Norfolk and Suffolk NHS Foundation Trust

On this page

• 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 caring as good. At this assessment the rating has remained good.

Staff treated people who used services with compassion and kindness. They respected the privacy and dignity of people who used services. They understood the individual needs of people who used services and supported people who used services to understand and manage their care, treatment or condition. Staff involved people who used services in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

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 treated people with kindness, empathy and compassion and respected their privacy and dignity.

We observed care and treatment in 2 health-based places of safety (HBPoS) and during telephone and face to face assessments. Staff attitudes and behaviours were discreet, respectful and responsive. During handover meetings, staff discussed people who use services in a respectful way which demonstrated empathy and understanding.

We spoke to 17 people who use services. People who use services said staff treated them well and behaved appropriately towards them. However, 2 people commented that some staff were not always helpful, and 1 person reported feeling judged by staff.

We observed calls taken by the 111 service at Norfolk and saw staff providing people who use services with help, emotional support and advice at the time they needed it. This included making a safety plan with a caller and signposting to other support services.

We spoke to 11 carers of people that had used the service. Feedback from carers was overwhelming positive about staff attitudes and behaviours.

The service provided examples of feedback given by people who use services via the family and friends survey between January 2025 and March 2025. People who use services mainly expressed satisfaction with the care and attitudes of staff. Out of 135 responses, 96 said the service was good or very good, with comments such as:

• ‘empathic and understanding’
• ‘they made me feel like they cared, they were sensitive’
• ‘very attentive and calming manner’.

However, 26 submissions stated they found the experience of using the service poor, with comments around dissatisfaction with the services lack of action and feeling judged by staff.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards people who use services without fear of the consequences and told us they had done this through the freedom to speak up guardian in the past. They were aware of the trust whistleblowing policy and how to raise concerns with a manager.

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

Staff received training in recognising and responding to autistic people and people with a learning disability. Ninety-eight percent of staff had completed part 1 of training in supporting people with a learning disability or autism.

The service made reasonable adjustments for people who used services including meeting people’s specific communication needs. For example, in Central Norfolk an autism intensive support service was being developed to provide additional support to autistic people who used services working alongside their practitioners from the CRHT. The service was recruiting to this team at the time of our inspection. One person told us their individual needs relating to their autism and attention-deficit hyperactivity disorder (ADHD) were reflected in their care plan.

Staff could provide information in accessible formats, and had access to British Sign Language translation services and interpretation services for people with English as a second language.

Managers ensured that staff and people who used services had easy access to interpreters and/or signers. Staff gave examples of using interpreters on calls and at face-to-face meetings and said the service was easy to access and responsive.

In the health-based places of safety patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

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

During our inspection we saw examples of staff promoting independence during initial contact with the service. For example, people who use services who called the 111 service who did not meet the threshold for referral to a crisis team were given information about other services which could support them and how to access them. Staff had good access to information about other resources and services which were available to support people who used services.

We were given examples of staff working together to ensure people who use services had choice and control over their treatment. For example, nursing and medical staff worked together to arrange additional appointments and prescribed appropriate medication to meet a person’s needs and avoid the need to admit them to an inpatient service.

Out of 17 people who used services we spoke with, 15 told us they felt empowered by staff to give their views.

People who used services could access advocacy from an independent service and posters were displayed in clinical areas, with contact details also available on the trust website.

Staff could access support from dedicated carers’ leads to ensure carers were provided with information about support services and their rights. The trust’s intranet had appropriate information for staff about supporting carers, including a carers directory. There were online systems to enable managers and staff to monitor the recording of carers’ needs and contact with carers, with a clear process for staff to follow. Not all the staff we spoke with were aware of the Triangle of Care, but managers told us self-assessments against this had been completed. The Triangle of Care is an improvement tool based on 6 principles to ensure providers include and support unpaid carers. Staff provided carers with a welcome pack which outlined this and support available to them.

Staff were aware of peer support groups in their area and gave examples of when they had signposted people who used services to these peer support groups. For example, staff in the 111 service in Norfolk told us they often signposted people who used services to support hubs and evening sanctuaries ran by local voluntary sector agencies.

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

Staff were aware of and dealt with specific risk issues and these were reflected in safety and care plans. We saw risk assessments and safety plans were updated in response to any changes in people’s presentation, risk or levels of distress.

Staff identified and responded to changing risks to, or posed by, people who used services. Staff worked with people who used services to assess and understand any risk issues which were regularly reviewed.

Staff reported there were rarely delays in admitting patients to a health-based place of safety. They told us the daily flow meeting responded well to any increase in demand so beds could be accessed.

Staff completed training in conflict resolution so they could use de-escalation techniques to reduce the need for physical interventions when people who use services behaviours became heightened. Staff we spoke with in health-based places of safety showed an understanding of de-escalation techniques and told us incidents of physical restraint were rare.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt positive and proud of their teams and to work in the service. They told us that recent management changes meant they now felt respected, supported and valued.

The provider recognised staff success within the service. Staff felt their work was recognised and success rewarded within their own teams. The trust had the ’TALK Awards’ scheme designed to recognise staff who embodied the trust TALK values. TALK values were:
• We are a Team
• We are Accountable
• We Learn and improve
• We are Kind
Staff were aware of the award and had nominated each other. However, some staff told us they did not always feel their work was recognised by senior managers and leaders, outside their locality.

Staff in the 111 service were well-supported by managers, who were present in the office and helped them deal with difficult calls. We observed senior staff placing a call on hold and assisting a junior member of staff to deal with a complex and difficult call.

Staff had access to support for their own physical and emotional needs. Some staff were Trauma Risk Management (TRiM) trained, and all staff were offered TRiM support following a traumatic event or incident. One team told us of support offered by TRiM practitioners within their team, following a very difficult year due to the death of some colleagues. They were proud of how the team supported each other.

Staff could access peer support from trained champions. The service had champions in areas such as wellbeing, veteran support, menstrual health and menopause support. There was a staff support and occupational health service which also offered support to staff for their physical and emotional needs.