Hampshire and Isle of Wight Healthcare NHS Foundation Trust

On this page

• 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 assessment we rated this key question Good. At this assessment the rating has remained Good.

We rated this key question as good because:

• Staff involved the young people in developing their care plan
• There was a full range of treatments available at the hospital
• Staff provided information in a format suitable for the young person

However:

• Families were not given a prompt update following the young persons ward round

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.

We reviewed 2 out of the 8 sets of care records during our on-site inspection. Staff completed a comprehensive mental health assessment of the young person when they were admitted to the hospital. Staff had assessed the patients’ physical health needs and when necessary had developed a care plan with the young person to meet any identified needs. Staff routinely took physical health observations, such as blood pressure and weight, to help ensure any change in the young person’s physical health was identified and addressed.

Staff involved the young people and, if appropriate, their families in developing care plans so that they were personalised for each young person. Staff reviewed care plans with young people regularly and updated them to address any changes in their care needs.

Staff were able to offer a full range of treatments to the young people. This included psychological therapy, including family and creative therapies, occupational therapy, and medicines. There was an education department on site where young people continue their school or college studies with support from teachers working at the service. There was a therapy kitchen to help the young people gain independence skills.

The young people remained registered with their existing GP and staff helped them access physical health appointments such as the dentist or specialist hospital appointments.

The service took part in local audits and were working towards an accreditation with Quality network for inpatient CAMHS (QNIC). QNIC is run by the Royal College of Psychiatrists and designed to improve the quality of care in CAMHS inpatient services.

The ward has access to the full range of professionals needed to meet the needs of the young people admitted to the hospital. This included nurses, psychologists, pharmacists, social workers, dietitians, occupational therapists and creative therapists, activity co-ordinators and teachers. The staff working at the hospital were qualified and experienced. The hospital ran an induction programme to ensure new staff had the skills they needed to provide care to the young people.

Staff told us that they were supported by their managers, received regular supervision, and had yearly appraisals. Managers would set goals and identify training courses with staff at their appraisal. At the time of the inspection 82% of staff had received their yearly appraisal. Staff told us they could request training outside this process if they saw a course that would benefit their development.

The ward manager could get support from the trust if they needed to address poor staff performance. There were no staff in disciplinary processes at the time of the inspection.

Mental Health Act

All staff received Mental Health Act training and at the time of the inspection 71% of staff were up to date with this training. Staff we spoke with had a good understanding of the Mental Health Act and of the code of practice. Staff were actively reducing restrictive practices. Staff had access to policies and procedures around the Mental Health Act and could access support from the trust. Staff we spoke with knew who to contact for support.

Young people had access to a Mental Health Act advocate.

Staff explained young people’s rights under the act to them and recorded that they had done this. Staff had access to easy read rights for the young people if needed. The young people can access the community using section 17 leave and staff ensured this happened.

On the day of the inspection there was no sign on the exit to the ward telling the young people about their right to leave the hospital and what they should do if they wanted to leave. We spoke with the staff team, and they sent us evidence that they had now put a sign on the door. The sign explained the rights of both young people in hospital informally and young people who had been detained under the mental health act and what they should do if they wanted to leave the hospital.

The staff team had regular MDT meetings and daily safety huddles to discuss the young person’s care. Staff told us that the ward rounds had recently changed and parents and professionals, who did not work on the ward, were no longer invited to ward rounds. Staff told us this was because the meeting had become too large, this did not benefit the young people and the young people had asked for the size of the meeting to be reduced. Staff would contact the young person’s family by telephone after the meeting and follow this up with an email within a week. Family members we spoke with told us that this was not always happening and that they had to contact the hospital to get an update on their young person’s care.

Staff we spoke with said they had good working relationships with colleagues across the hospital and with other teams involved in the young person’s care. For example, the young person’s social worker. Staff also reported that they had good working relationships with other organisations such as the young people’s GP and the local safeguarding team. However, some staff reported that there was a difference between clinical staff and other staff and that managers did not value the input of non-clinical staff in the same way they valued clinical staff.

Staff helped young people to live healthier lives by offering advice and support around healthy eating, stopping smoking and vaping and encouraging exercise. There was a gym and sports hall on site to encourage appropriate and regular exercise.

Staff used outcome measures to review how effective the treatment was. Staff used the Health of the Nation Outcome Scales (HONOS) that were included in the electronic patient record to monitor the young person’s progress. Staff reviewed the HONOS results at ward rounds and CPA meetings, and any changes needed to the young person’s care and treatment could be discussed at these meetings and actioned by staff.

Staff worked with the young people to get consent for their treatment plans. The records we reviewed showed that the young people, and where appropriate, their families, were involved in making decisions about care. Staff offered young people information in different formats, including easy read or different languages. This was to help the young people understand their treatment options.

The trust had policies and procedures in place to ensure young people had their capacity to consent assessed. If a young person lacked the capacity to consent, the trust had systems in place to ensure any decisions made were in the young person’s best interest and on a decision specific basis. Where appropriate, the young person’s family were involved in decision making.