Humber Teaching NHS Foundation Trust

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• 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.

Staff treated people who used services with compassion and kindness. They respected peoples’ privacy and dignity. They understood people’s individual needs and supported them to understand and manage their care, treatment or condition. Staff involved people in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

This service scored 75 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We spoke with 4 people who used services, 2 carers and 1 person who was detained in the health-based places of safety. People were complimentary about the service, said they had received good care and did not have any concerns about any aspects of the service.

We observed 3 home visits and saw that staff attitudes and behaviours when interacting with people showed that they were discreet, respectful and responsive, providing people with help, emotional support and advice at the time they needed it.

People who used services told us they had been provided with support and information to help manage their care. They were provided with various coping strategies and practical techniques to help alleviate symptoms.

We observed staff being respectful and showed compassion. Staff built up a good rapport with people and communicated well with them and provided help and support to people who used the service and carers and relatives who were involved in their care. We saw in 2 care records that staff referred carers for carers support if they identified a need.

People told us staff had supported them to access other services and signposted or provided information when required and staff had involved them to make choices.

People who used services told us staff were kind, caring and treated them well and behaved appropriately towards them. They said staff understood their individual needs and were well prepared when they visited which meant they did not have to repeat their story. Although they did see a range of staff, they were often with someone they had met previously which gave a sense of continuity.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards people who used services without fear of the consequences. Staff maintained the confidentiality of information about people.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled people. When people were seen on site, interview rooms were on the ground floor and accessible. People who had communication needs, such as deaf people, had the option to use a sign language application on an electronic device. Occupational therapy staff ordered equipment for people with mobility issues if required. All of the health-based places of safety and interview rooms were on the ground floor.

Staff ensured that people who used services could obtain information on treatments, local services, and how to complain or provide feedback on the service. The information provided was in an accessible format. All people we spoke with knew how to contact the service including out of hours. Staff told us they could produce information in different languages when required and had easy access to interpreters and signers.

The service audited calls to the NHS 111 Option 2 to see if people were appropriately supported. They had developed a frequent caller pathway in conjunction with other services such as the CMHTs and psychiatric liaison and developed care plans so they could appropriately support the person. The joint care plans advised staff how best to support them if they telephoned the service.

Patients detained in the health-based places of safety were provided with a choice of hot food from the adjoining wards. Staff had access to a small kitchen where snacks and hot and cold drinks could be prepared.

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

From the care records we reviewed, we could see that staff discussed treatment options with people who used services and carers, to make decisions together. Staff gave people choice about their care and treatment. For example, they had choice about times of the day or locations where they wished to be visited. All people we spoke with said they had received information about medicines so they could make informed choices. Families and carers were also involved with decision making when the person consented.

Staff supported people to remain independent as much as possible and prevent hospital admission. Staff provided daily visits when people were initially referred and still undergoing assessment. They would supervise and support medicine compliance so the person could remain at home. Staff would signpost to third party organisations, such as drug and alcohol services, that could offer support when required. People gave us examples of other services and organisations they had been referred to that would benefit them, such as primary care and talking therapies. One person told us about the therapeutic activities they were doing which staff supported them with, to aid recovery and improve their wellbeing.

In the health-based places of safety, patients could keep their mobile phones after an individual risk assessment. A selection of chargers were kept in the office. Patients had access to the wireless internet connection.

There was a range of activities to keep patients occupied in the HBPoS whilst waiting for assessment. Staff said they could access sensory items for neurodivergent people and would refer to the person’s hospital passport.

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

Staff identified and responded to changing risks to, or posed by, people who used the service. Each morning staff reviewed people whose risk had changed in risk meetings and planned care accordingly to meet people’s needs. Staff were flexible and visits could be planned and accommodated around people’s needs and wishes. For example, one person wanted to be seen only at Miranda House, rather than at home.

The service was available 24/7 and staff could respond quickly. When required, visits would be quickly increased dependent on need. People and relatives we spoke with were aware of how to contact the teams and said staff had been responsive whenever they had contacted them. One person told us staff were more responsive at answering the telephone now than when they had previously been under the care of the team a couple of years prior.

People and relatives said staff communicated well with them, explained their care plans and informed them when they would be visiting or making contact by telephone. People said they had been offered and received copies of their care plans and they had been updated as changes were made.

Staff were aware of and dealt with any specific risk issues and care planned for these accordingly. For example, all trust premises were smokefree, therefore patients brought to the HBPoS would be asked whether they were a tobacco smoker. If so, they would be prescribed and administered nicotine replacement therapy to ensure they were kept comfortable whilst in the suite.

Staff in the HBPoS used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. At the time of our inspection, 81% were trained in de-escalation, management and intervention training.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

All staff we spoke with said they felt respected, supported and valued. They said they supported each other, were a strong team and made sure everyone was OK. They told us managers and leaders supported them and were approachable. They felt able to approach managers and challenge them if required.

Many of the staff we spoke with had worked for the trust for a number of years. Staff told us they felt positive and proud about working for the trust and their team. They felt the culture was good and managers encouraged them to take breaks and time owing

Staff had access to support for their own physical and emotional health needs through an occupational health service and wellbeing helplines. Staff wellbeing was discussed in team meetings. The trust organised and promoted wellbeing campaigns aimed at supporting staff. The trust had a zero-tolerance approach to bullying and harassment and had Respect and No Excuse for Abuse frameworks in place to address any issues.

The trust recognised staff success including the staff awards. The team celebrated good work and achievements. The team encouraged each other to nominate colleagues each month and provided the winner with an award.

Managers provided staff with an appraisal of their work performance. Staff appraisals included conversations about career development and how it could be supported. At the time of our inspection, 100% of staff had received their annual appraisal.

Staff followed lone working protocols. All staff had access to an emergency phone number they would ring if they felt unsafe during visits or an assessment. Staff were reminded of the protocol in team meetings. Although staff did not have access to personal alarms when out in the community, staff told us they felt satisfied with the protocol in place.