Lancashire & South Cumbria NHS Foundation Trust

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

Staff managed beds well. A bed was available when a patient needed one. 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.

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.

Patients mostly described feeling involved in their care and treatment. Patients were involved in decision making about their care and in relation to their wards through community meetings.

The service took action based on patient feedback. The trust provided a summary of actions taken in response to October’s Friends and Family test results, including changes being made to menus and making sure that healthier drink options were available to patients.

Patients stated that staff helped them with understanding aspects of their care plan and supporting them in line with their communication needs.

The trust had introduced a patient-led outcomes scale to assist staff with providing care and treatment that was focused and tailored towards each individual patient.

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.

Patients could access a range of facilities on-site including a gym, sensory room and occupational therapy centre. Patients gave positive feedback about being able to access facilities and activities off the wards.

Staff supported patients to maintain contact with their families and carers. Staff described how they supported patients with maintaining family contact. The service had a visiting room which could be booked to facilitate contact with family and loved ones.

Staff supported patients to access their chosen place of worship within the community where appropriate.

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

Staff made notifications to external bodies as needed.

Information governance systems included confidentiality of patient records.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Patients stated that staff would provide them with information and advice as required. Managers gave examples of how staff had adapted their communication to meet the needs of patients.

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

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.

The service had received 17 formal complaints in the 12 months prior to the assessment across 7 of the 14 wards. 6 of the complaints had been upheld, 7 were not upheld, 1 partially upheld and 1 withdrawn by the complainant. 2 complaints remained open as the investigations were still ongoing. There were no significant themes across the complaints.

The trust had received one contact from the Parliamentary and Health Service Ombudsman in relation to Guild Lodge services, although this related to care delivered in 2019. The PHSO’s decision on review of the trust’s original complaint responses was that they would not assess the case further and it was therefore closed.

Patients knew how to complain or raise concerns. Patients generally felt confident that they could raise concerns within the service.

The trust had a Patient Advice and Liaison Service (PALS) that patients could access to support them with addressing any concerns. Posters were on display on each ward with the contact details for the PALS team.

Patients had access to an independent advocacy service, who could provide patients with support in raising concerns.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met. Staff made reasonable adjustments for patients. Managers gave examples of where staff had made adjustments to support patients with specific mobility needs.

There was adequate medical cover day and night and a doctor could attend the ward quickly in an emergency.

Staff planned for patients’ discharge, including good liaison with care managers/co-ordinators. Staff informed patients about their care and treatment including considerations and planning about potential discharge.

The service had discharged 44 patients across the 14 wards in the 12 months prior to the assessment.

At the time of the assessment, the service had 20 patients that were considered a delayed discharge across 9 of the 14 wards. The ward with the highest number of delayed discharges was Langden ward with 5 patients. The service provided the reasons for the delays in patients being discharged and the ongoing actions they were taking to address this, such as ongoing engagement and escalation with external stakeholders and commissioners.

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.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patients mostly felt that they could give their feedback and views on the service, including raising any issues that they had.

Staff were trained in equality, diversity, inclusion and human rights. Staff received equality and diversity training with an average compliance rate of 95% across the service.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future. Patients generally felt informed and involved in their care and treatment.

Staff created personalised care plans to account for the patient’s needs, wishes and feelings. Care plans were mostly individualised to each patient and were reflective of their needs and preferences.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.