East London NHS Foundation Trust

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• 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 effective as good. At this assessment the rating has remained good.

Staff completed comprehensive assessments of young people’s physical and mental health on admission, taking into account their developmental needs, risk factors, and family dynamics. They developed personalised, age appropriate care plans, which were regularly reviewed and updated through multidisciplinary team (MDT) discussions, ensuring care remained responsive to the changing needs of young people.

Young people received a range of evidence-based treatments and interventions aligned with national guidance and best practice for CAMHS services. The ward team included, or had access to, a full range of specialist professionals required to meet the complex needs of young people.

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.

Quality Statement Score: 3

The evidence showed a good standard.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 16 care records of young people and found that staff carried out comprehensive mental and physical health assessments on admission, including assessments of capacity where appropriate. Physical health checks were consistently completed on admission, with evidence of ongoing monitoring throughout the young person’s stay.

Care plans were personalised, holistic and recovery-oriented and were regularly reviewed and updated, particularly following incidents or changes in presentation.

We saw evidence of rapid changes in medication, including antipsychotic treatment, where clinically indicated. These changes were documented, reviewed, and monitored by the MDT to ensure safe and effective care.

Staff considered how family relationships, peer relationships and environmental factors affected young people’s mental health and recovery. Young people were actively involved in shaping their care and treatment goals. Staff also involved families in care planning and support to help understand difficulties within the wider context of the young person’s relationships and experiences. These were discussed in MDT meetings, handovers, and safety huddles.

Staff demonstrated a good understanding of individual communication needs. where specific ‘dos and don’ts’ for communication and interaction were clearly shared to ensure consistent approaches across the team. For example, one young person spoke openly about how their autism affected their communication style and use of language, and staff adapted their approach accordingly.

Quality Statement Score: 3.

The evidence showed a good standard.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff delivered care and treatment using evidence-based approaches tailored to the individual emotional and mental health needs of young people. Interventions were informed by structured assessments and clinical formulations, ensuring care reflected recognised best practice and responded to each young person’s individual circumstances and risks.

We observed a clearly defined assessment pathway for young people admitted to the service. Young people attended an assessment clinic on admission, which included participation in a porch meeting followed by comprehensive multidisciplinary assessments undertaken by psychology, medical staff, family therapists and social workers. This supported a holistic understanding of the young person’s needs, presentation and family context.

Staff used psychological formulation approaches to develop a shared understanding of each young person’s difficulties, informed by multidisciplinary perspectives, lived experience, family relationships and wider social and environmental factors. Staff used structured models, including the 5 Ps framework (predisposing, precipitating, perpetuating, protective and presenting factors), to identify underlying causes, triggers and maintaining factors affecting the young person’s mental health. This supported care planning that extended beyond diagnosis alone.

Each ward provided a structured programme of therapeutic and recreational activities, including drama therapy, people participation, creative skills, pet therapy and outdoor activities. Young people generally spoke positively about the range of activities available, although some said they would like access to a wider variety of activities and even more opportunities for activities during weekends.

Overall, the service demonstrated a coordinated, formulation-driven and evidence-based approach to delivering care and treatment for young people. Care was individualised, trauma-informed and supported by strong multidisciplinary collaboration and therapeutic engagement.

Quality Statement Score: 3.

The evidence showed a good standard.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service demonstrated highly effective team and partnership working, supporting safe, coordinated, and person-centered care for young people. We found that staff, teams, and services worked collaboratively and effectively to deliver coordinated care for young people. We observed strong collaborative working across teams, particularly at the Evergreen unit, where there were very good interaction and rapport between nursing staff, the MDT, and the wider clinical team. This was also echoed by feedback from young people, who spoke positively about staff team working and engagement. Across all units, the staff consistently spoke highly of one another and described feeling supported by their colleagues and the matron. At the Coborn Centre, staff told us they worked well together, showing care and respect both for the service and for each other. Staff demonstrated pride in their work together and a clear sense of dedication to providing high-quality care.

