Oxford Health 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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant young people were supported and treated with dignity and respect.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with young people showed that they were discreet, respectful and responsive, providing young people with help, emotional support and advice at the time they needed it. We observed many positive interactions between young people and staff throughout our inspection. Staff we spoke with knew the young people well. We carried out an observation using the short observational framework for inspection (SOFI) during lunchtime at Highfield unit and observed staff engaging with young people with warmth, empowering young people and encouraging them to become involved in group conversations.

Staff directed young people to other services when appropriate and, if required, supported them to access those services.

Young people mostly said staff treated them well and behaved appropriately towards them. Young people told us that staff treated them with respect, for example knocking on their bedroom door before entering.

However, young people on Highfield unit could not control the visual privacy panels on their bedroom doors.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for young people who were disabled. All of the wards had lifts available to enable people to access the upstairs areas. However, the lift at Marlborough House was not working during our inspection due to a water leak. The disabled toilet on Highfield unit was also out of order during our inspection. However, none of the young people receiving treatment at the service at the time of our inspection required these facilities.

Staff ensured that young people could obtain information on treatments, local services, patients’ rights and how to complain. They provided young people and carers with information packs on admission.

The information provided was in a format accessible to young people. The information was clear and easy to understand.

Managers ensured that staff and patients had easy access to interpreters and/or signers. Staff arranged for interpreters to attend sessions via video calls.

Young people had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

Staff ensured that young people had access to appropriate spiritual support and provided religious materials for young people. A chaplain visited Marlborough House weekly and visits to Meadow and Highfield units could be arranged on request.

In some care records staff had recorded which pronouns the young people preferred to use.

Quality Statement Score: 2

We scored the service as 2. The evidence showed some shortfalls. The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

All the young people we spoke with during our inspection told us they did not feel involved in their care planning. Managers told us they had moved from using a questionnaire for young people to input into their care plans to a face-to-face conversation. However, due to high levels of acuity on the wards these conversations were not always able to go ahead.

Staff did not regularly remind young people detained under the Mental Health Act (MHA) of their rights. Four young people at Marlborough House and four young people at Highfield unit had not been reminded of their rights since they were originally read to them following admission. One young person at Highfield unit had not had their rights read to them for 6 months. Some of the young people we spoke with told us they were not aware what their rights were.

Staff provided young people with a choice around the food they ate. There were several options available and young people could choose what they wanted to eat.

Quality Statement Score: 2

We scored the service as 2. The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff were aware of specific risk issues but did not always ensure young people had care plans in place to support them with these. For example, a young person requiring restraint for nasogastric feeding did not have a care plan in place for this.

Staff did not consistently use de-escalation techniques to reduce the need for physical interventions when young peoples’ behaviours became heightened. Young people told us that staff often restrained them before attempting other interventions first, and 2 young people on Meadow unit said that staff sometimes threatened them with restraint and seclusion.

Staff responded to feedback from young people. For example, on Highfield unit the young people had fed back that the lighting was too bright, so staff had arranged for softer, sensory-friendly lighting to be installed.

Young people were invited to attend a monthly patient forum to provide feedback to staff. Staff then updated “you said, we did” boards to demonstrate how suggestions they had made had been implemented. For example, on Highfield unit the young people had fed back that the bean bags needed refilling, and this had been completed. However, the minutes from these meetings showed that in some instances young people were feeding back the same things to staff repeatedly, and staff had not documented what action, if any, had been taken in relation to this feedback.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported and valued.

Staff felt positive and proud about working for the provider and their team.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Staff told us they felt supported if they needed time off work and could return on a phased approach if needed.

The service’s staff sickness and absence were low at 3-5% across the wards.

Staff on Meadow unit had attended an away day in September 2025, this had given them the opportunity to reflect on the first 2 years the service had been in operation.

Staff appraisals included conversations about career development and how it could be supported.

The provider had organised separate debrief sessions for staff who had been seriously injured from being assaulted at work. Psychological support for staff had been offered via Trauma Risk Management (TRiM).

Staff at Marlborough House attended a wellbeing group and participated in a choir, baking activities, a music group and mindful walks.