Sussex Partnership NHS Foundation Trust

On this page

• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people’s needs were not always met.

This service scored 62 (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 1. The evidence showed significant shortfalls. The service did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

The service did not always provide care that was centred around the young peoples’ needs, preferences and wishes. Care plans lacked evidence of personalised care planning. We reviewed 6 care records and found care plans did not always reflect the young person’s voice or demonstrate how they had been involved in identifying their goals, preferences or support needs. Whilst some Positive Behaviour Support (PBS) plans were more personalised, they were not consistently kept updated following changes that had been discussed between psychology and the young person.

The service did not always ensure effective provision, integration and continuity of care through meaningful involvement and personalised care planning. Opportunities to promote independence and choice were limited by blanket restrictions on the ward. Young people could not independently access snacks, hot drinks, bedrooms, or the garden and laundry room. These restrictions were not based on individual risk assessments so because of this care and support was not always tailored to individual needs, risks or preferences. Young people told us they did not always feel involved in their care. The trust had a CAMHS Acute Expert by Experience Advisory Forum which was led by the Lead Social Worker. This had led to the development of leaflets, welcome packs for Chalkhill and my communication passport. The OT and Education Independent Living Skills Group, which is a intervention that supports meaningful skill development, community integration, vocational learning, and discharge preparation. The group provides structured opportunities for young people to develop practical life skills, increase independence, and build confidence in real-world settings.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of young people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported young people to access education, via a school which was onsite. This meant young people could continue with the curriculum and ensure continuity in the young people’s education. Young people told us school was good and were positive about their experiences.

Staff supported young people to maintain contact with their families and carers.

Staff supported young people to access their chosen place of worship within the community.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies when required, including submitting statutory notifications to the Care Quality Commission.

Information governance systems supported the confidentiality and secure management of young people’s records.

Information boards were displayed throughout the ward and included information relating to therapies and group activities on the wards, safeguarding, the Mental Health Act, advocacy services and complaints processes. There were photographs of key staff for the ward displayed. Information was presented in a format that was accessible and simple to read.

However, staff did not always ensure consistent communication with relatives and carers. Some relatives reported problems with communication, particularly in relation to being informed of any incidents involving their child and receiving updates about how their child had been during the day so they still felt up-to-date with their lives, as they would had they been at home.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for young people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve young people in decisions about their care or tell them what had changed as a result.

Systems for sharing learning from complaints were not always effective. Staff told us they did not consistently receive feedback on the outcomes of complaint investigations or any actions identified as a result or when changes had been made as a result. This meant opportunities to embed learning and improve practice and demonstrate how concerns led to service improvements were sometimes missed. For example, young people had repeatedly requested the installation of sanitary disposal bins in the toilets, stating that the existing process, which required them to hand sanitary waste to a member of staff for disposal, compromised their dignity. This improvement took a long time to introduce, and some staff were not yet aware they had been introduced.

However, young people knew how to raise concerns and make complaints. Information about the complaints process was displayed on noticeboards throughout the ward, and young people told us they were able to raise concerns during community meetings or directly with members of staff.

Young people reported that when they raised concerns or made complaints, they generally received feedback and were kept informed of the outcome. However, some told us that responses were not always provided within the timescales they had been told they would be. As a result, they often felt they needed to repeatedly ask for updates, which led to frustration and lack of confidence in the process.

Staff understood their responsibilities in relation to receiving and managing complaints and were able to describe processes for escalating concerns appropriately. Staff also took steps to ensure young people who raised concerns were protected from discrimination, harassment or negative consequences as a result of speaking up.

We scored the service as 3. The evidence showed a good standard. The service made sure that young people could access the care, support and treatment they needed.

Staff ensured the needs of young people with mobility issues were met. For example, there was a lift which would enable anyone who used a wheelchair or had mobility needs to be able to access the bedrooms which were all located on the first floor.

Staff told us they had equipment and tools to support sensory needs. For example, activity boxes with items such as fidget spinners.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital and there was an emergency response procedure in place.

Staff ensured young people had access to post-discharge care, for example, S117 aftercare, community mental health services and crisis services. Staff planned for young people’s discharge, including good liaison with care managers/co-ordinators. Discharge was never delayed for other than clinical reasons. There was evidence in care records that community teams and social workers were involved in discharge planning.

Common reasons for delayed discharge from the ward were young people awaiting placements in the community or having turned 18 and waiting for an adult bed. Staff told us they only discharged young people when they felt satisfied there was support in place for them.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about young people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff provided a variety of opportunities for young people to give feedback about the service, including community meetings and surveys and during their 1:1 time with key staff as well as ward rounds. Staff also encouraged feedback through general conversation.

Managers and senior leaders used data to identify health inequalities and gathered feedback from young people and their families. This meant that leaders listened to information about young people who were most likely to face inequality.

Staff had completed training in equality, diversity and inclusion. The trust was embedding Patient and Carer Race Equality Framework (PCREF).

There was a comprehensive equality, diversity and inclusion policy in place.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff prepared for discharge early in the young person’s admission and treatment. Staff worked well with other professionals and organisations to ensure a smooth transition of care between future placements.