Central and North West London 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

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

Staff provided information to patients and families in several ways and had initiatives to listen to and involve people in improving services. The trust collected information about their local communities and patient group in order to better understand their needs and had equality objectives to gather and promote a strong staff and patient voice from diverse community backgrounds, to improve care.

At our last assessment, published in June 2019, we rated this key question Good. At this assessment the rating has remained Good.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Each patient had their own bedroom and privacy windows they could adjust.

Patients could keep possessions in their bedrooms or secure lockers in the nursing office. Patients could use mobile phones to make phone calls in private and could also access a ward phone.

Most wards had access to well equipped kitchens to support activities of daily living sessions with occupational therapists. Some wards had sensory rooms we saw some equipment was not working.

Patient feedback about food was mixed. Some patients said food was good and others said it was not. Patients were able to bring their own food and drinks and store it on the ward.

Although patients should have had access to cups to make their own hot and cold drinks, at Park Royal and St Charles, we saw several times when there were no cups available for patients. This had not been identified by staff and we highlighted this.

On some wards, such as Pond Ward, there was an unmanned counter in the space outside the nursing office and we observed that patients could not easily get attention of staff because of the counter. These counters were near the entrance to the ward so there were often a lot of people and activity congregated to one place and patients would shout to staff in the office behind the counter to get their attention. This was not conducive to a supportive environment.

We observed some wards could be loud with several alarms going off over the day, which could be disruptive and disturbing to some patients, especially autistic people or people with a learning disability. At the Campbell Centre, the ward environment appeared chaotic at times. Two patients on these wards told us it was too noisy for them.

Work to address plumbing and temperature issues at the Campbell Centre and St Charles was underway at the time of inspection. New windows were being installed in bedrooms to improve the thermal efficiency of the bedrooms.

The provider used patient experiences, feedback from staff and stakeholders, as well as national guidance to aim to deliver co-ordinated services that considered the needs of the individual patients on the wards. The provider worked to understand the diverse health and care needs of the local community and service user group.

There were a number of initiatives with external organisations that allowed patients to engage with activities in the community. The trust had a link with Brunel University and patients were able to play football there. At Northwick Park, there was an ongoing project with charity which supported Black male patients to work on and produce a music album.

Staff supported patients to maintain contact with their families and carers.

Staff communicated with external services where someone was being discharged.

Staff provided appropriate, accurate and up to date information to patients, families and carers. This could be provided in different languages if needed.

Information governance systems included confidentiality of patient records.

Staff supported, informed and involved families or carers. Families or carers were invited to and involved in ward rounds, where appropriate. At Riverside, we saw that feedback and conversations with family members were included in hand over information.

Notice boards were well ordered and had information about the Mental Health Act, advocacy, activity and community meetings. There were boards dedicated to complaints and the topic of racism and discrimination.

At Riverside, feedback from 6 relatives was that sometimes information about discharge could be shared in a better way. For example, a discharge being planned for a certain day and this changing last minute with relatives informed at late notice. Across all sites, a small number of relatives said staff did not always communicate consistent information with relatives.

Relatives had mixed experiences on being able to get through to the wards on the phone.

The service welcomed and encouraged people to share feedback, ideas or raise complaints about their care, treatment and support. Most patients told us they knew how they could make a complaint.

The service treated concerns and complaints seriously, investigated them and learned lessons from the results. In the examples we looked at, we saw complaints were reported, escalated and dealt with appropriately and information and outcomes were shared within agreed timescales with patients and/or families. The service clearly displayed information about how to raise a concern in patient areas. Staff understood the policy on complaints and knew how to handle them.

Most relatives said although the process to make a complaint had not been explained explicitly to them, they would speak to a member of staff or management if they had a complaint.

The service used compliments to learn, celebrate success and improve the quality of care. Managers shared feedback from complaints with staff and learning was used to improve the service.

The service was accessible to patients who needed inpatient care, although at the time of inspection, there was a lot of pressure on the wider mental health system, impacting on the length of time a number of patients were waiting to access to an inpatient bed. The trust had systems and processes dedicated to bed management and patient flow to monitor and address delays.

The trust ensured the needs of patients with mobility issues were met. Reasonable adjustments were made where needed.

Staff planned for patient discharge and liaised with care coordinators and external services about discharge.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support.

Staff received training in equality and diversity. The trust collected information about their local communities in order to understand their needs. The area the trust covered was very diverse and over 150 first languages were spoken. The trust had 6 equality objectives for 2023 to 2026. This included a behavioural framework and to have a stronger staff and patient voice from diverse community backgrounds to shape a better experience.

The trust was engaged with the NHS England Patient and Carer Race Equality Framework (PCREF), which is a mandatory framework aiming to support providers to become actively anti-racist organisations and reduce racial inequalities experienced in mental health services. The ongoing work involved engaging with communities and supporting services to embed the voices of people with lived experience.

Where appropriate, staff supported patients to consider longer term decisions about their care, treatment and discharge.