Pennine Care 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

Caring:

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 changed to requires improvement.

Requires improvement: This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff mostly 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 patients showed that they were mostly discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. We carried out 3 Short Observational Framework for Inspections (SOFI). Most interactions we observed were warm and supportive; however, we observed 1 member of staff not interacting with patients on Moorside ward.

Staff supported patients to understand and manage their care, treatment or condition. For example, most patients told us that staff explained their medicines to them. Not all patients said they were involved in their care plans. For example, patients we spoke to on Moorside did not feel involved in or have a copy of their care plans but patients on Oak ward told us they were involved in the development of their care plans and had copies of these. Staff directed patients to other services when appropriate and, if required, supported them to access those services.

Patients mostly said staff treated them well and behaved appropriately towards them. Patients told us staff were caring and helpful and feedback from patients included comments such as ‘staff are brilliant’ and ‘they are always available’. However, patients on South ward did not feel supported as they felt that staff did not have time for them. Some patients felt that no one spoke to them and said they did not always feel safe on the ward. We also received feedback on Aspen ward that staff did not always interact with patients and that bank and agency staff were not as supportive as permanent staff.

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

Staff treated people as individuals and made sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients; for example, services had accessible bathrooms, although we found some of these were being used as storage rooms, there were lifts to wards that were upstairs and staff could access equipment such as shower chairs and wheelchairs. Staff could also access sign language interpreters where possible.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Information was available on notice boards and patients received information packs when they arrived on the ward.

The information provided was mainly in a form accessible to the patient group, for example staff sourced easy read medication leaflets to help patients understand their medicines. However, managers did not always ensure that staff and patients had easy access to interpreters. We came across examples of staff accessing interpreters for patients but staff also told us it was sometimes difficult to access interpreters for less common languages. We were told by one patient that they had requested an interpreter as they were struggling with English being their 3rd language but had not been able to access one. Staff made information leaflets available in languages spoken by patients although staff did not translate care plans into patient’s 1st language.

Patients 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 patients had access to appropriate spiritual support. Patients and staff told us they had access to religious and spiritual support including religious leaders coming to the ward to offer support and access to religious items to support prayer. Some patients were also supported to go to church.

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

Where patients were detained under the Mental Health Act, staff read them their rights and repeated these as and when required to ensure patients understood their rights whilst they were detained in hospital.

Patients and their families were invited to ward rounds where they could discuss patient’s care and treatment. Oak ward had implemented a more patient centred approach to ward round. This involved staff supporting patients to complete a form with questions they wished to ask in the ward round prior to the meeting and completing debriefs with patients following ward rounds.

There were blanket restrictions on some wards which limited patient’s independence. For example, patients on some wards did not have access to a key for their bedrooms. This meant they had to ask staff to lock or open their door each time they used their rooms.

Staff did not always listen to and understand people’s needs, views and wishes or respond to these in that moment and act to minimise any discomfort, concern or distress.

Staff did not always deal with any specific risk issues, such as falls or pressure ulcers and staff had not always completed a care plan for these issues. For example, we found that staff were not always monitoring fluid charts, carrying out respiration checks, or carrying out skin integrity checks for patients who needed them. Care plans did not always contain sufficient detail to support patients with needs such as diabetes, self-harm or wound care.

Staff did not always identify and respond to changing risks to, or posed by, patients. Risk assessments were updated when concerns to risks had changed, however these risks were not always responded to. For example, we found that although staff identified increasing risks of self-harm to a patient, there was no increases in mitigating actions to address the risks.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened.

The trust cared about and promoted the wellbeing of their staff, but they did not always support and enable them to deliver person centred care.

Staff mainly felt respected, supported and valued. However, some staff told us they had not received enough supervision to support their needs and we were told by some preceptorship nurses that they had struggled to complete the requirements of their preceptorships due to the demands on the wards.

Staff felt positive and proud about working for the provider and their team. They had access to support for their own physical and emotional health needs through an occupational health service. Staff appraisals included conversations about career development and how it could be supported.

The provider recognised staff success within the service. For example, the provider held Pennine care awards which staff could nominate colleagues for and there were shout outs for staff achievements on Pennine communications. Wards would also have days were everyone brought in a snack or a dish to share.