Birmingham and Solihull Mental Health 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 meant people’s needs were met through good organisation and delivery.

At our last assessment we rated responsive as requires improvement. At this assessment the rating has improved. The service understood the diverse health and care needs of patients and the local communities. The design, layout, and furnishings of the wards supported patients’ treatment, privacy and dignity. The service supplied appropriate, accurate and up-to-date information.

This service scored 68 (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 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Most patients and those close to them were regularly involved in planning and making shared decisions about their care and treatment, so it was centred around them and their needs. We asked 7 patients across Eden acute ward, Larimar acute ward and Eden PICU if staff involved them and their family in their care. Five patients said yes on Eden PICU (3), Eden acute (1) and Lavender acute ward (1). However, on Eden acute ward, 2 patients said staff did not involve them in their care. On George ward we observed the MDT assessment of a new admission. The team took a person-centred approach and involved the patient. Staff told us they involved patients and their families in ward rounds. We found evidence of patient and carer involvement in most records reviewed (22), however we found staff had not recorded patient involvement in 1 record on Saffron ward and 1 on Eden PICU.

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

Patients received care and treatment from services that understood the diverse health and social care needs of their local communities. Occupational therapists helped patients to sort out their finances and signposted to additional community resources. This also included signposting patients from specific ethnic communities to support services within those communities locally. On Saffron ward the RC and junior doctor cover the ward and the Home Treatment Team. This ensured continuity of care across pre- admission, admission and post admission. We saw evidence in care records of staff linking in with community services to ensure appropriate support and accommodation was in place when patients were discharged.

The trust reported 151 delayed discharges across the wards we visited between 1 December 2024 and 31 May 2025. The most common reason for a delayed discharge was social worker allocation, followed by lack of supported housing provision. These reasons were outside of the trust’s control.

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.

Most people who used the service, their family, friends, and carers were provided with information that was accessible, safe and secure and supported their rights and choices. We asked 6 patients if they received information in an accessible way. On Eden acute ward, 2 patients said yes and 1 said no. On Eden PICU all 3 patients asked said yes. George ward manager advised that the ward carer’s link had been completing carers assessments, safeguarding DASS assessments and signposting carers/relatives to various self-help groups in the community. Carers of patients on Saffron and Lavender ward could access the monthly carers group at the Zinnia Centre. However, on Eden acute ward 2 patients allowed us to view their bedrooms. Each bedroom had an information board with space to write in the names of the patients named nurse and RC. One of the boards included this information but the other was blank. There were noticeboards in Eden acute ward communal areas displaying information on patients’ rights and how to complain. However, the noticeboards were disorganised and contained out of date information. There was no information displayed in easy read formats.

Patients could expect information to be tailored to individual needs. On Lavender ward some staff spoke different languages and were able to support patients whose first language was not English, this support was available formally too. Information was displayed about mental and physical health issues. Saffron ward manager told us they support lots of patients whose first language is not English. Staff booked interpreters for one-to-ones, ward rounds and other meetings. Interpreters also supported family members whose first language was not English and staff used electronic tablets with a translation application to support communication with these patients and their families. The trust did not have an information accessibility standard in place at the time of the inspection and advised that the Lead for Recovery, Service User, Carer and Family Experience was incorporating the information accessibility standard into a re-written accessible information and communication policy which was being co-produced with Experts by Experience.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The trust reported receiving 33 complaints across the wards visited between 1 December 2024 and 31 May 2025. Larimar ward reported the highest number with 11. The Trust reported all complaints received reached a resolution. Three of the 33 complaints were progressed as formal complaints. Of these, 2 were partially upheld and 1 did not have consent. The Trust reported 3 compliments were received between 1 December 2024 and 31 May 2025.

