Hertfordshire Partnership University 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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider largely delivered person-centred care and treatment, with systems in place to involve young people and their parents/carers in planning, reviewing and responding to changes in need. Care was coordinated through a multidisciplinary approach and reflected a broad understanding of young people’s mental health, emotional, social and safeguarding needs.

Care plans reflected young people’s presenting needs and risks were reviewed regularly through ward rounds and MDT meetings. Families were involved in care planning discussions, and all young people told us their families attend ward rounds.

Young people told us they understood their care and treatment and felt involved in decisions about changes to their treatment, particularly during ward rounds. Whilst nursing care plans were in place and reviewed, opportunities remained to strengthen collaborative development of nursing care plans to ensure young people felt actively involved in shaping the care they received whilst on the unit.

The service demonstrated a need to make reasonable adjustments, particularly for neurodivergent young people and those with sensory needs. The provider had identified environmental challenges in relation to the noise levels and were developing a bespoke sensory room and working towards National Autistic Society ward accreditation to improve inclusivity and person-centred care for young people diagnosed with autism.

The provider demonstrated a good understanding of the diverse and complex needs of the local population and delivered care that was joined-up, flexible and supportive of continuity.

Forest House provided specialist inpatient care for young people experiencing acute mental health crises, many of whom had high levels of complexity, including neurodivergence, safeguarding involvement and eating disorders. The service worked closely with a wide range of parters, including community CAMHS, eating disorder services and children’s social care.

Children’s social care routinely attended ward rounds where appropriate, supporting continuity and shared ownership of care planning. Transitions and discharge planning were considered early and managed through MDT discussion.

Service activity and outcomes data supported the effectiveness and continuity of care delivery. Over a 12 month reporting period, there were 56 admissions, with an average bed occupancy of 10.5 beds per month. The average length of stay was 66 days, which reflected the complexity and acuity of the cohort. The 12-month readmission rate was 7%, suggesting effective assessment, stabilisation, discharge planning and coordination with community services.

The provider ensured that young people and their parents, or carers, were given appropriate, accurate and up-to-date information, tailored to individual needs and delivered in ways that supported understanding, choice and involvement.

Young people told us they received information about their care and treatment in ways they could understand and spoke positively about the information they were provided in ward rounds to ensure that they felt involved in decisions about their care.

Families and carers were provided with information about the ward upon admission and said they were involved in decisions about their child’s care during ward rounds. Whilst one carer informed us that communication over the weekends was “not great”, and that on one occasion they had not been informed that their child had been physically restrained, overall, feedback regarding communication with families and carers was positive. There were process in place to keep families informed of care and treatment plans.

The service had systems in place to support people’s rights to information and consent. We saw evidence that Mental Health Act rights were explained to young people. Documentation relating to consent and treatment authority was accessible and up to date.

The evidence showed an exceptional standard. The service was exceptional at enabling young people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

Young people told us they felt involved in discussions about their care and we saw evidence that community meetings prioritised collecting feedback from young people on how to improve their care.

Carers and families told us they felt confident that if they complained, they would be taken seriously and treated compassionately. During a reporting period of 6 months, the service had received 7 formal complaints. The provider’s response timeframe was 35 days, and we saw evidence that complaints were investigated appropriately.

The service received 44 pieces of feedback over 6 months, including compliments, ward round feedback surveys, Friends and Family Test responses, and a service user and carer survey completed in April 2025. This demonstrated good engagement with a range of methods for obtaining feedback and an openness to hearing people’s views.

Feedback and complaints were analysed to identify themes and areas for improvement. Key areas identified included strengthening co-production of care plans, improving carer and parent support, and enhancing staff training and knowledge. The provider implemented improvements in response to feedback, such as a structured process for communicating with parents each week and an increased focus on co-production of ward activities.

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

The provider demonstrated focus on making reasonable adjustments for young people with additional needs. Service leaders recognised that the ward environment could present sensory challenges, particularly for neurodivergent young people, and were actively addressing this through the development of a bespoke sensory room and work towards National Autistic Society ward accreditation. This showed a proactive approach to reducing environmental barriers and improving equitable access to care.

The provider also considered equity in access through multidisciplinary working and partnership with external agencies. Links were maintained with children’s social care, education, community CAMHS and specialist pathways, supporting coordinated access for young people with complex health and social care needs.

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.

The provider demonstrated consideration of protected characteristics through reasonable adjustments, including accommodating religious dietary requirements. The provider was also working towards ward accreditation with the National Autistic Society, and was developing a bespoke sensory room, to improve outcomes for neurodivergent young people.

The provider used a variety of methods to obtain feedback, including community meetings, ward rounds, surveys, compliments and complaints, to maximise access for young people and carers who may be at risk of disadvantage or unequal experiences. This supported inclusive engagement and helped reduce barriers to sharing views and experiences.

Young people were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

The provider supported young people to plan for future transitions, including education, in a way that recognised their mental health needs, capacity, and readiness for engagement.

Education attendance data showed an overall attendance rate of 22%, with 24% unauthorised absence and 52% authorised absence in the past 12 months. The provider demonstrated an understanding that authorised absence was often linked to clinical need, including illness, therapy appointments, mental health incidents, home leave, observation levels, and periods of increased risk or acuity on the ward. This reflected the complexity of the cohort of young people.

The provider was taking proactive steps to support young people to re-engage with education as part of future planning. The education timetable had been refreshed to improve motivation to attend, including introducing subjects such as current affairs and debate. The provider also used individualised attendance plans to tailor support according to each young person’s needs.

Positive reinforcement strategies included reward certificates and vouchers to encourage attendance. The provider reported that they had seen direct benefit of these results and a positive impact on young people’s engagement with education.

The provider also supported young people to plan for discharge and planning for periods of leave was embedded within the care pathway. Young people reported feeling involved in decisions about their care, such as going on leave. A parent also reported feeling involved in discussions when planning for a period of home leave.