Cumbria, Northumberland, Tyne and Wear 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 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 good.

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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.

• Staff attitudes and behaviours when interacting with patients showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. We observed 4 home visits, 5 reviews, 3 depot clinics, a clozapine clinic and 2 appointments. Within all of these, staff were respectful of patient’s needs, listened to patients views and preferences and explained the treatment and next steps in an accessible way.
• Staff supported patients to understand and manage their care, treatment or condition. Information was provided to patients both verbally and in written form. Within reviews, we saw doctors explaining to patients the treatment options and possible side effects. We observed staff explaining different interventions available including psychological therapy, family therapy and employment support, also support out of hours via the crisis team. Patients were encouraged to ask questions and staff ensured they understood the next steps.
• Staff directed patients to other services when appropriate and, if required, supported them to access those services. We saw staff signposting patients to the resources and information about support available in the waiting room.
• Patients said staff treated them well and behaved appropriately towards them. Feedback from patients was that staff were respectful, good at listening to them treated them as individuals.
• Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. When it was the first time a staff member was meeting with a patient, we saw that staff reviewed their care record to ensure they had the required background information. For staff who had been supporting a patient for a while, we observed positive professional relationships, with knowledge of the individuals needs and circumstances.
• Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.
• Staff maintained the confidentiality of information about patients. Discussions took place in secure offices and records were electronic and accessed via secure log in of the staff member.

• The service made adjustments for disabled patients – for example, by ensuring disabled people’s access to premises and by meeting patients’ specific communication needs. As several buildings were not accessible, with several stairs and no lifts, staff arranged to meet with people either in their own homes or other venues including clinics. We saw emails and pictures in use for a patient in the early intervention team in psychosis Sunderland and South Tyneside.
• Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. We reviewed the waiting areas and a variety of leaflets and resources were available for patients. The service leaflets had information about the service and how to give feedback including how to complain.
• The information provided was in a form accessible to the particular patient group (for example, in easy-read form on wards for people with a learning disability). Information leaflets included a section about the patient information centre who could arrange for translation to different formats.
• Managers ensured that staff and patients had easy access to interpreters and/or signers. In Gateshead East Community Treatment team, records showed that a letter had been translated from English to Farsi and that an interpreter was involved in an assessment visit with consultant.
• Two patients told us there had been changes in staff and a lack of consistency with workers either supporting them or doing the phone reviews which was not helpful. Patients also said that if they contacted the duty worker, it was not helpful as staff did not know them. This meant patients had to repeat their circumstances and situation again.

• People told us that staff listened to them and were interested in their views, experiences and preferences.
• We observed staff working in a person centred way, providing patients with the information about treatments and interventions and support available, discussed this by encouraging questions and then encouraged the patient to make an informed decision. Regular reviews of care took place to review progress and agree a future plan.
• Patients told us that staff facilitated home visits where that was their preference. This meant patients could participate more fully in their treatment.
• Patients told us they felt involved in their care, and the creation of their care plan with 22 people confirming they have received a copy of their care plan. However 7 people said they had not received a copy of their care plan. This meant not all patients had easy access to their care plan.

• Staff were aware of and dealt with any specific risk issues, such as patients risk to others. We saw and staff told us that joint visits took place where there was a risk to staff.
• Staff identified and responded to changing risks to, or posed by, patients. Patients told us when their mental health deteriorated, staff increased their support to them and examples were given where they had an urgent review by the consultant psychiatrist.
• Staff used de-escalation techniques when patients’ behaviours became heightened. We saw a patient becoming distressed, staff responded in a compassionate and supportive manner and validated the patients feelings.

• Staff felt respected, supported and valued.
• Staff felt positive and proud about working for the provider and their team. Staff told us working at this service was a more positive experience than previous employers.
• Staff had access to support for their own physical and emotional health needs through an occupational health service. Managers told us they could refer staff to occupational health.
• The service’s staff sickness and absence were high in some teams, with community treatment teams challenged in Sunderland West with 11% sickness, South Northumberland with 8% sickness and 16% nursing vacancies, and Gateshead with 8% sickness and 17% nursing vacancies. Also the Early Intervention in Psychosis Team Northumberland with 12% sickness. This meant staff had higher caseloads or were involved in more monitoring appointments whilst patients were waiting for intervention from the team. In Gateshead and Sunderland West, the clinical leads and pathway managers had patients allocated for their oversight due to absences within the teams, this meant managers were providing support to patients whilst waiting for a worker to be allocated, staff told us they had to rearrange supervision due to workload. In Sunderland West, a wellbeing meeting had been introduced monthly to try to support the team.
• Staff appraisals included conversations about career development and how it could be supported.