Norfolk and Suffolk NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

EFFECTIVE
Effective Rating: Good

This meant we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we did not rate this key question. At this assessment the rating was Good.
This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

Assessing Needs
We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.
We reviewed 2 care records during the inspection.
Staff completed a comprehensive mental health assessment of patients in a timely manner at, or soon after, admission.
Staff assessed patients’ physical health needs in a timely manner after admission. We saw specific needs being met when patients had additional health needs.
Care plans were personalised, holistic and recovery oriented. Patient involvement was present and patients were being supported in activities of daily living and finances, as well as their physical and mental health. However, one care plan needed to be more specific around supporting the patient when they were in the community.
 

Delivering evidence-based care and treatment
3. We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well
Staff ensured that patients had access to physical healthcare, including access to specialists when needed.
The team included a range of specialists required to meet the needs of patients in the service; this included a physical health support worker, dietician, occupational therapist, physiotherapist and speech and language therapist.
Staff delivered interventions in daily living skills in line with NICE guidelines, such as providing activities to develop skills in laundry, budgeting and cooking.
Staff organised weekly communal lunches with rotating cultural themes. MDT staff and patients cooked and ate together, promoting cultural learning, providing meaningful activity, and making MDT staff more approachable and accessible.
Staff used technology to support patient care, this included patients having a personal device to communicate with family and carers.
Managers supported staff to develop through yearly, constructive appraisals of their work. Appraisals were between 88% and 100% complete over the previous 12 months.
Managers supported staff through regular, constructive supervision of their work. Managerial supervision compliance was between 88% and 100% over the previous 12 months.
MENTAL HEALTH ACT
At the time of inspection, 96% of staff had received training in the Mental Health Act.
Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice.
Patients had easy access to information about independent mental health advocacy.
Staff told patients their rights under the Mental Health Act in a way they could understand.
 

How staff, teams and services work together
We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.
Staff held regular, daily multidisciplinary meetings to discuss patients and improve their care. Ward reviews took place every 2 weeks.
Staff shared information about patients at effective handover meetings within the team.
Information relating to care, help and support, advocacy access, activities, care ambassador details and feedback on care was displayed on the ward notice board for patients.
The teams had effective working relationships with teams outside the organisation, including practitioners to support physical health, such as GPs.
 

Supporting people to live healthier lives
We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.
Staff identified patients’ physical health needs and recorded them in their care plans.
Staff supported patients to live healthier lives, for example, through participation in a smoking cessation scheme. They also provided guidance around menstrual health and had access to a designated menopause champion.
Ward activities helped promote a healthy lifestyle for patients and included going for regular walks and having access to the healthy choices shopping guide. Patients were allocated £25 per week to budget for food and drink and were supported by staff to make informed and healthy choices whilst shopping.
 

Monitoring and improving outcomes
We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.
Staff used recognised rating scales to assess and record severity and outcomes. We saw that NEWS2, sleep monitoring charts and an alcohol screening tool were used.
Staff used the DIALOG+ assessment framework to enable personalised conversations about their goals. Progress is reviewed at fortnightly MDT meetings. The Global Assessment of Functioning (GAF) scale which measured changes in functional ability over time was also used.
 

Consent to care and treatment
We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.
Staff took all practical steps to enable patients to make their own decisions, this was clearly recorded in care plans.
Staff assessed each patients’ capacity to consent to admission and treatment.
In the records we reviewed, patient’s views and wishes were recorded.
Staff engaged with patients’ families; they had a carer’s ambassador who facilitated carers days where the views of the patients’ and their carers were discussed.