Lincolnshire Partnership 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

Staff on the Vales were generally kind and caring. We saw calm, compassionate interactions where staff offered reassurance and support. Most patients told us that staff tried their best to help them. However, experiences were inconsistent. Some patients said they did not always feel listened to or respected, and language barriers sometimes made communication difficult. One patient said they felt “worthless” after being ignored by a staff member, and another told us they felt unsafe after being assaulted twice by another patient. Care plans were not always personal or recovery-focused, and patients were not routinely involved in decisions about their care or risk management. High acuity and staffing pressures limited opportunities for daily-living activities or independence.

Staff morale on the Vales was low. Some staff described a culture of blame and favouritism, and others said they had experienced or witnessed racial discrimination. Leaders had begun to address this through Every Voice meetings, cultural-awareness events and a Tackling Racism Action Group, but it was too soon to see meaningful change. Overall, staff wanted to provide compassionate, person-centred care, but inconsistent communication and low morale affected how well people’s emotional and cultural needs were met.

We found this to be a breach of Regulations 12 and Regulation 17.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most interactions we saw on the Vales were kind and respectful. Patients said staff cared and tried their best. However, not all interactions showed dignity and respect. One patient described feeling ignored and “worthless” when a staff member rolled their eyes instead of responding.

One patient said they felt unable to raise concerns about a staff member of a different race because previous feedback had been misinterpreted as racism. Another said that language barriers made it hard to communicate their needs.

Staff reported a culture of blame and low morale on the Vales, and several said they had experienced or witnessed racial discrimination. Leaders had started to act but had not yet created a fully respectful or inclusive culture.

Staff on the Vales cared about patients but did not always plan care around each person’s needs. Care plans were generic and often lacked measurable recovery goals. Positive Behavioural Support and Reducing Restrictive Practice plans were detailed and trauma-informed but not integrated into core nursing plans.

Advocacy and family involvement were available, and patients received timely information about their rights under the Mental Health Act.

Patients on the Vales could personalise their bedrooms and make some daily choices. Structured mealtimes were in place, but some patients preferred to eat alone, which limited consistency and independence. We saw 1 patient using a low-stimulus room under enhanced observations as an alternative to seclusion, with staff reminding them that they could leave at any time.

However, most care plans lacked clear goals for independence or recovery. Staffing pressures and acuity limited opportunities for choice or skill development.

Staff on the Vales were visible and responded quickly during incidents. Reducing restrictive practice plans promoted trauma-informed practice and prioritised oral medication before restraint.

Staff failed to anticipate the need of patients following being assaulted and reporting to feel unsafe on the ward. In addition, staff had not identified that a patient whose first language was not English placed a potential communication barrier and made it difficult to ask for help and support.

Physical-health checks were inconsistent. Due to this inconsistency we were concerned that staff would not be able to respond quickly or anticipate the need for intervention if a patients physical health deteriorated.

Four out of 5 staff we spoke with on the Vales said there was a culture of blame or favouritism and a lack of boundaries between patients and staff. Four out of 5 staff also reported racial discrimination from patients or colleagues. Leaders were addressing these issues through cultural-awareness work, but the changes were recent. Staff did not yet feel fully supported or psychologically safe.