Coventry and Warwickshire Partnership NHS 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

At our last assessment we rated this key question good. At this assessment the rating has remained as good. This meant people’s needs were met through good organisation and delivery.

The service met the needs of all patients, including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result. The service employed former patients to encourage engagement and user involvement in development projects. However, on some wards there were excessive restrictions placed on patients. Some patients spent a long time in hospital due to challenges in finding suitable placements to be discharged to.

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.

The evidence showed some shortfalls. In most situations, the service ensured that people were at the centre of their care and treatment choices and they decided, in partnership with them, how to respond to any relevant changes in their needs. However, on some wards, patients felt there were excessive restrictions and that these restrictions were applied in a way that did not account for individual needs.

Staff ensured that patients could access advocacy. We spoke with an advocate that visited patients on Ferndale and Stanely wards. They told us that they met with patients detained under the Mental Health Act within 3 to 5 working days of their admission to the ward and checked in with informal patients when they completed routine ward visits. They reported that the ward staff were responsive and collaborative to meet patient needs and would offer alternatives if requests were denied. For example, if a patient was not able to leave the ward due to risk to pick up the newspaper, then staff could provide these instead.

However, on some wards there were restrictions. For example, patients on Stanley ward did not have routine access to a television remote control and bedroom doors were locked. Patients told us that staff told them to go to bed before they wanted to and, at times, staff did not appreciate their level of independence. Other wards were less restrictive. We were told that these restrictions were in placed due to requests from patients.

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.

Family members of patients told us that they were accommodated for visits whenever they wanted and that they were able to maintain their relationships with their loved ones.

The service liaised with housing officers to support with housing for discharge and kept in touch with social workers whilst patients were admitted to the service.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed, for example to the CQC and commissioning board.

Information governance systems included confidentiality of patient records.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress. This may be via communication with family as well as family attending MDT reviews alongside the doctor with the patients’ consent.

There were noticeable information leaflets on the wards for patients to access if they needed on Ferndale.

Pembleton ward did not have information around advocacy, and there were information leaflets outside of the main ward area, so patients may have struggled to reach these. Woodloes ward had leaflets on display around sexual safety, and how to make a complaint.

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.

Patients and their families knew how to complain or raise concerns.

Staff knew how to handle complaints appropriately. There were 2 complaints within the service within the last 3 months. One of these was not upheld. The other had been investigated, and the response was being reviewed via the trust’s governance process at the time of the assessment. One of these was related to a delayed discharge.

Ferndale Ward employed a Lived Experience Engagement Facilitator (LEEF) for 2 days a week. Stanley and Pembleton wards were recruiting a Carer Peer Support Worker for 30 hours per week to strengthen the contribution of lived experience roles across the service. Across the trust, experts by experience were involved in projects and recruitment processes.

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. For example, all bedrooms and ward areas were at ground level.

Staff made reasonable adjustments for patients. For example, people with mobility issues were provided with walking aids, shower chairs.

There was adequate medical cover outside normal working hours. A doctor could attend the wards quickly in an emergency and the hospitals were within a reasonable travelling distance to the local acute hospital.

Most family members informed us that their loved ones were admitted to the ward relatively quickly from being referred, usually within the same day. Within the last 6 months, the longest reported wait for admission was 10 days, with the individual remaining in the local general hospital during this period.

The average stay in this service was 6 weeks. At the time of the assessment, there were varied amounts of time for patient stays on the wards. Woodloes ward exceeded this the most with 12 patients out of 15 that had been there longer than 6 weeks, 3 of these had been there longer than a year. Reasons for this were challenges in finding a suitable placement to suit patient needs or making sure there was adequate equipment in homes such as stair lifts. Eleven out of out 20 people on Ferndale ward had been there longer than 6 weeks. Six out of 11 people on Pembleton ward had been there longer than 6 weeks. Stanely ward had the lowest number of patients exceeding a 6 week stay across the service, with 4 out 11 people there longer than 6 weeks.

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. This was shown through the feedback from “I Want Great Care” forms that patients are encouraged to complete.

The service adapted for the population group. The service identified that there were less occupied male beds, and a higher need for female beds within the local population. In response, they tailored the service and ward state to meet this need by changing the gender allocation to wards, with more female beds.

Staff were trained in equality and diversity; compliance was 100% for all 4 wards. the provider had not undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

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, including at the end of their life.

Occupational therapists conducted home assessments when patients were ready for discharge so that staff could be assured that patients were being discharged to safe and appropriate environments.

The service had fortnightly discharge meetings to maintain oversight of discharges, but a senior leader told us they may revert this back to weekly meetings. Some patients stayed at the service longer than usual, due to staff wanting to be assured that discharge was handled safely. A manager also mentioned a “length of stay” project to improve oversight and management of how long people are in hospital for.

Staff supported patients to make decisions about their care and treatment and their future. For example, staff worked sensitively to support patient to make decision about whether they wanted to receive cardiopulmonary resuscitation in the event of an emergency.

Staff from care homes visited patients on the ward in the run up to their discharge so they could build relationships.