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

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.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The Trust always treated people with kindness, empathy and compassion and respect their privacy and dignity. They treated colleagues from other organisations with kindness and respect.

During our on site assessment, we carried out short observational framework for inspection (SOFI) on several of the wards we visited. 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.

During our on site assessment, we spoke with 21 patients and 11 carers. We received universally positive feedback about the service in terms of the care the patients received. We received extremely positive comments from carers, some of which are detailed below.

“the Team work together, they exude friendship, compassion and …they’re very knowledgeable”

“It’s an assessment unit but I wish he could stay there”

“dad is actively involved in his own care and medication changes”

“the attitude of the staff is “very sensitive but really clear and open, especially the psychiatrist”

“it’s always clean, staff are very attentive, there’s always plenty of staff, yes”

One family member we spoke to, who’s relative had received end of life care on the ward told us“they made a big difference to me, I will always be grateful to them”.

We were made aware of one incident currently being investigated by the trust where there is a concern that not all staff treated a patient with dignity and respect. However, the trust have responded to this issue appropriately and with a thorough investigation process.

Staff supported patients to understand and manage their care, treatment or condition.

Staff directed patients to other services when appropriate and, if required, supported them to access those services.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. We saw good evidence of the use of life story work to care for patients in a manner that was appropriate for them. Examples of this included personalised playlists for patients so that music they enjoyed was played whilst completing tasks that could sometimes agitate them such as washing and dressing, understanding the era the patients was currently living in and adapting care to meet these needs (for example serving lunch in a packed lunch style in the garden for one patient who used to work on a building site and always ate outside), use of past skills to occupy patient time, for example knitting and crocheting.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences. All staff told us they had no fear of advocating for a patient when care was below the standard they would expect.

Staff maintained the confidentiality of information about patients.

The Trust treated people as individuals and made sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients – for example, by ensuring disabled people’s access to premises and by meeting patients’ specific communication needs. All the wards had been adapted to make them more dementia friendly for those wards where dementia patients were admitted. Examples of this included bedroom doors being a different bright colour to help patients find their room, memory boxes outside of bedrooms so that families and carers could add photos and familiar items to try to maintain independence when the patient was looking for their bedroom. All the dementia wards had dementia friendly information, for example signs with large type and pictures as well as written words. We also saw some good examples of using the environment to encourage conversation and memories, for example on Mowbray and Roker wards there was maps of the local area with bright large pictures of local attractions such as the lighthouses along the Northeast coast and the angel of the north. They had also created “era” walls where each era, for example the 70s or 80s was depicted with musicians from that decade, popular adverts and household items.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

The information provided was in a form accessible to the patient group (for example, in easy-read form on wards for people with a learning disability).

Staff made information leaflets available in languages spoken by patients. Managers ensured that staff and patients had easy access to interpreters and/or signers.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. The menus at all sites we visited had options for any patient requiring a special diet due to religious or personal reasons, for example kosher food, halal food, vegetarian and vegan dishes. They were also options available for patients who had specific allergies such as gluten free or lactose free.

Staff ensured that patients had access to appropriate spiritual support from a diverse chaplaincy service. We saw multi faith areas at different sites as well as signs on the ward noticeboard about how to access spiritual support if needed.

The Trust promoted people’s independence, so they knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients we spoke with and their carers/family felt very well informed about their care and treatment. Patients and their carers/family described that they had received information about their medication and that they were involved in reviews about their care and treatment. Patients and their carers/family reported that, where appropriate, their family, carers or loved ones were involved in meetings about their care.

The Trust valued patient and care feedback and went to great lengths to ensure that they got this feedback in any way possible. They actively sought and reviewed feedback via several initiatives which were supported through the Trust’s dedicated service user and carer engagement team and quality assurance functions which included the your voice survey and you said we did, as well as community meetings on each ward and informal feedback via discussions with families and carers. We reviewed feedback from your voice surveys and found that in the time from December 2024 to the date of our assessment there had been 77 responses across all 9 wards. Out of the 77 responses, 76 were positive. Comments included describing the care as outstanding, patient centred, supportive and empathetic and understanding. It was clear that not only had the staff cared for the patients but that the family members and carers who had responded, had also felt their needs were respected, considered and valued. Each ward had a support worker who was there to support family and carers. This role was very well received by patients relatives and carers and we only received positive feedback about this role.

We reviewed patient and carer community meeting minutes and found these to be consistent in their content and held on a regular basis. We could see evidence of the patient voice within the minutes such as requests for certain activities and to celebrate events such as the Kings Birthday. We saw when it was carers week that the wards combined the patients meeting with the carers meeting and events were ongoing throughout the week to celebrate the work that carers do.

Where patient were detained under the Mental Health Act, we saw evidence that they were reminded of their rights and that there was signage to inform patients that were not detained that they had the right to leave the ward.

We also noted that for patients who had sensory or physical health impairments, the ward had access to equipment to maintain some level of independence for patients. Examples of this included, walking frames, wheelchairs and hoists so patients still had access to a bath or shower.

The Trust listened to and understood people’s needs, views and wishes. They responded to these in that moment and acted to minimise any discomfort, concern or distress.

Staff were aware of and dealt with any specific risk issues, such as falls or pressure ulcers and care planned for these accordingly. We saw that the teams accessed tissue viability nurses for any concerns arounds wounds or breakdown of skin.

Staff identified and responded to changing risks to, or posed by, patients. We saw that patients had person centred care plans that showed staff how to respond to their needs in terms of falls risk, nutrition and skin care. Staff on all wards we visited were very familiar patients they were caring for and were able to tell us about their specific needs and how to manage these.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. Staff received de-escalation training as part of their prevention and management of violence and aggression training and the staff we spoke with told us that they would always attempt to verbally de-escalate an incident before resorting to physical restraint. However, compliance with prevention and management of violence and aggression training were below 70% on 5 out of 9 wards and 4 out of 9 wards had 66% or below compliance with breakaway training. Some staff reported that it was difficult to manage the staff rota to ensure that there were enough staff on each shift who were compliant with training to ensure patients were safely managed if a restrain situation was needed. However, in terms of de-escalation, we did not see this having an impact, we observed the staff dealing with patients who were agitated or becoming verbally or physically aggressive on wards and staff dealt with this in a skilled manner.

The trust care about and promote the wellbeing of staff, and support and enable them to always deliver person centred care.

Staff felt respected, supported and valued. We received positive feedback from staff and leaders about the wards and the trust being a supportive place to work, with good access to staff well-being initiatives and flexible working arrangements. All the staff we spoke with confirmed their workload was manageable and they felt safe in their place of work. The ward managers told us staff retention was high and often students would choose to stay on the ward once they were qualified. Staff had a structured induction at the start of their employment. A couple of members of staff did refer to a clique on Ruskin Ward and that they felt like they did not always feel they were not part of the team. They explained that they felt managers were aware of this issue but had not so far acted upon it. This was fed back to the senior manager on site at feedback.

Staff had access to a lot of well-being resources, including reflective supervision, well-being initiatives, and a monthly newsletter with information about well-being resources. Managers supported staff through regular managerial supervisions and annual appraisals were offered, however, yearly appraisals were only completed at above 80% compliance on only 4 out of the 9 wards. The following wards had below 80% compliance, Castleside 56%, Cleadon 63%, Roker 52%, Ruskin 55% and Oakwood 76%. Despite this when we spoke to staff they did tell us that they felt well supported by immediate managers and that their career development objectives were supported. We saw examples of staff progressing in their career and being supported to take promotion opportunities.