Lancashire & South Cumbria NHS Foundation Trust

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This is the first assessment for this newly registered service.

This key question has been rated outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Quality Statement Score: 4

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. The overwhelming theme from feedback was that patients felt like they were well supported, listened to, and their views and opinions really mattered.

During our on-site assessment, we spoke with 8 patients and 4 carers. We received universally positive feedback about the service in terms of the care the patients received, some of which are detailed below:

‘Support is very good - made me feel at home’

‘Brilliant approach to patients’

‘knows she will always have support following discharge’

‘absolutely fantastic’

“Someone is always available’

Staff supported patients to understand and manage their care, treatment or condition.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. Patients said staff treated them well and behaved appropriately towards them.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. We observed on the ward that patients who were on special observations were given privacy when partners visited (if this was safe to do so) and women who were breastfeeding were given privacy and support to do this in a safe and calm environment. In the community, we saw care given to time of day for visits for new parents, along with genuine understanding and respect for cultural differences in the way new babies were welcomed into a family.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of information about patients.

Quality Statement Score: 4

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. Providing specialist equipment for post operative women and therefore ensuring women received specialist perinatal care at the earliest opportunity. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics and ensured that care was provided in line with the patients wishes and traditions where possible

Patients fed back to us that they were supported to care for themselves during pregnancy and when their baby was born, in a way that they felt comfortable with. The patients we spoke to described the care as both personalised and with safety in mind.

The service made adjustments for disabled patients – for example, by ensuring disabled people’s access to premises and by meeting patients’ specific communication needs. Staff received mandatory training in equality and diversity and in meeting the needs of people with a learning disability and autism. The ward also had a specially adapted room for women who had recently had a delivery via caesarean section. The bed was a hospital profiling bed, which meant it could be raised up and down, as well as the head and foot of the bed being adjustable. There was also a fully assisted bathroom. This meant that women could be moved over to the inpatient perinatal unit earlier than would have been possible if this equipment was not available, meaning women were provided with specialist perinatal care at the earliest opportunity.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. These were available in different languages if required. The information provided was in a form accessible to the particular patient group (for example, in easy-read form).

Managers ensured that staff and patients had easy access to interpreters and/or signers. Staff told us there was generally no issues with accessing these services and the booking process was straightforward.

Patients on the ward had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. There was a fully working kitchen on the ward where patients could prepare food for themselves, store snacks and drinks as well as milk and other food for their baby. There were enough high chairs for babies to sit in whilst eating and these were readily available when they were required. The ward had received accreditation for The Baby Friendly Initiative via UNICEF. This was designed to provide parents with the best possible care to build close and loving relationships with their baby and to feed their baby in ways which would support optimum health and development. In order to gain this accreditation, the ward implemented the standards in stages and when all the stages were passed, they were accredited as Baby Friendly, this was done via an external review from UNICEF.

Staff ensured that patients had access to appropriate spiritual support. There was a quiet room on the ward that could be used for religious practice, such as prayer, or just quiet time for patients to reflect. Staff were also aware of different traditions surrounding the birth of a baby in different cultures and religions, these were always respected as far as possible whilst maintaining the safety of the baby.

Quality Statement Score: 4

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients we spoke with, and their carers/family felt very well informed about their care and treatment. Patients described that they had received information about their medication and that they were involved in reviews about their care and treatment. Patients reported that, where appropriate, their family, carers or loved ones were involved in meetings about their care.

The Trust valued patient and carer feedback and went to great lengths to ensure that they got this feedback in any way possible. They actively sought and reviewed feedback via several initiatives which were supported through the Trust’s dedicated quality assurance functions. We reviewed feedback from patients on the friends and family test for all teams and found that from September 2024 to the date of our assessment there had been 397 responses across the 4 teams. Every team was above 90% positive with Pennine Community team receiving over 99% positive comments from 102 responses.

Comments included:

“I've never had the help like I've received, absolutely amazing service”

“An amazing service that I wouldn't have got through last 15 months with out”

“I wouldn’t be where I am mentally or emotionally if I hadn’t accessed services when I did”

“All of the professionals I have worked with from the team have been brilliant. They were all helpful, supportive, non judgemental and understanding”

“This service helped me become well again, and for that I will be forever grateful”

We reviewed patient community meeting minutes for the ward and found these to be consistent in their content and held on a regular basis. We could see evidence of the patient voice within the minutes such as requests for certain activities and to celebrate events. We were able to see evidence that requests had been acted upon, for example a celebration at Christmas included a Christmas Market type event in the ward garden, that was attended by patients and their families.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. 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.

All patients we spoke with told us that staff quickly responded to them when they needed something. They told us staff always listened to them and tried to reduce any distress they may have had.

Staff identified and responded to changing risks to, or posed by, patients. We saw that patients had person centred care plans that showed staff how to respond to their needs. Staff at all services we visited were very familiar with the patients they were caring for and were able to tell us about their specific needs and how to manage these.

The service had access to on-call rota that clearly showed the medical support, senior management, and ward management availability. We observed 2 morning safety huddles (one for inpatients and one for community) and saw that peoples’ immediate risks and needs were addressed and discussed.

Patients on the ward had access to call bells when they needed immediate assistance.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. Staff received de-escalation training as part of their prevention and management of violence and aggression training and the staff we spoke with told us that they would always attempt to verbally de-escalate an incident before resorting to physical restraint.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff felt positive and proud about working for the provider and their team. Staff felt respected, supported and valued. We received positive feedback from staff and leaders about the wards and the trust being a supportive place to work, with good access to staff well-being initiatives and flexible working arrangements. Most of the staff we spoke with confirmed their workload was manageable and they felt safe in their place of work. However, due to vacancies in some of the community teams, some staff reflected they felt there was some pressure on the teams and there was a small waiting list for patients to be seen. They said this weighed heavy on their minds, given the potential risks of the patients they saw. In the main, staff retention was high. Staff had a structured induction at the start of their employment.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Staff had access to a lot of well-being resources, including reflective supervision, well-being initiatives, and a Trust newsletter with information about well-being resources.

The service’s staff sickness and absence were similar to the average for the provider.

The provider recognised staff success within the service – for example, through staff awards.

Staff appraisals included conversations about career development and how it could be supported.