Sussex Partnership NHS Foundation 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.

At our last assessment we rated this key question Outstanding. At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 young people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff were discreet, respectful, and responsive when caring for children and young people. We witnessed some positive and friendly interactions during our inspection. We observed staff discussing young people in a respectful manner during meetings. Staff displayed a strong understanding of their individual needs and circumstances. Staff gave children and young people help, emotional support and advice when they needed it. All young people had a named keyworker who they had dedicated time with each week. The young people also attended one-to-one therapy sessions and occupational therapy sessions. Overall, young people and parents were very positive about the current therapy they received.

Staff directed young people to other services when appropriate and supported them to access these services where required. For example, on young person had enrolled at the local gym and was supported by staff to attend.

Feedback from young people and carers about staff interactions was mixed. Young people spoke positively about individual staff who worked regularly on the ward. They described them as caring, supportive and responsive to their needs. Young people told us they knew which staff to speak with if they wanted anything and would often seek out interaction from those few staff only as they made them feel comfortable.

Staff we spoke with understood the young people’s individual needs, including their personal, cultural, social and religious needs.

Staff maintained the confidentiality of information about young people and supported them to make personal phone calls in private.

However, staff told us they did not always feel able to raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes without fear of consequences. Staff told us about incidents on the ward that had happened, where some staff had refused to complete enhanced visual observations for certain young people and this went unchallenged.

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

Young people we spoke with told us that most staff treated them as individuals. They said staff who worked on the ward regularly knew their likes, dislikes and interests and would play games with them and they had enjoyable conversations. They said most staff treated them with dignity and respect, would address them with their chosen name and pronoun and would knock before entering their bedroom.

Staff ensured that young people could obtain information on treatments, local services, patients’ rights and how to complain. They provided young people and carers with information packs on admission.

Managers told us young people had easy access to interpreters and/or sign language when required.

Young people told us they had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

Staff ensured that young people had access to appropriate spiritual support and provided religious materials for young people.

However, Staff did not always communicate information in a way young people could understand or respond to effectively. This was particularly relevant for young people with autism and other neurodiverse needs; communication approaches were not always thought about or adapted to individuals’ preferences or level of understanding.

We scored the service as 2. The evidence showed some shortfalls. The service did not always promote young people’s independence, so young people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Young people were not always involved in their care planning. We reviewed six records and spoke with four young people who told us they were not always involved. There was evidence that staff held regular meetings with young people to gain their feedback about their experiences on the wards. However, this did not always result in action being taken to improve the service.

Restrictions were in place which limited young peoples’ access to parts of the ward including the garden, quiet room, multi-faith room, bedrooms and gym. There were not always enough staff to facilitate young people accessing areas of the ward that required staff supervision, such as access to the garden. Young people could access the communal area and dining room. We saw there was not always enough staff to ensure that young people could be supervised in these areas if they needed to access them.

Opportunities for activities were not always available. The service had one part-time Occupational Therapist and one activities coordinator, who did work one day at the weekend. However, young people told us that they felt there were not always enough activities available on the ward during evenings and weekends. During the evenings and at weekends, activities relied on ward staff, and due to the needs of other young people on the ward, staff were not always available to support them.

Young people spoke positively about ward outings and movie nights organised by staff. Some told us they enjoyed using the gym and could play sports games in there. Others told us they enjoyed the one-to-one activities they had with the Occupational Therapist or activities coordinator and enjoyed spending time with them.

Opportunities for young people to provide feedback about their care was not always acted upon. There were community meetings on the ward and ward rounds where young people could provide their feedback, however, all of the young people we spoke with told us they did not always feel listened to or that staff understood them and because of this their views and wishes were not consistently reflected in decisions about their care and treatment We did not see evidence of advanced decisions recorded in any of the young people’s care records we reviewed. For example, whether a young person would request to not be restrained in their bedroom. Some of the young people told us they did not like being restrained in their bedrooms.

We observed some staff interacting with and supporting young people in a very positive and engaging manner and this created a good rapport between staff and young people.

Young people and their families told us they could see each other as much as possible with visits to the service and time spent out in the community or overnight stays at home.

Young people told us they could choose their food options from a menu. They said the food was “alright” and they could ask staff to get them snacks and drinks when they wanted them.

Young people had their rights read and revisited on a regular basis and consent was gained and recorded correctly in young people’s care records.

We scored the service as 1. The evidence showed significant shortfalls. The service did not listen to or understand young people’s needs, views and wishes. Staff did not respond to young people’s needs in the moment or act to minimise any discomfort, concern or distress.

The individual needs of young people were not always met. For example, a young person regularly accessed the extra care area (ECA) when feeling anxious or agitated and required a quiet space to regulate their emotions. Despite this being a recognised support strategy, there was no care plan in place to guide staff on how and when this intervention should be used to meet the needs of the young person consistently.

Staff did not consistently use de-escalation techniques to reduce the need for physical interventions when young people became distressed. Young people told us that staff often restrained them before attempting other interventions first, and that some staff used restraint too much instead of recognising when they needed support and helping them.

Staff did not always support young people following incidents. For example, following an incident in which a young person attempted to assault a member of staff, staff in the immediate vicinity did not provide support or assistance.

We scored the service as 1. The evidence showed significant shortfalls. The service did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff feedback indicated low morale across the service. All staff we spoke with told us they did not feel supported and described feeling burnt out because they found it challenging to meet the needs of young people admitted to the ward as well as high use of agency and bank staff which put additional pressure on permanent staff.

Staff described concerns about the availability of additional support to manage incidents if needed because the unit was isolated from other trust services.

Staff told us they had collectively raised concerns about their own safety and the safety of the young people on the ward through a letter sent to senior leaders within the trust. Staff said leaders had subsequently met with them to discuss the concerns, but they had not seen any meaningful improvements following these discussions and felt their concerns had not been acted upon. As a result, many staff told us they felt unheard, unsupported and undervalued by trust senior leaders.

Newly qualified nurses were not always supported appropriately. Some were put in charge of shifts despite being inexperienced. Staff told us they had raised this as a concern on several occasions, but no actions had been taken to support staff or support safety on the ward.

The staff team included a high proportion of junior staff who required ongoing support, supervision and development to build their experience and knowledge. Staff told us they did not feel supported and felt they were expected to carry out tasks and manage risk on the ward without having the experience or expertise and support to do so.

Several staff members told us they were leaving or planning on leaving the service because they felt unhappy in their roles. Staff also expressed their concerns and anxiety about the impact of several experienced and key members of staff leaving the service.

Staff had access to trust wide occupational health services. However, all staff we spoke with told us they felt emotionally exhausted and did not feel supported with their own well-being needs.

Staff told us that formal debriefs following incidents did not routinely take place. Staff said they would have benefited from structured opportunities to reflect on incidents, support each other and identify learning as a team but the ability to hold debriefs had not been effectively supported by senior leaders at the service. This had been identified by the trust own internal quality review in July 2025, with actions identified but no improvements made.

Staff appraisals, supervision and development discussions were not consistently done and staff said the trust lacked supporting them with their career development and professional growth.