals to other services which would benefit them in the future such as employment, therapies, housing, benefits and education. Support staff offered practical help to patients who may need it, particularly those with complex needs.

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