Derbyshire Healthcare NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective - this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first inspection for this service. This key question has been rated good.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients felt their needs were understood and said staff took time to listen and involve them in care planning when they were able to participate. Some patients were not always able to be fully involved due to the impact of their mental health condition. In these cases, staff supported involvement as far as possible and followed appropriate legal and best interest processes when patients lacked capacity to engage. Where patients were unable to communicate their preferences directly, staff sought input from family members, carers, or advocates to inform assessments and care planning.

Staff carried out timely and comprehensive assessments of patients’ physical, mental, emotional, and communication needs. The assessments were person-centred and recovery-focused and regularly reviewed with the patient whenever possible. Staff used a range of clinical tools and professional judgement to ensure they gained a full understanding of each person’s needs. When patients had reduced capacity, staff ensured decisions were made lawfully and, in the person’s, best interests. Carers were also included in assessments and supported in their roles.

We reviewed 12 care records during the assessment. All records showed that staff completed a full mental health assessment either on admission or shortly afterwards, alongside an assessment of physical health. Care plans were developed in response to the needs identified and were personalised, holistic, and outcome focused. Records showed that staff reviewed and updated care plans regularly. Communication needs were clearly recorded, and where necessary, adjustments such as simplified language or visual prompts were used to support understanding.

The service had an effective, structured approach to assessing and reviewing needs. Staff assessed each person’s physical health, mental health, wellbeing, and communication needs promptly and updated these routinely. Assessments were aligned with national best practice and informed care planning that was tailored to individual goals.

Staff delivered a range of care and treatment interventions, including Cognitive Behavioural Therapy (CBT) Compassion Focused Therapy (CFT), and Eye Movement Desensitisation and Reprocessing (EMDR) and activities developed by the occupational therapy. Staff followed guidance from the National Institute for Health and Care Excellence (NICE) and had access to regular clinical updates. Care we observed during our site visits was consistent with current good practice.

Where people had specific dietary needs, individualised support was in place. Hydration needs were assessed; however, they were not always monitored in line with national guidance. For example, staff did not consistently record fluid intake for people who required monitoring. Prior to our inspection, there had been limited oversight of how hydration was recorded. The provider took prompt action to address this following our feedback.

Staff were encouraged to explore new, research-backed approaches to improve outcomes. Staff took part in clinical audits, benchmarking, and quality improvement initiatives. For example, staff held Older Adult Flow Pathway meeting to support communication on wider flow issues across the division as a result of CRISIS teams benchmarking against the Fidelity model for CRISIS.

People experienced coordinated care across teams and services. Staff worked in a multidisciplinary team, including doctors, nurses, psychologists, occupational therapists (OTs), health care assistants (HCAs), and external partners such as the rapid response dementia team and community-based mental health teams. Relevant professionals were invited to care reviews, ensuring continuity for patients and their families.Staff described strong working relationships within their teams and across the wider organisation. They held regular multidisciplinary meetings where care and treatment plans were reviewed and updated. Effective handovers took place between shifts, and information was shared consistently within the team. Staff also reported good communication with other internal services such as community mental health teams and crisis teams. We observed handovers and multidisciplinary discussions that were focused and well-structured. There were clear processes in place to ensure care remained coordinated when people moved between services. Discharge and transition planning considered individual needs and circumstances. When clinical tasks were delegated or referrals made, information was shared appropriately to maintain safe and effective care.

Staff supported people to manage their health and wellbeing, empowering them to make healthier choices and maintain independence. Health-promoting activities were encouraged, such as smoking cessation, healthy eating advice, and exercise options like walking groups, Tai Chi, and chair-based exercises like ‘chairobics’. The service also ran a gardening project, which promoted patient involvement and physical activity. Healthy meal options were available, with staff encouraging and supporting people to make nutritious choices.

Health assessments were carried out regularly, and staff referred individuals to specialist services, such as Speech and Language Therapy (SALT), to meet their specific needs.

The service focused on identifying potential health risks early, ensuring timely interventions to prevent deterioration.

Staff routinely monitored people’s care to ensure positive and consistent outcomes. They used recognised rating scales, such as the Health of the Nation Outcome Scales (HoNOS), Malnutrition Universal Screening Tool (MUST), and physical health screenings to assess severity and track progress. This helped to align care with clinical expectations and meet the individual needs of people using the service.

The service had effective systems in place to ensure that care and treatment outcomes were consistently positive. Staff actively participated in monitoring and improving care, using technology where appropriate. Regular reviews of care plans ensured they remained aligned with people’s changing needs, and external benchmarking schemes and clinical audits were used to improve treatment pathways. Staff were engaged in continuous quality improvement initiatives, working collaboratively with other services. For example, on one of the wards staff were involved in initiative about improving wound care for people from different ethnic backgrounds.

Staff ensured that people were supported to make their own decisions about their care and treatment wherever possible. For patients with impaired mental capacity, staff assessed recorded their capacity on a decision-specific basis, particularly for significant decisions. This process adhered to the Mental Capacity Act 2005 (MCA), ensuring that individuals were supported in making decisions for themselves when possible. When patients were unable to make decisions, decisions were made in their best interests, in line with the MCA guidelines. Patient’s wishes, feelings, culture, and history were always considered when making these decisions.

For patients who were detained under the Mental Health Act 1983, staff also adhered to the legal requirements of the act. They respected the rights of individuals and ensured they were informed of their rights regarding detention, as well as their right to appeal. For example, staff read patients their Section 132 rights on admission and then monthly or when their section, consultant or treatment plans changed. Staff recorded reading of Section 132 rights in the patient care records. Consent to treatment in regard to medication, T2 and T3 forms were in place for those patients that required them. We found no issues with the forms.