Pennine Care NHS Foundation Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive:

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always make sure people were at the centre of their care and treatment choices and they did not always decide, in partnership with them, how to respond to any relevant changes in their needs.

All but one patient had a care plan. Care plans contained short-term and long-term goals. Some goals were written in a patient centred way whilst others were generic statements, for example one care plan stated, ‘to be well supported with a person-centred approach’. Care plans did not always cover all patients’ individual needs. Care plans were mostly written in a way that patients could understand, although patient views were not always evident in their care plans. However, patients were receiving 1-1 sessions and we saw these were recorded in their care notes.

Patients could attend weekly patient’s meetings where they discussed concerns they had about the ward and shared ideas about ward activities and improvements to the ward. Walkerwood PICU had implemented psychiatric intensive care unit (PICU) packs which were completed with patients during their admission. These used a Reinforce Appropriate, Implode Disruptive (RAID) model which is a positive approach to addressing challenging behaviour, and a positive behavioural support approach. These packs were completed with the patient throughout their admission and used to inform improved care planning and offer a more person-centred approach to interventions.

The trust understood the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Staff supported patients to maintain contact with their families and carers. Families were invited to ward rounds and could attend virtually. Patients could borrow digital equipment if they wanted to facetime their loved ones, whilst they were on the ward. Some wards offered events such as coffee mornings to support carers. Oak and Aspen ward had a family liaison worker who worked between both wards.

Staff supported patients to access their chosen place of worship within the community. For example, some patients were supported to attend church services. Groups offered on the wards were reviewed regularly by the occupational therapy team. The team used the recovery model which focused on a patient’s purpose and connections, when planning groups and the team aimed to offer activities that could be continued when patients were discharged into the community.

Staff provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Patients received welcome packs on wards and information was also displayed on notice boards. The information provided was in a form accessible to the patient group, for example, staff provided patients with a learning disability with easy read information.

Staff made notifications to external bodies as needed. Information governance systems included confidentiality of patient records.

Staff mostly ensured carers, families and commissioners were regularly updated about the patient’s progress. The results from the service’s family and friends test showed there where occasions where contact with them had been delayed.

Staff made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. They involved them in decisions about their care and told them what had changed as a result. However, complaints were not always being investigated and resolved in a timely manner.

There were 14 complaints to the trust in the last 6 months across 7 of the 12 wards we visited. All these complaints were ongoing at the time of our inspection. Complaints were not being completed within the timescales provided and this was recognised as an issue within governance reports. Complaints were categorised into themes with the main concerns being around poor communication and the values and behaviours of staff.

Most patients knew how to complain or raise concerns, and most patients felt they could raise a complaint if they needed to. Patients could also raise concerns at community meetings and we saw patient concerns recorded in the meeting minutes. Managers tried to resolve complaints locally where possible.

When patients complained or raised concerns, they received feedback. We reviewed 2 complaints responses. Both were responded to appropriately and included apologies and learning was identified from the complaints.

Staff knew how to handle complaints appropriately and protected patients who raised concerns or complaints from discrimination and harassment. Staff received feedback on the outcome of investigation of complaints and acted on the findings. Complaints were a standing agenda item on 3 wards out of the 12 wards we visited, however staff told us the outcome of complaints were shared with them.

The trust did not always make sure that everyone could access the care, support and treatment they needed when they needed it.

Staff mostly ensured the needs of patients with mobility issues were met, upstairs wards could be accessed by lifts and corridors were wide enough to be accessible for wheelchair users. However, patients on Aspen ward with mobility needs could only access the garden by going off the ward which meant those patients could not access the garden unless they had section 17 leave. We also found the assisted bathrooms on 2 wards were being used as storage rooms. There were no accessible bedrooms on Woodbank PICU. Staff made reasonable adjustments for patients, for example, the learning disability psychologist on Walkerwood PICU had completed sessions with staff on how to support patients with a learning disability and people with mobility issues were provided with walking aids and shower chairs where required

There was mostly adequate medical cover day and night, a doctor could usually attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital. However, we were told that on call was challenging in Stockport because there was 1 doctor covering the whole of Stockport. This meant that it was sometimes difficult for doctors to respond in a timely manner and that they had to leave other activities such as ward rounds to respond to on call issues.

Staff ensured patients had access to post-discharge care – for example, S117 aftercare, community mental health services and crisis services.

At the time of our inspection there were 40 delayed discharges. The ward with the highest number of delayed discharges was Saxon ward, however there were delayed discharges on every ward except for Walkerwood and Woodbank Psychiatric intensive care units. Delayed discharges were mainly due to clinical reasons and challenges involved in finding patient’s placements that met their needs. Staff planned for patients’ discharge, including good liaison with care co-ordinators. Managers were involved in weekly bed management meetings which involved reviewing patients who had delays over 60 days.

The trust actively sought out and listened to information about people who are most likely to experience inequality in experience or outcomes. They tailored the care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. For example, the trust was developing a set of anti-racism actions, and some of the wards had put on events to celebrate pride month and support the lesbian, gay, bisexual, transgender, queer plus (LGBTQ+) community.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. The provider had staff networks in place including the race equality network, the positive ability network and the LGBTQ+ network to provide support for staff. All staff had received equality and diversity training.

The trust supported people to plan for important life changes, so they had enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future.

Staff did not always create personalised care plans to account for the patient’s needs, wishes and feelings. Although care plans contained short-term and long-term goals, these were sometimes generic and were not always person centred.

Care for people who are nearing the end of their life was managed and communicated in a sensitive and dignified way. For example, Oak ward had end of life boxes used to support patients nearing the end of their lives create memories for their loved ones.

Staff mostly ensured relevant healthcare professionals and other relevant bodies are involved in planning the care and treatment of people with complex needs.