Derbyshire Community Health Services NHS Foundation Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring - this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. This was the first inspection for this service. This key question has been rated 'Good', reflecting the quality of care provided.

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.

Throughout our assessment, we found that staff treated patients with kindness, compassion, dignity and respect. Patients spoke positively about their relationships with staff, One patient told us, “I couldn’t ask for better, staff are very kind, and nothing is too much trouble, they really are all angels.”

Staff built trusting relationships with patients, demonstrating deep knowledge of their preferences, personal histories, and individual needs. They actively listened and communicated in ways patients could understand. Staff provided emotional support, reassurance, and encouragement, especially during mealtimes.

We observed privacy and dignity was maintained. Gender-specific support was provided where needed. The service fostered a culture of kindness, compassion, dignity, and respect with staff demonstrating a caring approach at all times.

Staff treated patients as individuals, and provided care, support, and treatment that was tailored to meet their individual needs and preferences. Patients told us they felt included and listened to. One patient said, “Staff always listen to me, and always include my family which makes me feel better. They spend time with me and know what I do and don’t like and need.”

Care plans reflected personal, cultural, religious, and social needs. Staff considered patients’ backgrounds, beliefs, and protected characteristics when delivering care. Upon admission, patients were supported to complete a personal history questionnaire, the occupational therapy team also provided a social history questionnaire (Getting to know your loved one) to the patients families. The information gathered from both documents formulated a “This is me” document and ensured all staff and visiting professionals knew the patient as well as they possibly could.

The service effectively met individual communication needs. Information was available in different formats, staff adapted their approach and used communication resources to ensure patients not only engaged in decisions about their care, but had genuinely meaningful conversation about who they were, and what they liked. Dietary requirements and preferences were met. For example, vegetarian, gluten-free, religious, and cultural meals were provided upon request.

Staff empowered patients to have choice and control over their care and treatment wherever possible. They involved people in decisions with their capacity and legal status always considered and supported patients to ensure they understood their rights.

Staff helped patients maintain important relationships and stay connected to their communities. The service organised weekly family and carer engagement on the ward via the carer café, where loved ones and carers could visit, speak with nursing staff, therapists, and access information and support. Staff supported patients to maintain family connections by encouraging visits and enabling leave with relatives where appropriate.

Patients took part in a range of meaningful activities based on their choices and abilities. These included light physical activities, chair-based exercise, music and movie evenings, arts and crafts, relaxation sessions, and reminiscence groups. Activities were adapted to each patient’s individual needs, preferences and capabilities. Sensory activities were also promoted, for example, massages, and hair and nail care.

To gauge and build on existing independence, the service supported patients, and their families or carers to complete a Pool Activity Level Checklist (PAL). The PAL checklist assessed the capabilities of each patient with daily living skills, for example, bathing, dressing, eating, and performing practical tasks. Following completion of the PAL checklist, therapies, activities, and assessments were formulated and tailored to suit individual need, and ability. After assessment, and where appropriate, staff provided specialist and adaptive equipment such as mobility aids, handrails, with accessible bathrooms readily available throughout the ward.

Staff prioritised patients’ comfort and acted promptly to address any immediate need, concern, or distress. They stayed alert and were vigilant in recognising changes and responded quickly and appropriately. Patients felt confident approaching staff with concerns, knowing they would be taken seriously and helped without delay. One patient told us “Yes, the staff are all very good. They always have the time to listen to me, and they always help.”

Throughout the assessment, we saw staff responded quickly and effectively to the needs of patients. When ward alarms activated, staff reacted immediately to identify the patient’s needs, and further staff members arrived quickly to offer support. Staff used effective de-escalation techniques to reduce the need for physical intervention if patients became distressed, and behaviours or emotions became heightened.

Staff completed needs assessments for patients upon admission. Any specific risks or issues were identified and addressed, for example, mobility issues and falls, or pressure ulcers. Needs were care planned accordingly.

Leaders promoted staff wellbeing to ensure the delivery of safe, and effective person-centred care. They promoted and encouraged regular breaks and created a culture where staff felt supported, valued, and able to speak openly. Staff consistently described management as always available, approachable and responsive. One staff member told us, “I honestly feel 100% supported by managers, I have had reasonable adjustments made for me around my care commitments at home. They’re very approachable.”

Staff accessed a wide range of wellbeing resources. The service provided 24/7 support through its online wellbeing system, along with a dedicated wellbeing team, Resolve counselling services, bereavement support, and menopause support. Staff were also supported by the human resource department (HR), and Occupational health teams when required.

Leaders made reasonable adjustments for staff who had family, caring, and social commitments, and promoted a healthy work-life balance. Staff told us they felt proud to provide quality care, and to be a part of the organisation. They felt valued and appreciated the flexibility, understanding and support shown by managers.

Staff felt confident to raise concerns and give feedback without concern. Leaders responded promptly to feedback received, and concerns raised. This promoted a culture of inclusivity, openness, and shared ownership. Regular appraisals included career development discussions, where performance was reviewed, future goals set, and professional development opportunities were identified. Staff felt listened to and involved in decisions about their work and the wider service.