South London and Maudsley 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

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

At our last inspection we rated this key question good. At this inspection the rating has remained good.

Good:This meant people were supported and treated with dignity and respect.

Staff treated people who used services with compassion and kindness. They respected the privacy and dignity of people who used services. They understood the individual needs of people who used services. informed and involved families and carers appropriately.

However, not all care plans we reviewed were updated in response to changes of presentation and circumstances. People who used services were not always aware of being involved in identifying their needs nor had copies of their care plans. Some staff did not always feel supported and enabled to deliver person-centred care.

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.

The service treated people with kindness, empathy and compassion and respected their privacy and dignity. They treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours were respectful and responsive when interacting with people who used services. Staff provided people who used services with help, emotional support and advice and we observed kind and respectful interactions during our inspection.

We spoke with 12 people who used services. Feedback was mostly positive about staff attitudes and behaviours. Nine out of 12 people told us staff supported them to feel safe, and staff treated them well.

People told us staff supported them to understand and manage their care, treatment or condition, with people saying staff had been ‘great’ and had ‘helped so much’.

We spoke to 7 carers of people that had used the service. Feedback from carers was overwhelmingly positive about staff attitudes and behaviours.

Staff actively sought feedback on the quality of care provided. The service provided the results of feedback given by people who use services via the family and friends survey between January 2025 and June 2025. This showed 84% of people who used services said their experience was good or very good and 88% of carers said their experience was good or very good. Carers left comments such as:

• ‘as a carer I felt listened to, valued and supported throughout my journey’
• ‘I felt well supported and there was good communication’
• ‘the service has been brilliant. I can’t thank the whole team enough for the support they provide’

The service 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.

Staff treated people as individuals and offered individualised support. We observed staff working flexibly to engage with people using services and staff told us about football tournaments they had organised and taken part in with people who used services.

Staff made adjustments for people who used services who had additional needs or disabilities. Staff told us about helping someone with physical adaptions and skill development following a stroke.

Staff gave examples of working with community groups to ensure people were offered individualised support. They worked with a local community centre, supporting people to attend a gardening club. Staff met people who used services in community centres and venues to plan and support their discharge from services.

Staff directed people to other services when appropriate and supported them to access those services. People who used services told us they had been given information on support groups and other services offering help and support. Staff worked with an independent peer support service that offered advocacy and support to people from different cultures and backgrounds.

Staff could provide information in accessible formats and had access to interpretation services for people with English as a second language. Managers ensured that staff and people who used services had easy access to interpreters. Staff gave examples of using interpreters on calls and at face-to-face meetings and said the service was easy to access and responsive.

The service promoted people’s independence, so they knew their rights. However, some people told us they did not have the opportunity to give their views on their care and treatment.

During our inspection we saw examples of staff promoting independence for people who used services. Each team had a collocated employment worker who supported people to gain and maintain employment, enabling them to work independently.

Staff informed and involved families and carers appropriately. Staff showed an awareness of how the triangle of care helped them to support the needs of carers. The Triangle of Care is an improvement tool based on 6 principles to ensure providers include and support unpaid carers. The trust’s intranet had appropriate information for staff about supporting carers, including a carers charter which recognised the essential role carers played and ensured it was respected.

People who used services could access advice and support from independent advocacy services. Staff knew how to refer people who used services to advocacy services and told us there were no issues accessing independent advocates.

However, some people we spoke with told us they had not been asked to contribute their views on their care and treatment, even though they felt comfortable to do so. We spoke to 12 people who used services and only 1 said they had been asked for their views. Nine said they had not been given the opportunity to give their views on care and treatment.

The service mostly listened to and understood people’s needs, views and wishes. Staff responded to these in that moment and acted to minimise any discomfort, concern or distress.

Staff were not always aware of specific risk issues, and these were not always reflected in safety and care plans. Not all care plans we reviewed were updated in response to changes of presentation and circumstances. People who used services were not always aware of being involved in identifying their needs nor had copies of their care plans.

Though staff met daily to identify and respond to risks to, or posed by, people who used services, risk assessments were not always updated. People we spoke with were not always aware of being involved in working with staff to identify their own risks and put safety plans in place.

Staff completed training on reducing restrictive practice. This enabled them to develop knowledge and skills in the least restrictive management of people when they had a heightened emotional reaction. This was bespoke training to the trust and had been developed with support from carers, community groups and people who used services. However, though compliance with this training had improved since our last inspection it remained below the trust target of 85%. Compliance was at 73% in Croydon directorate, 66% in Lambeth directorate, 79% in Lewisham directorate and 78% in Southwark directorate.

Though the service cared about and promoted the wellbeing of staff, some staff did not always feel supported and enabled to deliver person-centred care.

Staff told us they felt positive about working for the service and their immediate teams. They felt supported and valued, especially by local managers. However, some staff told us they did not always feel well supported to manage large and complex caseloads.

Each directorate had an action plan to address feedback from the NHS staff survey. We reviewed the plans and saw there were a range of tailored actions. These included team development days, promoting safe working patterns, introducing weekly ‘celebrations’ into morning meetings and monthly wellbeing events.

Staff had access to group reflective practice. In Southwark directorate this was provided by psychology staff to the assertive outreach team. In Croydon directorate all CMHTs received reflective practice with separate sessions for managers and leaders.

Staff could access support following an incident from the critical incident support service who offered post incident debriefing.

Staff had access to support from an occupational health service. We were given examples of how this supported staff, including with injuries obtained at work.

Staff gave examples of being supported to develop their careers. For example, one manager described how they had been supported to develop into the role from practitioner level. Other staff told us about accessing nursing apprenticeships.

The service had systems to recognise and reward staff and took part in trust-wide programmes to promote staff engagement and recognition. This included recognition programmes such as the monthly and annual staff recognition awards and a weekly Trust Broadcast which highlighted outstanding contributions from individual staff or teams. Managers recorded positive feedback about staff on the online reporting system. In Southwark directorate they held ‘Sparkly Fridays’ to share good news and positive feedback in the weekly meeting.

Most staff received an annual appraisal, which was completed between April and July each year. The service provided information which showed at the end of this appraisal window in 2024 compliance was 100% in 8 teams, between 90 and 99% in 3 teams and between 70 and 90% in 6 teams. However, teams in Lambeth directorate had low compliance with annual appraisal. Lambeth Single Point of Access was 0% compliant, Lambeth LWC North Focused Support team 40%, Lambeth LWC South East Management and Admin team 60% and Lambeth LWC S West Management and Admin team 66.6%. The data provided indicated a number of appraisals were pending, to take compliance to 100% across all teams. However, it was not clear from the data if these were completed or had dates set. Following our inspection, the service provided evidence to show by the end of the appraisal window compliance with annual appraisal across Lambeth was 89% and across the service was 92%.

Staff had personal emergency alarms that could be activated if urgent assistance was needed.