Hampshire and Isle of Wight Healthcare NHS Foundation Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last assessment we rated responsive as good. At this assessment the rating has remained good. Staff managed beds well. A bed was available when a patient needed one. Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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 scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff regularly met with patients to understand their views on care and treatment. These discussions took place in one-to-one meetings with nurses and in multidisciplinary team meetings. Staff completed routine observations and discussed any changes in patients behaviour or presentation at twice daily handover meetings and safety huddles.

Ward managers described what they did to ensure people were supported with their protected characteristics, for example cultural needs or physical disability. Staff gave examples of how people were involved to ensure that their care meets their individual needs. For example by ensuring correct dietary requirements were available for patients of the Muslim faith and ensuring there were faith space was available for people to pray at the correct times of the day.

The services provided therapeutic and recreational activities to meet the needs and personal interests of patients. A timetable of therapeutic activities was displayed on the wards. Some patients said they had participated in music sessions, cooking, creative arts activities, visited the gym, played board games and watched films. However, the overwhelming feedback from patients was that there was not enough activity in the evenings and at the weekends to keep them engaged.

The therapy team at Ravenswood House had been involved in developing a seclusion specific therapy programme which aimed to reach patients in seclusion with specific interventions to engage them with the aim of reducing incidents and re-engaging patients.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Throughout the patients care, the services ensured that patients-maintained contact with people in their local area. Staff had regular telephone contact with patients’ families and health professionals. Family members, bed managers and care co-ordinators were all invited to multidisciplinary team meetings. Staff supported patients to maintain contact with their families and carers. The service facilitated attendance by video link if people were unable to attend the service locations.

Across the services there was mixed feedback from patients regarding their experience of care provision, integration and continuity. Ten patients were happy with the support they received on working towards discharge from the hospital and identified it would a gradual process. One patient on Ashurst ward said they were feeling stuck and were not being appropriately supported to progress towards discharge.

Staff encouraged and supported patients toundertakeworkandeducation opportunities.We met with several patients who were involved in paid employment they had successfully been Interviewed and appointed to. They spoke very highly about this process, and it made them feel valued within the hospital.

Ward managers described the systems in place to ensure that patient flow was not delayed. There were effective systems to support communication with patients' community mental health teams. The clinical teams were streamlined and managed continuity of care for patients well.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The services provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff had access to the equipment and information technology needed to do their work. The nurses’ offices had access to computers when required by staff. The ward managers were based in the ward environment, so they were available and able to support with the patients care and accessing care records information when required.

Ward managers had access to performance information to support them with their management role. This included key performance information on the management of the wards, staffing and patient care. This information was presented and discussed in clinical governance meetings regularly.

The services made notifications to external bodies as needed. The hospital wards submitted notifications to the Care Quality Commission in accordance with the requirements of their registration. The service submitted safeguarding referrals to the local authority, this process was overseen by dedicated safeguarding leads.

Staff made sure patients could access information on treatment and local services. Staff explained that information was provided for patients if it was needed. Staff displayed information about safeguarding, infection control, the Mental Health Act, the independent mental health advocacy service and a list of mental health solicitors on a notice board on each ward. The service complied with the Accessible Information Standard.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Patients said they knew how to complain, with some stating they had complained previously.

Staff understood the policy on complaints and knew how to handle them. The ward managers shared feedback from complaints with staff and learning was used to improve the service. Staff kept an electronic log of all complaints, formal and informal, received about the services.

Patients feedback from the community meetings and patient council fed back into the organisation via the clinical effectiveness meeting and we could see change being discussed at operational level which had come from the patient meetings for example patients had complained about the chairs in their bedrooms not being comfortable and the clinical effectiveness meeting had identified a source for new risk assessed furniture that would be suitable.

The wards used the “you said we did” process to feedback ideas or raise complaints about their immediate environment. The wards displayed accessible information for patients about mental health problems, the staff that worked on the wards, local services, treatments, helplines, how to complain, who was in charge of the ward, advocacy services and sexual safety.

In the three months preceding the inspection there had been no formal complaints reported across the services and 13 informal concerns raised relating to topics ranging from communication to equipment. In the same time period there had been six compliments raised. These compliments were predominantly thanking staff in the CAMHS services for supporting with their loved ones through challenging episodes.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for patients – for example, people with mobility issues were provided suitable bedrooms, walking aids, shower chairs etc.

There was appropriate medical cover day and night, a doctor could attend the ward quickly in an emergency and were able to attend wards out of hours whenever required.

There were measures in place to support people with their protected characteristics. Staff showed us that the wards were accessible to wheelchair users and patients had access to spiritual support on the ward, including multi faith rooms.

All patients had access to advocacy, and the advocacy service was engaged with patients within the wards. Advocacy posters were displayed on all of the wards. Staff supported patients to access advocacy and provided a private room to ensure that meetings were confidential.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Patients were able to personalise their rooms, they had done this by putting posters and pictures on the walls. Patients were able to store their possessions securely. The wards had quiet areas where patients could relax and there was space on the wards for therapies and activities. At Ravenswood House there was an area called the Ravens Nest where patients were able to socialise between wards safely and group therapeutic activities could be held.

Patients had a place where they could meet visitors. Patients had access to mobile phones and were able to make phone calls privately. Information leaflets were available in languages spoken by patients who used the service.

We observed staff engaging in activities with patients. However, some patients on the ward did report they felt bored in the evenings and at weekends. Patients said they had access to spiritual support and could see the chaplain they were also able to visit the onsite chapel.

The wards actively sought and listened to information about people who were likely to experience inequality. Staff described patients differing needs and made adjustments to support them. For example, staff told us when they booked interpreters for patients whose first language was not English.

The service provided a variety of food to meet the dietary and cultural needs of individual patients. Staff made sure patients could access information on treatment, local services, their rights and how to complain.

We scored the service as 3. The evidence showed a good standard. People were supported by planning for important life changes, so they could have enough time to make informed decisions about their future,

The multidisciplinary team planned for each patient’s discharge and return to their local area. Staff ensured that appropriate arrangements were in place to sustain the patient’s mental health. This included liaising with health and social care professionals in the patient’s local area to ensure they had appropriate accommodation to be discharged to and that a package of care was provided by the local mental health services.

Of the 15 patients we spoke with, 9 patients were happy with the support they were receiving to work towards discharge from their wards. Five patients said they were able to take part in education and work-based opportunities during their time on the wards.