Humber Teaching NHS Foundation Trust

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated effective as good. At this inspection the rating has remained good.

Staff assessed the physical and mental health of people who used services and developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for people based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of people who used the service. Staff from different disciplines worked together as a team to benefit people. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well. However, care plans were not fully recovery orientated or written in the person’s voice.

This service scored 67 (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 did not ensure care plans were fully recovery orientated or written in the person’s voice. However, staff made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 14 care records during the inspection. Staff completed a comprehensive mental health assessment of the patient in a timely manner following referral and assessment. Staff completed the trust’s biopsychosocial formulation assessment to understand the person’s difficulties and risks.

Staff developed care plans that met the needs identified during assessment. Initial duplicated handwritten mental health crisis intervention plans were completed. One copy remained with the person using the service and the other copies were scanned onto the electronic care record, although we only saw this in 1 set of care records although they were available for staff to review. As the on-going assessment progressed, electronic care plans were created. They were personalised and holistic and were updated whenever necessary. They included target dates and realistic goals which were time focused However, they were not fully recovery orientated. For example, staff would list their dates of review rather than state interventions that would help the person recover. Care plans we reviewed included a section which included the person’s view of their current issues, which was not written in the person’s voice and included jargonistic language. Staff said they were completed in collaboration with people using the service, but they were written by mental health professionals. People told us they were offered copies and said they felt included in care planning.

Staff assessed most peoples’ physical health needs in a timely manner following assessment. This incorporated a full physical screening for all people on the caseload. We saw health improvement profiles within some notes but not all. We saw in 1 person’s care record they received daily physical observations when starting an anti-psychotic due to an existing heart condition. Staff had recorded in some instances when they had been unable to complete physical health monitoring due to the person’s mental state. However, the trust used the same electronic care record system as GPs, therefore they had access to information about any existing physical health concerns, recent tests and current medication. Managers told us they were focused on improving physical health monitoring and one of the doctors in the team was leading on this within weekly teaching sessions. Staff in the HBPoS had access to relevant equipment to monitor patients’ physical health when required. Staff told us they kept physical health monitoring equipment in their cars, so it was available when needed.

The service undertook monthly audits of care records which consisted of a review of at least 5 records. Between March 2025 and March 2026 average compliance against the trust standards was 92%.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well

Staff provided a range of care and treatment interventions suitable for people who used the service. The interventions were those recommended by and were delivered in line with guidance from the National Institute for Health and Care Excellence.

The team psychologist provided twice weekly formulation sessions to discuss and reflect on complex presentations. Occupational therapy assistants completed sensory ladders, gradient exposure and escorted people to the Humber Recovery and Wellbeing college. The college is a platform that gives people access to face-to-face sessions, e-courses and podcasts co-produced and co-designed to help people understand and manage mental health conditions, empowering them to take control of their wellbeing and recovery journey.

In line with the trust’s physical health strategy, staff ensured that people who used services had good access to physical healthcare. The trust and local GPs shared the same electronic notes system, therefore staff were able to review any existing health conditions and GPs could monitor tests the team may have undertaken such as blood tests.

Staff participated in clinical audit and quality improvement initiatives. Since January 2026, the trust had implemented 5 priority areas in line with patient safety priorities to measure quality, consistency and the impact on the experiences of people who used services within care records audits. The priority areas were patient and family engagement, quality of care planning, medication and support, clinical supervision of decision making under the Mental Health Act and quality of discharge arrangements. The trust told us these would be monitored in all relevant services, including the crisis resolution and home treatment team.

The team included or had access to the full range of specialists required to meet the needs of people who use the service. As well as doctors and nurses, there were occupational therapists, associate practitioners, healthcare assistants, clinical psychologists, social workers and administrative workers. Staff were experienced and qualified and had the right skills and knowledge to meet the needs of people on their caseload.

Managers ensured that staff had access to regular team meetings. We reviewed team meeting minutes and saw there was a standard agenda that included information to keep staff up to date with team reminders and trust updates. However, most of the information appeared to be repeated from each meeting.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge, including specialist training. Following a series of incidents in the health-based places of safety (HBPoS), staff attended trauma informed care training and basic dialectical behavioural therapy (DBT) skills training, which included interventions such as mindfulness. Staff had completed Safewards training which aimed to reduce conflict on mental health wards, which helped them when working in the HBPoS.

Staff had the opportunity to participate in monthly peer supervision with other staff of the same grade which enabled them to reflect and learn from each other. The practice educational nurse provided support and learning to students and inductees.

Managers dealt with poor staff performance promptly and effectively. They were supported by human resources.

Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. At the time of our inspection, 88% of staff were compliant. Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were. Staff stored copies of patients' detention papers and associated records correctly and they were available to all staff that needed access to them. Staff completed regular audits to ensure the Mental Health Act was being applied correctly and further oversight was provided by the Mental Health Legislation Steering group.

We reviewed 4 care records for patients who had been detained in the HBPoS. Staff had explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it. The patient we spoke to whilst on site told us they had received their rights, and staff had kept them informed about the assessment process.

