Devon Partnership NHS Trust

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were supported and treated with dignity and respect; and involved as partners in their care. Staff informed and involved families and carers appropriately.

This service scored 70 (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 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff were observed walking around with patients and seated outside patients’ rooms, giving patients’ space when needed. Interactions seemed appropriate for patients’ needs, with staff talking to patients at times and being quiet when that was needed, which showed that staff were discreet, respectful and caring of patients. Staff were proud of patient progress and demonstrated sensitivity to trauma and disordered eating. Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences and maintained the confidentiality of information about patients.

Patients told us that staff were positive and listened to them about their medication and helped them get medicines prescribed. Patients said staff treated them well and behaved appropriately towards them and played games with them.

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.

The service had accessible ramps into the building and no steps that would obstruct mobility. We saw accessible bedrooms large enough for wheelchairs and carers and bathrooms with ceiling hoists and bath seats. Worktops could be adjusted to wheelchair height in both the kitchen and garden area. Care plans included adjustments for individual patient’s communication needs and meal support.

We observed staff interacting with people respectfully. One staff member checked on a person's wellbeing and showed concern in relation to a recent injury. Staff informed and reassured a person when there was a slight delay in their medication being prepared.

Staff knocked on doors and asked permission before entering peoples’ rooms. Staff engaged in banter with a patient whilst they played a game of throw and catch in the corridor space. We observed that lighting was adjusted according to individual patient’s preferences by staff. Staff explained this met the person's needs as they were sensitive to lighting. The lights were also turned off in their private space, which was naturally lit by sunlight.

Patients are given information on treatments, local services, patients’ rights, and how to complain in their welcome pack. The patient handbook was in easy read format, describing the staff team, care plans, and how they could give feedback. A large print bible was available for a patient with sight problems and communication aids like talking mats were tailored to individual needs with the help of the speech and language team.

Patients had a diverse menu choice of 4 to 6 food items to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Patients had access to appropriate and varied spiritual support through a chaplain and faith room onsite. The chaplain was observed engaging with a patient, was available to staff and patients and staff told us the chaplain was a valued member of the service.

One carer has said “The Brook are a breath of fresh air. I think they’re very inclusive, very thorough, the best experience I’ve had so far, [I'm] generally very impressed.” Another carer said “They’re very open ... they actively seek my views about what is helpful for supporting my loved one. There’s a lot of care and respect” “Staff seem to genuinely care ... they all seem lovely.” “There is a lot there that’s good, [but] everyone needs to work better as a team. There needs to be more trust within the team - a power imbalance is detrimental to the team.”

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People were involved in daily decision making. People decided what they eat to what they wear. Patients had their own kitchens to make food and drink in their rooms and were able to cook and bake with staff. People could choose to eat in their rooms or the social hub. Patients were also supported to do their own laundry. One patient had an iPad to listen to music which they liked.

The service had access to a car to facilitate patient leave and hospital appointments. Patients accessed the local community and went for walks with staff in grounds. Patients could also have walks with family members in the grounds.

There was a sensory room with a range of equipment and a sensory gym. A therapy dog came in sometimes. Games activities were available in rooms in cupboards. The therapy team had 3 staff, including art therapy, music therapy and drama therapy in the unit's activity room, a gardening club and a visiting schedule to the local leisure centre and countryside parks. Staff noted that each patient had a needs-led, individualised activity timetable, developed primarily by the occupational therapy team and shared with key staff, as well as access to a wider ward activity timetable. The therapy team offered 1 or 2 open door sessions a week that patients could attend or do activities in their own rooms.

The well-designed garden beds established as part of the original service design were somewhat neglected. Staff told us the occupational therapy team had a gardening project planned, but many occupational therapists had left the service since it had opened and the planned activities had been cancelled or were not happening. Staff told us “people here are just doing observations”.

We saw a person had a personalised duvet cover and another person had a very plain room in line with their wishes and sensory needs. One person's care plan stipulated that they were to be enabled to vape three times a day, in accordance with their personal preference. Staff explained there was some flexibility for this person around the times and numbers depending on the person's mood.

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 minimize any discomfort, concern or distress.

Staff identified and responded to changing risks to or by patients. We observed staff to be responsive and remained with patients talking with them. There was evidence of personalised support plans that detailed list of triggers and warning signs for distress and sensory support needs. Staff told us they had a good general awareness and understanding of each person's needs regarding lighting and the time each person needed to process information.

Additionally, the service used staff specific, measurable, achievable, relevant, and time bound (SMART) targets with patients. Targets were broken down into 5-7 steps and activity profiles were developed to support patients to address the steps and targets. 96% of staff have completed training in positive behavioural support (PBS) and reducing restrictive practice. Staff described PBS as 'the culture' of the unit and were able to describe relevant aspects of the PERMA model in practice: supporting positive emotions, engagement, relationships, meaning, and achievements. All new staff attend a 2–3-day PBS training course as part of their induction and all band 6 nurses had completed an 18-month PBS diploma. The service has 1 PBS lead as part of the staff team who was completing a masters level qualification in PBS. The team ran an in-house PBS course every 2 months for the staff team. All patients had positive and proactive support plans (PPSP) and these are reviewed every month at PPSP meetings. Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened..

We scored the service as 2. The evidence showed some shortfalls. The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff told us the initial training given when the service opened in August had not prepared or equipped them for the level of repeated violence directed towards staff members by the first two patients admitted to the service. Several staff were hospitalised having been bitten or knocked out by a patient, which is confirmed in the service incident record for the months of September 2025, January and February 2026. Some staff told us they were afraid of being assaulted by patients and felt inexperienced and insufficiently trained to handle incidents, leading some staff to hide during incidents.

Some staff distrusted management decisions and felt observation levels for patients had been reduced to save money despite the risk from patients. Staff told us they had repeatedly raised their concerns about personal safety, patient risk and incidents of physical violence towards them via their team leads which had been escalated informally, but leaders of the service hadn’t changed anything. Staff told us this is why so many staff have left. We reviewed incident records of violence against staff. Whilst incidents were recorded there was no record of the service discussing staff safety concerns in meeting minutes. The first quarterly HCA support meeting was not convened until January, when it was noted that HCAs were unaware regular monthly HCA meetings had been scheduled.

In response to feedback provided at the inspection, the service confirmed it had recently launched work around ‘staff culture’ which includes additional coaching for staff by the corporate organisational development team, as well as additional physical intervention support to improve staff understanding and confidence. The service has also provided trauma risk management (TRiM) counsellors to listen confidentially, provide practical support, and identify colleagues at risk of psychological harm following traumatic incidents using structured instruments. These Counsellors also supported new global majority workers.