Hertfordshire Partnership University 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

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection we rated this key question as good. At this inspection the rating has improved to 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 95 (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 4. The evidence showed an exceptional standard. The provider 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.

During the inspection, we observed lovely interactions between staff and people using the service. Staff were kind and caring and supported people to understand and manage their care and treatment by using different methods of communication considering their individual needs. All staff demonstrated a genuine passion for supporting people with learning disabilities, advocating for their needs and ensuring they could enjoy full, healthy lives in the community.

Staff developed therapeutic relationships with people based on trust, compassion, and understanding. They demonstrated a strong awareness of individual needs, preferences, and personal histories and always treated people with dignity and respect.

We saw many examples where staff had gone the extra mile to support and care for people. For example, staff had collaborated to commission a bespoke standing frame for a person who had physical as well as learning disabilities. The new custom built frame allowed for them to stand much straighter which led to great improvements in swallowing, respiratory and bowel health and overall quality of life.

People were overwhelmingly positive when talking about the staff and the care they, or their loved ones, had received. We saw many examples of positive feedback and compliments, for example, ‘Staff are very caring, very kind, very tolerant and really helpful’, ‘My nurse has helped me learn what a proper healthy relationship is... he explained the info really well so I could understand’, ‘He has been brilliant throughout…he taught my son so many techniques how to address worries and feelings…he got my son to open up about struggles then supported him in how to address situations’. ‘I like it when you come to see me. I've learnt about my trauma. I have nice dreams now; the nightmares have gone.’

Results from the NHS Friends and Family Test for February to July 2026 showed the average percentage of positive feedback received for the community learning disability teams was 99%, with the Essex teams receiving 100% positive feedback between these dates.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff had an excellent understanding of each person’s individual needs. Staff adapted care around each person's communication, sensory, environmental and physical health needs through accessible information, Easy Read materials, communication passports, augmentative and alternative communication (AAC), sensory screening and profiling, environmental modification and specialist MDT assessment.

Staff ensured that people using the service and their families could obtain information on treatments, local services, people’s’ rights and how to complain, in a way the individuals could understand. Families and carers were given information about other local services that provided support to people with learning disabilities and their families.

The service demonstrated a strong commitment to meeting the diverse needs of all people, particularly those with protected characteristics under the Equality Act 2010. Staff provided dedicated support for communication, advocacy, and cultural and spiritual needs. We saw examples where staff worked sensitively with refugees and other people where there were religious considerations, undertaking capacity assessments and establishing if they could make informed decisions around physical intimacy, sexual health and consent.

Staff incorporated discussions around culture and spiritual practices within care plans and assessments, including dietary needs. The trust had a spiritual care team and spiritual champions who offered support and organised events recognising different faiths and cultural celebrations.

Reasonable adjustments were made to meet the needs of disabled people, and all service locations were accessible to individuals with reduced mobility and wheelchair users. Where people were unable to attend appointments, staff visited at home or arranged appointments in alternative suitable settings.

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.

Staff empowered and supported people to have as much choice and control over their care and treatment as possible. They involved people in decisions always considering their capacity and legal status.

Care plans set out current needs, promoted strategies and short-term goals to enhance independence, and demonstrated evidence of planning and consideration of the longer-term goals of each person.

The trust employed Health Access Champions who used their lived experience of learning disabilities to support others to know their rights, advocate for themselves and have choice and control over their own care and treatment. The Health Access Champions chaired ‘Making Services Better’ meetings which were attended by people and staff including senior nurses and managers. The aim of the meetings was to listen to peoples’ experiences of care and treatment and improve the experience of care and outcomes for all those who used learning disability services, for example by improving the involvement of people with lived experiences in interviews for new staff.

The trust had developed a ‘Making Positive Moves’ easy-read toolkit designed to help people with learning disabilities build the life they wanted in the community after leaving a mental health or forensic hospital setting. The toolkit, co-produced with people with learning disabilities, families, carers and professionals, supported people to think about their goals, make choices that matter to them and identify the support they may need to live well and thrive.

The trust had a carer practice policy in place which set out expectations for working in partnership with carers and was based on the nationally recognised Triangle of Care standards, ensuring carers were identified, supported and appropriately involved in assessment, care planning and discharge. The Triangle of Care was an improvement tool based on 6 principles to ensure providers included and supported unpaid carers.

We scored the service as 4. The provider was exceptional in how they 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.

Each team operated a daily duty system ensuring that a designated member of staff was available to respond promptly to requests for support and advice. Staff from the intensive support teams responded swiftly to assess need and provide timely interventions for people in crisis or distress. One family member told us about their experience of getting support for their son in a crisis, ‘He was picked up in a time of crisis, and they said what does he need? What do the family need?.... I felt it was like a safety net – I’d got to burnout point… …the relationships they build are brilliant – they just seem to know where to go’.

Where appropriate, staff gave people interim support strategies to address immediate needs whilst they were waiting for treatment. For example, in Hertfordshire, psychology staff recognised the needs of people waiting for individual psychological therapy by offering supportive group interventions. For example, the ‘Tree of Life’ narrative therapy group supported people who had experienced trauma or loss, while ‘Coping Well’, an adapted dialectical behavioural therapy (DBT) group, focused on developing coping strategies for people experiencing emotional distress. The ‘Coping Well’ group was particularly successful, with many participants making such good progress they no longer required further psychological treatment. Others found the group setting so beneficial that they chose to continue meeting as a group rather than move to individual sessions.

In Buckinghamshire, staff responded to an increase in referrals for people with sexual health needs by offering additional staff training and to a large increase in referrals for physiotherapy by recruiting an additional member of staff and using the team budget more flexibly to meet peoples’ immediate needs.

We scored the service as 4. The evidence showed an exceptional standard. The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff had access to the trust’s employee assistance program which provided a variety of support options for a range of issues. The trust also offered a wide range of services to support wellbeing, staff development, reflective practice, access to supervision, and leadership support. For example, structured staff development days, wellbeing champions and peer support, informal wellbeing initiatives, psychological safety and reflective practice and newsletters. Staff had access to the Professional Nurse Advocate service, which provided restorative clinical supervision (RCS) for nurses and wider health and social care staff.

The trust recognised staff success within the service. The trust Inspire awards recognised and rewarded staff who consistently demonstrated the trust values every day and went above and beyond what was normally expected of them. Winners were invited to attend an informal presentation with the chief executive and members of the executive team where they were presented with a certificate, commemorative badge and £50 voucher. We saw examples where staff from the learning disability service had been nominated for, or won, Inspire awards.

Psychologists offered Adaptive Mentalization Based Integrative Treatment (AMBIT) sessions to staff. AMBIT is a framework designed to help teams create effective systems of care and was developed to support staff who work with clients with multiple needs. It encourages equal attention to how teams work effectively with complexity, how colleagues support and reflect on each other’s practice, how services build strong multi-agency relationships, and how teams continuously learn and adapt their approaches. Staff in Buckinghamshire had conducted an audit on the use of AMBIT in February 2025 and found that 62% of staff surveyed had taken part in AMBIT training and 84% had found it helpful or very helpful.

The trust issued a weekly round-up sharing updates across the organisation, including positive practice, quality improvements, staff recognition and compliments, as well as news, events and wellbeing information. It also provided guidance on staying well at work and signposted useful resources for staff.

Staff felt extremely positive and proud about working for the trust. Staff morale was high and staff valued the collaboration, teamwork and exceptional support from managers as well as the opportunities for their own learning and personal and professional development.