Rotherham Doncaster and South Humber 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 good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

All rooms had privacy blinds that could be operated by people from within their room.

Patients and carers who spoke with us mostly said staff were kind, polite, respectful and supportive towards them. They said staff took time to listen to them and understood their needs. One carer fed back that they felt some staff could be very rude.

Staff who spoke with us were aware of the needs of their patients. They told us that they worked hard to build therapeutic relationships with their patients.

Care plans showed that staff had gained consent for information to be shared and included patient’s wishes and likes or dislikes.

Staff offered patients a private space to talk when required, although staff and patients said they sometimes had to wait until a staff member was available to be able to do so. There was a policy in place around therapeutic engagement and observations. Managers told us each member of staff completed an annual checklist whereby they reviewed how they spent meaningful time with patients. Throughout our inspection, we saw staff interacting with patients in a kind and supportive way.

At the Tickhill Road site there were only 3 or 4 bracelet door locks available on Cusworth ward. This meant some patients could not get in and out of their bedrooms when they wanted without staff assistance. Staff were located at the end of the corridor to support patients, but we observed some patients wedging their bedroom doors open with towels or items of clothing. Staff fed back that the bracelet locks were expensive and that patients kept taking them home. We were concerned that this did not promote patient’s privacy and dignity, and that managers had not taken action to resolve this. We raised this with the trust after the inspection who told us they would take action to address this.

Patients told us that they had copies of their care plans, and they were written in a way that made sense to them.

Interpreters were available if patients needed one. There were multi-faith rooms available to all patients.

The kitchen offered a menu that catered for cultural needs, such as a Halal menu. Staff also supported carers and families to bring in food at the request of patients.

Patients said staff were respectful and knew about their individual needs. We observed staff giving reassurance to patients when they needed it. Staff were caring and supportive to patients. Interactions we observed showed that staff knew each patient well and understood their needs.

We saw clear and detailed care plans and records for all patients. All records contained evidence of discussions between patients and staff detailing patient’s wishes and preferences. One patient with a learning disability had a positive behavioural support plan in place. Staff had also developed a communication passport for the patient which set out ways in which the patient preferred to communicate with others. Staff had also arranged for a member of the community team to visit the ward on alternate days to support staff with providing care to the patient.

Consent to share information was clearly documented in patient’s records. The multidisciplinary team invited family and carers, where consent had been given, to attend meetings so information sharing could be undertaken.

Patients also told us that staff were informative, and that they felt comfortable with their care and treatment.

On admission the occupational therapy team completed a special interest’s checklist. This documented each patient’s likes and dislikes which staff said helped inform care and treatment.

Staff arranged face to face meetings to aid with communication for patients whose first language was not English. Easy-read information was available for those patients who needed this and there were information leaflets in a range of different languages.
Patient care plans included the patient's choices and preferences. Staff described how they tried to promote patient’s choice and control wherever possible, for example regarding access to leave.

Staff described how they accommodated patients and carers wishes and offered flexible visiting times.

A manager we spoke with described how they had worked closely with a patient to ensure their choice in care arrangements was taken into consideration for their discharge placement. The service had worked closely with the assertive outreach team to ensure the patient’s views about how they were supported in the community were implemented into their discharge plan. Staff said this was important for them to feel safe and to try and ensure the discharge was successful. We were informed that this had resulted in a successful step down to a community placement.

The service had recently introduced a monthly carers forum. This gave carers the opportunity to provide feedback to staff about what they needed or what they would benefit from. Staff also provided carers with information about the ward, timetables, multidisciplinary teams, the role of the named nurse role, and relevant points of contact. There were allocated link champions within the service who advertised carers and events and encouraged carers to attend these.

Staff told us that they would use verbal de-escalation in any first instance, and this would often be used to good effect.

Staff told us they carried personal alarms and would use these to request urgent support from colleagues to aid a patient who needed urgent help.

The seclusion rooms were safe and offered appropriate viewing areas whilst offering dignity and privacy for the user. The area also offered an outside space for patients spending time in the seclusion area.

We saw staff members undertaking observation checks accordingly on each of the wards that we visited.

We saw clear and detailed risk assessments in place for staff to follow should a patient require urgent help.

There was a restraint policy and process in place on all wards. There was a process to follow when a patient required the use of seclusion. We looked at 2 seclusion records and found these were fully complete and followed guidance within the Mental Health Act Code of Practice.

There were observation processes and guidance in place on all wards. Staff used observations as an opportunity to engage with patients, ask them how they were, and whether they needed any support.

People were involved in all aspects of their care planning. Staff understood people's likes and dislikes. Care records demonstrated that staff were alerted to people's needs and responded promptly and appropriately to these. We saw that the team regularly discussed individual needs and engaged with people and their families in how best to respond.

Staff generally told us that they felt listened to and supported by their managers and senior managers to undertake their roles. Some staff fed back that they were extremely busy. The most recent staff survey results showed five questions relating to health, safety and wellbeing at work had less than 50 per cent positive responses. These included questions about burn out, emotional exhaustion and frustration at work. During interviews, managers acknowledged that some staff felt overstretched and very busy on the wards. They said they tried to accommodate the needs of the workforce and made reasonable adjustments in line with legislative requirements.

Staff had access to regular management support and clinical supervision. They also had access to occupational health and an employee assistance programme.

There was a staff health and wellbeing network within the trust which was available to all staff. Managers described how the network could support staff and provide them with information including how to keep well and manage work-related anxiety or stress.

The trust had recently held a stress awareness month. There were pop-up stands across the sites which provided information to staff about how to access support.

There were two ‘legacy mentors’ working across the trust. These were dedicated members of staff who worked in the evenings to enable night staff to contact them if they needed support.

There were monthly organisational development bulletins. These contained information about sessions that were available to staff including talent management or coaching networks.

All staff had one day per month protected time for learning. Staff could use this time to complete any learning they wanted outside mandatory training for personal development.

Staff could access free yoga classes, and the trust could also sponsor staff to take part in slimming world.

There were a range of non-mandatory training courses and electronic learning available to staff who wanted to develop their skills or had an interest in a specific area. The trust’s intranet had a learning and development page which provided information on courses and learning available.

Managers had completed leadership courses and there were non-medical prescribing courses available to staff including electrocardiogram and phlebotomy courses.

The trust had recently introduced a civility and respect training module. Managers told us they had sought staff feedback in the development of this.

Managers completed de-briefs and contacted individual staff members following incidents to check whether they needed any support.

Managers provided training and gave information to staff to protect their safety. They received breakaway and conflict management training and were provided with peoples’ risk information, for example when escorting them on leave. All staff carried fob alarms.