Staff monitored the use of the Mental Health Act to ensure it was applied correctly. From 2 March 2025 to 28 February 2026, there had been 484 detentions in the HBPoS, equating to an average of just over 40 a month. Staff audited the timeliness of Section 136 detentions. None had breached 24 hours. However, in all the care records we reviewed we found that the doctors and the Approved Mental Health Professional (AMHP) had not attended within 3 hours of the patient’s arrival. This was not in line with best practice recommendations made by the Royal College of Psychiatrists and the trust’s policy.

Staff in the HBPoS were responsible for contacting the AMHP team who co-ordinated the Mental Health Act assessment and requested the Section 12 approved doctors. Staff told us they have experienced delays in sourcing the AMHPs and Section 12 doctors, especially overnight. There were 2 local authorities who covered the trust: Hull City Council and East Riding of Yorkshire Council. East Riding AMHPs worked 24 hours a day, 7 days a week but were based outside of Hull; Hull City were based on site but worked from 07.00 to 02.30 so there was a gap in their service for a few hours. They told us there were occasions when community assessments may take priority due to risks. Staff told us the gap in service for Hull City was a concern and senior staff reviewed incidents and delays in joint agency meetings.

Patients can be legally detained under Section 136 of the Mental Health Act for 24 hours. In exceptional circumstances, an extension of 12 hours may be granted. In the 12 months prior to our inspection there were 5 extensions, although none had breached 36 hours.

In the 12 months prior to our inspection there were 6 occasions when an inpatient bed was not available following further detention under the Mental Health Act such as Section 2 or 3. Out of the 6, 5 patients remained in the suite less than 12 hours; 1 patient remained for 43 hours whilst staff sourced a children and adolescent mental health bed.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings to discuss and review care, treatment, progress and discharge planning. These were attended by the full range of disciplines including nurses, doctors, support workers, occupational therapists, psychologists and social workers. Each team held a daily morning meeting to review risk and plan and allocate tasks for the day. We attended 1 morning meeting and 1 multidisciplinary meeting. We found they were organised and well attended.

Staff shared information about people using the service at effective handover meetings within the team at least twice a day. Shift coordinators ensured tasks for the day were allocated and managed, planned assessments and home visits and provided support and guidance to staff, including those taking referrals.

The service had effective working relationships with other relevant teams in the trust. To improve communication and prevent delayed discharges with the Hull community mental health team (CMHT), staff had recently set up a regular meeting to discuss referrals and potential blockages of transfers of care. Managers said this had improved the flow of people through to the CMHT and delayed discharges had reduced. Staff in the health-based places of safety told us that when an older adult patient was admitted, they liaised with the older adults’ crisis team.

The teams had effective working relationships with teams outside of the trust such as primary care, voluntary organisations, and social services. Staff liaised with external agencies when required such as GPs and local authority safeguarding teams. Staff provided information and attended external meetings when required to discuss and review care.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff supported people to live healthier lives. Staff worked with or referred to other organisations to support people’s physical health. For example, staff told us they referred people to external organisations such as substance misuse services if they identified a need.

The trust was a smoke-free site, therefore patients in the health-based places of safety were not able to smoke tobacco, and vaping was not allowed. Staff provided nicotine replacement therapy whenever required.

When people had a diagnosed physical health condition, staff liaised with other care providers and produced appropriate care plans. For example, we saw increased physical health monitoring for a person who had started an anti-psychotic and had an existing health condition.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Within the care records we reviewed, we found various rating scales to assess and record severity. These were used when indicated for individual people.

The trust planned to introduce an evidence-based patient rated satisfaction scale across services later this year. This is a therapeutic intervention designed to improve conversations between mental health clinicians and people who used services to provide a structured, solution focused approach to care planning and recovery.

Staff used technology to support people effectively, for example on-line blood tests. Staff had easy access to laptops, and all staff had a mobile telephone. Staff utilised technology to communicate quickly and easily with both internal and external teams within multidisciplinary and risk meetings.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Across the crisis resolution and home treatment teams staff assessed and recorded capacity to consent appropriately. Capacity to consent was considered at each initial assessment when people were admitted to the crisis service to ensure they understood and agreed to the care and treatment provided. We saw this reflected in care records and observed staff reviewing and discussing capacity in multidisciplinary meetings. Staff ensured patients could access advocacy when required, who could offer advice and support.

Staff took all practical steps to enable people who used the service to make their own decisions. If a person’s capacity was deemed to be lacking, then staff considered other options such as a Mental Health Act assessment. This was discussed within the multidisciplinary team.

Staff received training in the Mental Capacity Act. At the time of our inspection, 95% were compliant up to level 1 and 89% were compliant up to level 2.

The trust had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it. Staff knew where to get advice from within the trust regarding the Mental Capacity Act.

We saw staff had recorded whether people had consented to share information with other people such as carers or other organisations in all of the care records we reviewed.