Greater Manchester Mental Health NHS Foundation Trust

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• 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 means we looked for evidence that the service met people’s needs.

This is the first assessment for this service. This key question has been rated Good.

Good: This meant people’s needs were met through good organisation and delivery.

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.

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.

There was a flat within the ward, where partners could stay to assist with the care and parenting of the child, especially early on in an admission if the mother found it difficult to provide the care. We spoke to a patient and their partner who had accessed the facility and spoke very positively about the opportunity, the partner found the support and guidance from the staff helpful too.

Ward rounds included patients, their partner and external organisations including community teams. The patient and partner were involved in discussions about leave including overnight leave at home. The patient asked for some more psychological workbooks to use on home leave as they had found them helpful, the psychologist was arranging for additional resources for their next leave.

Within the ward round, the consultant encouraged and enabled the patient to share their views about the logistics of visits from the variety of teams providing support, enabling the patient to share their preferences about what would work well to avoid being overwhelmed.

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.

Staff supported patients to maintain contact with their families and carers. We observed visitors in the communal areas of the ward and family members attended ward rounds either in person or remotely.

The service hosted a Dads Matter group on the ward, which was a support group facilitated by an external organisation.

Action for Postpartum Psychosis, an external organisation provided peer workers into the service, we saw one of the workers encouraging patients to be involved in a craft activity and offered parenting support, advice and information about community group activities and support. The peer support worker provided patients and their families an opportunity to talk in a supportive encouraging way.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. We saw contact with local authority safeguarding teams and children’s services in care records.

Information governance systems included confidentiality of patient records. Care records were electronic and staff could only access these records if they had a secure log in to the system.

We did not see any communication assessments within the care records to meet the requirements of the Accessible Information Standard. We reviewed the care plan for a patient whose first language was not English and their Accessible Information Standard section was not completed. However, we saw interpreters were used for patients whose first language was not English.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. There was information on display on the ward and the welcome pack included information about the service including how to complain.

The information provided was in a form accessible to the particular patient group, the welcome pack included how to get the pack in a different format including different languages, Braille, large print, text only, and audio formats.

Staff had access to information leaflets available in languages spoken by patients. The service accessed resources created by action on postpartum psychosis including Recovery after postpartum psychosis, Postpartum psychosis: a guide for partners and Planning pregnancy: a guide for women at high risk of postpartum psychosis. These were available in Arabic, Bengali, Polish, Slovak and Urdu.

Staff mostly ensured carers, families and commissioners were regularly updated about the patient’s progress. However, partners told us that they were not updated as frequently as was agreed in ward rounds and found it difficult to know what was happening in their loved one’s care. We also saw that ward rounds overran and external people waiting to join were waiting for a while before being admitted to the meeting.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had received 2 complaints in last 12 months. Both of the complaints were partially upheld, one was not upheld and 2 were still being investigated at the time of the assessment.

Themes of the complaints were in relation to explaining rights to patients, making reasonable adjustments and confidentiality of notes in communal areas.

Patients mostly knew how to complain or raise concerns. One of the patients we spoke with was not sure how to complain. Information was on display on the ward and in the welcome book. When patients complained or raised concerns, they received feedback.

Staff knew how to handle complaints appropriately. Records showed contact with complainants and action taken.

Staff did not routinely receive feedback on the outcome of investigation of complaints, these were not standard agenda items for the team meetings.

The service received 6 compliments in the last 12 months. These were in relation to the care provided and the progress of the patients during their admission to the ward.

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.

Staff ensured the needs of patients with mobility issues were met – the ward was on the ground floor and had level access.

Equipment was provided for mothers and their babies, each baby had a bouncer and cot. The cots were mobile and if staff needed to take on the care of the baby during the night, the cot could be moved to the nursery.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was on the grounds of an acute hospital.

Staff ensured patients had access to post-discharge care, we observed in the ward round the offer for support post discharge which included the community perinatal team and a thriving babies confident parents programme offering multidisciplinary support with the aim of babies having safe, stable, permanent homes, remaining with their families and communities.

Staff planned for patients’ discharge, including good liaison with care managers/co-ordinators. We saw care coordinators and children’s services attending the ward round, discussions took place about increasing the patients leave at home and engaging with services in the community in preparation for discharge.

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.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. We saw this in meetings, activities and in one to one discussions with patients.

Staff are trained in equality, diversity, inclusion and human rights with 94% compliance for the service.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff supported patients to make decisions about their care and treatment and their future, staff always asked patients permission for them to administer medicines or care for the baby if required, for example if the patient was unwell or was attending a meeting on the ward. If patients refused to this, children’s services would become involved and this was documented in care records.

Staff created personalised care plans to account for the patient’s needs, wishes and feelings. They were focused on areas of need, goal and intervention required. All care plans were completed, however some were not very detailed, had gaps in the formulation section, background history and patients views of the care plan and whether they had received a copy of the care plan were blank in 5 out of 9 care plans we reviewed.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. There were children with additional needs who required involvement of specialists including speech and language therapist, audiology, records showed staff were liaising with those services regarding the care and treatment of the baby. The service worked holistically with the mother and baby with the aim of the best outcome for both mother and child.