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 key question has been rated as good. We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. People were supported and treated with dignity and respect; and involved as partners in their care. The ward was collaboratively designed with young people to provide a welcoming environment. Staff were able to respond to individuals needs and offer kind and compassionate care.

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.

Staff spoke positively about their team and explained that staff had worked there for a long time which provided continuity to patient care. Staff told us that there was a good culture and staff were supportive of each other. Staff told us that they led by example, in the way that staff addressed each other in front of young people and others. Staff said there was a culture of openness and honesty, and that young people felt safe to raise concerns to staff about how they were treated. Young people spoke positively about staff and told us staff respected their privacy and dignity. Young people told us that staff offered lots of reassurance and that they understood their needs. Staff demonstrated compassion and dignity by ensuring they identified young people by their preferred pronouns. We completed a Short Observational Framework for Inspection (SOFI) as part of the inspection. This is a framework for directly observing and reporting on the quality of care experienced by people who may not be able to describe this themselves. We observed 5 interactions between staff and people. 3 interactions were positive, and 2 interaction was reported as neutral, with 0 negative interactions. We observed staff treating people with kindness/compassion etc. Staff gave reassurance to people when they needed it. We observed positive interactions between staff and young people. The service organised and celebrated events such as birthdays and young people’s individual successes. Each young person had the opportunity to decorate one of the walls in the communal lounge on a daily basis. We saw that the wall displayed positive messages.

On admission to the ward, staff received handovers containing various information about the young person and how to help them to engage in a supportive and meaningful way. People were admitted with a risk profile, and the psychology team set up a formulation meeting to get to know the young person better. The service received feedback from young people and carers and used this feedback to ensure that care plans were personalised to the individual. Staff used reflective practice minutes to gain feedback about any concerns or issues, restrictions and other improvements that could be made to ensure that the service supported individual needs as much as possible. Staff involved young people in least restrictive intervention management plans to ensure appropriate use of techniques and therapies to meet people’s individual needs. Young people had access to interpreters, advocacy, and internal and external services to support physical health needs and dietary requirements. We completed a short observational framework for inspection (SOFI) observation and found that staff treated young people as individuals, delivering person centred care according to their specific plans, especially around mealtimes. We observed staff supporting a young person at lunch time. The staff member appeared to understand the young person’s individual needs/challenges and offered support and reassurance. We saw staff adapting communication and supporting young people’s individual needs by completing a short observations framework and observing interactions . Relatives and carers spoke highly of staff on Orion Ward. One relative stated “so far every single one of them has been absolutely brilliant” and “I have nothing to be concerned about, they are so supportive.” Another relative we spoke with stated “I can’t fault them (service), we were struggling so much before (admission), they have saved her life” and “Orion changed everything for us”.

People had positive behaviour support plans, in place which outlined ways to maximise their independence, choice, and control. Staff encouraged young people to attend ward round and multidisciplinary team meetings to provide feedback and share their views on their care. There were information boards on the ward which signposted people to helplines, advocacy services, therapies, local services in the area, complaints information and ward-based activities. Young people could provide feedback using a suggestions box located in the communal lounge. We attended a young person’s multidisciplinary team meeting and observed their wishes and hopes being discussed.

Young people told us staff were available when they needed them for support and that staff knew how to support them during difficult times. Staff were able to describe early warning signs of deterioration and how engagement and observations were used to identify and respond to changing needs. Staff had good awareness of the young people’s risks and what plans were in place to manage individual risk. Young people told us they felt staff were consistent and rarely did not recognise staff working on the ward. Staff received adult and paediatric basic life support training and training compliance was 87%. Staff were trained in moving and handling with training compliance at 100%. Restraint training was also above target at 100%, with new staff booked onto training. Staff were 100% compliant with Oliver McGowan learning disability and autism training. We observed positive and supportive interactions between staff and young people. Staff supported young people during mealtimes, and throughout the day, encouraging engagement in games and activities. Interactions showed established and mutual rapport. Staff were allocated to engagement observations to ensure they could spend time with the young people.

The staff we interviewed spoke positively about the service, leaders, and managers. Some staff felt additional psychology staff were needed to improve the quality of patient care. Overall, staff were happy at the service and felt supported and encouraged to progress in their roles. Staff told us that there were regular meetings and that they received supervision which promoted their wellbeing. One member of staff described the culture as the most positive aspect of the service, stating it “oozes compassion”. Staff were positive about training and development. They could give feedback on the service and nurses and health care assistants were given the opportunity to attend formulation meetings which they said benefitted their learning/ development. Staff told us they felt heard and that there were opportunities for career development. Managers recognised the achievements of staff and there was employee of the month’ awards in place where staff and young people could nominate staff. We observed good retention of staff and many we spoke to felt this was the best place they had worked.