Patients were not always able to give feedback about their experiences of care and support. We reviewed minutes from daily community meetings and weekly inpatient forums across the wards we visited. On Eden acute ward and Eden PICU these meetings did not provide patients with the opportunity to feedback on their experiences of care. The agenda for the weekly inpatient forum covered rules and expectations of being on the ward. On Eden PICU we saw patients had made suggestions under ‘any other business’ but there was no evidence that these were followed up or responded to. However, we spoke with 6 patients across Eden acute ward and Eden PICU about their experience of raising concerns. All 3 patients on Eden acute ward knew who to speak to if they had a concern, although 1 patient said managers ignored their concerns. All 3 patients on Eden PICU knew how to raise concerns and 1 told us about how responsive staff were to a concern they raised, with immediate action taken to rectify. On Saffron ward we saw a ‘you said, we did’ display detailing actions taken following weekly inpatient forums. We spoke with an advocate who told us they supported patients to make complaints and the service was responsive to concerns raised.

The trust shared the following that had been coproduced with patients and experts by experience: Next steps discharge pack; Welcome pack for service users on admission; Service user questionnaire, reducing restrictive practice; Seclusion poster; Smoke-free policy; Recovery College session; Hope and recovery sessions; Psychology – coping with suicidal thoughts sessions.

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

Most patients could expect their care, treatment and support to be accessible, timely and in line with best practice, quality standards and legal requirements, including those on equality and human rights. The trust reported their referral criteria as 25+ and registered with a GP in the Birmingham area or 18+ and registered with a GP in the Solihull area. The trust reported their exclusion criteria as primary issue of detoxification from drugs/alcohol in the absence of mental illness, patients with a risk of non-life-threatening self-harm, where there has been a breakdown in social circumstances where mental state does not indicate the need for admission, people known to trust services with a diagnosis of personality disorder, unless admission to hospital is required to manage crisis involving significant risk to self or others that cannot be managed within other services.

On Eden PICU all 3 patients asked said staff met their specific needs. Wards were accessible for patients with limited mobility. On Saffron ward staff told us about supporting a patient with a learning disability by encouraging them to use the self-soothing room. On Eden acute ward we observed the ward round for a patient, an interpreter was in attendance to enable effective communication with the patient. The patient refused to attend, so the RC, Care Coordinator and interpreter went to see the patient on the ward. However, on Eden acute ward, 1 patient spoken with said staff had not made reasonable adjustments to meet their mobility needs. We checked the care records for this patient and although staff referred the patient to physiotherapy, we did not see any evidence of this taking place.

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

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people using their services. Staff told us their wards developed good links with different faith communities that reflected the demographics of the patient group. We observed staffing on the wards we visited to be reflective of the local communities the trust served. Leaders ensured patients with a learning disability and autistic patients received care and treatment reviews (CTR) in line with NHS England’s Dynamic Support Register (DSR), CTR policy and within the expected timeframes. DSR’s are the mechanism for local systems to identify children, young people and adults (with consent) who are at risk of admission to mental health inpatient services without access to timely dynamic support.Inpatient Care (Education) and Treatment Reviews (ICETR) and inpatient Care and Treatment reviews are for children, young people and adults who are currently admitted to a mental health hospital. The trust told us they were reducing inequalities through targeted work with over and underrepresented groups.

We scored the service as 2. The evidence showed some shortfalls. People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Patients were not always supported to make informed choices about their care and plan their future care. We spoke to 4 patients about their involvement with discharge and transition planning, 3 patients across Eden acute, George acute and Eden PICU told us they did not have a discharge plan. One patient on Lavender said they were aware of their discharge plan. Another patient on George ward told us their discharge was delayed due to housing issues, but no-one was sorting it out. We reviewed 2 care records on Eden PICU and found no evidence of plans for transition from the service.

When patient’s future care preferences were for greater independence, professionals worked together to support them to achieve their goals. On Saffron ward we spoke with the OTA who told us how they supported patients with pre discharge home visits to ensure their home was safe and habitable. We spoke with the OTA on Eden acute ward, they told us community visits were organised by the OT for patients on discharge pathways. The OT would prompt personal care and during home visits assessed the environment to ensure people had the mobility aids needed before their discharge. They described a recent home visit where support with finances, adaptations and community involvement enabled a successful discharge. Staff on Larimar ward told us the OT and OTA would assess a patient’s housing situation and access any adaptations prior to the patient being discharged. They would also support the patient on home visits prior to discharge.