North Staffordshire Combined Healthcare NHS 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 assessment we rated this key question outstanding. At this assessment the rating has changed to good.

Patients were treated with kindness, empathy and compassion, and their privacy and dignity were respected. Staff treated others with respect and worked collaboratively with partner organisations. Care was person-centred, with people supported as individuals and their needs, preferences, strengths, culture and protected characteristics taken into account. Patients’ independence was promoted, and they were supported to understand their rights and have choice and control over their care and wellbeing. Staff listened to people and responded promptly to minimise distress and meet needs. However, whilst the service showed a commitment to staff wellbeing, not all staff felt consistently valued and supported.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff demonstrated polite, respectful, and responsive behaviour when interacting with patients, providing reassurance, emotional support, and advice at they needed it. Across numerous observations, staff consistently demonstrated kindness, empathy and support in their interactions with patients. For example, we saw patients and carers attend a clinical session and staff sensitively discussed diagnoses, treatment options, medication and coping strategies. The nurse involved was exemplary in their kind and sensitive interactions with the patient and their carers.

Patients told us staff provided clear information and explanations, particularly about their medication and treatment plans, helping them feel more confident and involved in decisions. Many patients also valued the information staff shared about local groups and support services, which helped them access additional support in the community.

The service was described as responsive and accessible. Patients said staff attended appointments promptly in their homes, and they were encouraged to contact the service between appointments if needed. Some patients highlighted that telephone calls were answered quickly, and reception staff were friendly and supportive. Patients who attended memory clinic group sessions spoke positively about these, saying they felt understood and benefited from meeting others with similar experiences. The older people outreach support team was particularly valued, with one patient stating they could not have coped without the help provided.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. For example, staff demonstrated good knowledge of patients, often drawing on long-standing relationships to provide detailed information about their backgrounds

Staff said they felt able to raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of patient information.

The service made adjustments for disabled people, including ensuring accessible access to the premises, accessible bathroom facilities, and the availability of a hearing loop. Staff and patients had access to interpreters and signers. Staff gave examples of making requests through a language line to book telephone or face-to-face interpreters and signers. One member of staff said they had involved the Blind Society when supporting a patient with a severe sight impairment. Staff were able to translate patient information in a format and language that met their individual communication needs.

The service treated patients as individuals and was responsive to cultural needs. A clinic led by a single consultant was tailored to meet the needs of older Asian adults, with translation support available and the use of culturally appropriate assessment tools. This helped ensure people were able to communicate effectively and receive assessments that respected their cultural background and individual needs.

Staff recognised and responding to patients’ specific circumstances and support needs. Staff designated as a Carers Link had developed a social information pack covering the North Staffordshire area, which was used during home visits to provide personalised support to carers and families. This enabled staff to tailor information and advice based on individual needs and local services. Nursing staff also used the pack to signpost patients to appropriate community support, helping ensure care and information were relevant to each person’s situation.

Staff provided caring, person-centred clinics, groups, and hubs, for example for people under 65 years or those with complex needs through the Young and Complex Hub. Support was tailored to individual needs and abilities. Staff supported people, their families, and carers with coping strategies, including where people were in work, and signposted them to appropriate support services such as the third‑sector organisation for those aged 18 to 65 years.

The service supported patients to exercise choice and control over their care wherever possible. Staff understood the importance of promoting independence in line with individual need, while balancing safety and safeguarding responsibilities. Most care planning was personalised, recovery‑focused and reflected what mattered to patients, including their goals.

Staff encouraged patients to take part in decisions about their care. They explained things clearly so patients understood their options and could make informed choices.

Staff identified and responded to changing risks by patients. Staff were skilled at recognising emotional distress and adapting their approach in the moment to help minimise anxiety, discomfort, or escalation.

Patients using the service were supported to access timely care when they felt unwell. They were encouraged to contact the service by telephone or attend the service site in person.

Staff recognised and responded appropriately to patients whose needs and risks were changing. Care plans were reviewed regularly and updated to reflect current risks, ensuring patients received timely and appropriate interventions.

Patients under the Older People Outreach Teams required short-term, intensive support. Staff delivered enhanced care through regular home visits and virtual monitoring, which enabled them to identify and respond promptly to any deterioration or emerging risks. However, some staff reported working under sustained pressure due to staff vacancies. While they remained committed to meeting patients’ immediate needs, this placed additional strain on the service and impacted staff capacity.

The CQC team spoke with 25 members of staff. Overall, staff wellbeing and support were variable across the service. Most staff told us they felt respected, supported and valued in their roles, and described positive working relationships with their line managers and the wider multidisciplinary team. However, this was not consistent across all teams, with some staff reporting less positive experiences of support and engagement. Staff within the Older People’s Outreach Team highlighted significant challenges that were negatively impacting their wellbeing. These included ongoing staff shortages, and feelings of being overstretched and experiencing burnout. Due to time pressures, staff described a shift towards more task-focused care, which limited their ability to consistently provide person-centred support. Low morale within the team was further compounded by limited visible leadership. Staff also raised concerns regarding limited communication and consultation around organisational changes, which contributed to reduced staff satisfaction. Some staff reported that they were considering leaving the service. Additionally, one staff member described routinely working beyond their contracted hours to complete patient records, indicating pressures on workload and capacity.

Sickness absence rates varied across the service. County CMHT reported the highest rate at 10%, which exceeded the trust target of 4.95%. City CMHT reported the lowest rate at 1% significantly below the target. These variations were monitored to assess potential impacts on staffing capacity and service safety.

Staff appraisals were caried out annually and compliance rates ranged from 84% to 100%. The lowest compliance rate was for County CMHT at 84%. The trust target rate was 85%. Staff appraisals included conversations about career development and how they could be supported.

Leaders recognised staff contributions through initiatives such as staff awards, which helped promote a culture of appreciation. However, the effectiveness of these positive initiatives was limited in areas where workforce pressures remained high.

Staff had access to support for their physical and emotional health needs through an occupational health service, including confidential counselling and support.