There were well established systems in place to support shared decision making, risk management, and multi-agency working. We observed robust discussions of risk and care planning across teams, including Senior Management Group (SMG) meetings, clinical review meetings, MDT meetings, and NCEL provider collaborative meetings. These involved a wide range of multidisciplinary professionals and included detailed discussions on risk, care planning, and safeguarding, as well as joint working with local authorities and external partners. This demonstrated strong collaborative partnership working.

Staff handovers were thorough, structured, and efficient, ensuring clear communication of risks and care needs. Staff also had time for reflection at the end of each shift, supporting shared learning, team cohesion, and staff wellbeing.

We also spoke with teachers across the service, who told us they felt well supported by nursing staff and the MDT. They described effective information sharing through attendance at meetings, handovers, safety huddles, and Care Programme Approach meetings, which ensured a strong awareness of young people’s care needs.

The education teams at both the Evergreen unit and the Coborn center made significant contribution to the development of young people, working alongside clinical staff to support their educational and developmental needs. We observed active participation of young people in classroom activities, demonstrating effective integration of education within the overall care model.

Quality Statement Score: 3.

The evidence showed a good standard.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Quality Statement Score: 3.

The evidence showed a good standard.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff told us that young people’s care was outcome-driven, with progress regularly reviewed and used to inform care planning and discharge. We saw examples of this in young people’s key working sessions, where discussions with stakeholders and other professionals informed decisions about care pathways. For instance, in one case, a young person’s need to relocate closer to home was identified and appropriately progressed.

Staff told us they used a range of validated outcome measures to monitor progress and the effectiveness of interventions. These included the Outcome Star on admission and the Children’s Global Assessment Scale within psychological interventions and ongoing therapeutic review. Additional outcome tools such as the Model of Human Occupation, the Canadian Occupational Performance Measure, and Health of the Nation Outcome Scales were also used to provide a comprehensive view of young people’s functioning and progress.

We saw evidence-based therapeutic models, including Dialectical Behaviour Therapy and Cognitive Behavioural Therapy, in young people’s care records, supporting measurable improvements in emotional regulation, coping skills, and overall mental health.

Outcome measures were discussed and reviewed within ward rounds, with involvement from multidisciplinary teams, including Crisis and Home Treatment Teams where appropriate. This supported a community-focused approach, ensuring that care planning and discharge strategies were aligned with ongoing support needs outside of the inpatient setting.

Staff told us that outcome monitoring helped to structure and expedite discharge planning, ensuring that young people were prepared for transition and that care remained focused on recovery and reintegration into the community.

Quality Statement Score: 3.

The evidence showed a good standard.

The service told people about their rights around consent and respected these when delivering person-centered care and treatment. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

We found that young people detained under the Mental Health Act (MHA) were aware of their rights and recorded in their care records. Young people’s rights were read and explained appropriately and within required timescales. Staff ensured that these rights were clearly explained and regularly revisited, and we saw evidence in care records confirming that young people had their rights read to them weekly in line with statutory guidance.

Records demonstrated that capacity to consent to treatment was appropriately assessed for young people detained under the MHA. Capacity assessments were completed on admission and reviewed on a weekly basis and thereafter, ensuring that decisions about care and treatment were made in line with the young person’s ability to understand and consent. We saw evidence in young people’s care plans that staff considered and documented Gillick competence where appropriate. Gillick competence refers to an assessment of whether a young person under the age of 16 has sufficient understanding and maturity to make informed decisions about their care and treatment, including the ability to consent independently.

We also saw evidence of Approved Mental Health Professional (AMHP) reports within care records, which supported the legal framework for detention and treatment under the MHA. These reports contributed to a clear understanding of the rationale for detention and ongoing care.

All young people, including those admitted informally, were provided with information about their rights, including access to an Independent Mental Health Advocate (IMHA). IMHAs attended the service at least weekly and were available as required, ensuring young people had access to independent support and advocacy.