Bradford District Care 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 means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained 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.

The service ensured patients were in involved in care and treatment. Patients we spoke with said that care and treatment had been arranged around their individual needs and preferences.

Staff completed various nationally recognised tools and assessments when developing care plans. Staff supported, informed and involved people using the service and their families or carers. Staff told us that patients were included in their care and treatment choices with carers being involved where appropriate.

During our tour of the wards, we saw that patients could personalise their bedrooms. There were multi-faith rooms available to patients.

We saw evidence in care records that decisions around care and treatment were made in collaboration with the patient and their carers where appropriate. Care records showed that staff sought feedback from patients about what their goals were, and how they could achieve this.

We saw evidence of discharge planning and that patients were supported to move on with the next steps of their recovery journey.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups. The hospital offered a good variety of food options including Halal, Kosher, vegan, vegetarian, gluten-free and healthy options such as fresh fruit and vegetables.

Staff made adjustments for patients with specific needs such as mobility or communication issues.

Staff worked well as a team, and with wider services to ensure patients had access to joined-up care. Staff communicated with patients in a way that they could understand the different aspects of their mental and physical health care and treatment.

Managers had regular engagement with stakeholders and funders, inviting them to regular meetings and care programme approach meetings.

Facilities and premises were appropriate for the services being delivered. Managers completed quarterly environmental checks to review the environment at each site.

Staff ensured they shared clear information about patients and any changes in their care. Staff worked alongside other teams within the trust and external stakeholders to ensure discharge from the service was smooth and that carers received appropriate support. This included ensuring housing and benefit arrangements to avoid delayed discharges.

The service worked closely with the acute service and their clinical managers within the trust. There was a daily ‘lean management meeting’ which was used to identify staffing deficits and enabled managers from both services to offer cross service cover

Staff encouraged patients to maintain relationships with those that mattered to them throughout their recovery. Care records and interviews showed that patients were supported to see family and loved ones during section 17 leave or through ward visits.

Patients and carers told us staff provided information in a way they could clearly understand.

Patients knew how to request information regarding their care and treatment. Staff made sure people could access information on treatment, local services, their rights and how to complain. Wards had notice boards in patient areas with a variety of information to support this.

Carers generally described good communication from staff and said they frequently provided updates and kept them informed in changes in their loved one’s condition.

Staff and leaders told us patient could be given information in a variety of ways to meet their needs. These included information in different languages, fonts, braille, easy read and via the use of flash cards. People had access to interpreters and signers if needed.

We saw evidence in care records that patients had been offered a copy of their care plan. Care plans were written in a way patients could clearly understand. Care records evidenced that staff regularly reminded patients of their rights.

Staff issued patients with service user welcome packs on admission. These contained a variety of information including a summary of the multidisciplinary team, key meetings they would attend, what was available on the wards, the daily routine, and a summary of the treatment pathway.

Staff contacted the patient’s family member or carer on admission subject to patient consent.

Staff maintained the confidentiality of information about patients. Care records showed that staff sought patient’s consent to share information and reviewed this regularly. Staff we spoke with understood the principles of data protection legislation.

Patients told us that they were encouraged to be involved in the development of their care and treatment and felt involved in their care. They felt listened to when they voiced their preferences or asked questions about their treatment or medication. Patients were able to attend monthly support meetings and had access to independent advocacy.

Carers, friends and families attended ward rounds and multidisciplinary team meetings where appropriate.

Feedback from carers about their involvement in care and treatment decisions was positive with them telling us staff valued their views and wishes.

Managers investigated complaints made by people using the service. In the last 6 months, there had been 5 formal complaints; 1 on Thornton ward, 1 on Ilkley ward and 3 on Baildon ward. Complaints received were investigated and responded to, with support provided to the complainant to understand the responses. Any learning identified from complaints was shared with teams via team meetings, Quality and Safety meetings and individual supervision where appropriate.

Staff understood the policy on complaints and knew how to handle them. People could raise concerns with any of the team, and they would try to resolve them as quickly as possible.

Patients fed back that they knew how to make a complaint. Information was readily available on the wards about how to raise a concern or make a complaint.

Staff were visible and available for people to speak to as and when needed. Staff were observed engaging with people. Staff supported patients and carers to give feedback on the service and care and treatment.

The service gathered feedback from patients and carers via a friends and family test. There had been 51 instances of feedback within the last 4 months. We reviewed this feedback and saw that this was generally very positive. Responders reported good communication, caring staff, good food choices, and being supported with activities and access to leave.
Advocates supported people in giving feedback to the service where they requested this. Care records specified whether people had advocates in place.

Staff made reasonable adjustments for patients – for example, people with mobility issues.

There was generally adequate medical cover day and night, although some seclusion records had missing medical reviews which staff said was because it was sometimes difficult to obtain medical cover out of hours.

Staff ensured patients had access to post-discharge care including section 117 aftercare, community mental health services and crisis services.

Staff planned for patients’ discharge, including good liaison with care managers/co-ordinators.

Patients told us that they could speak with staff and felt comfortable to do so.

Patients had access to a range of professionals including a dietician, psychologist, speech and language therapist, and an occupational therapist. Staff worked as part of a multidisciplinary team model where all professionals worked collaboratively to deliver holistic rehabilitative care.

Staff supported patients to complete a cultural checklist on admission to ensure reasonable adjustments to care and treatment were identified and incorporated into patient's care plans. This included gathering information on patient’s faith, cultural background, religious observances, festivals, or links in the community which staff could support them to maintain. Staff also identified whether patients needed a translator or if any additional support was needed for patients with a learning disability or physical mobility issues.

Staff worked collaboratively to facilitate safe discharges. The service ensured patients had appropriate support and access to services upon discharge. This included ensuring section 117 aftercare arrangements were in place. They involved community teams in the care progress and ward round meetings in preparation for discharge.

Patient’s human rights were protected; they were supported by staff who promoted

equality and helped them overcome barriers to care.

We did not identify any barriers to care, support and treatment. The service complied with legal equality and human rights requirements, including avoiding discrimination. They had regard to the needs of patients with different protected characteristics and made reasonable adjustments to support equity in experience and outcomes.

Staff members had access to cultural competency and humility training This training aimed to explore how cultural assumptions and biases shaped their work.

Patients told us they were given opportunities to say how they wanted to be treated through community meetings, one-to-one time with their named nurse and by speaking with advocates or an expert by experience within the trust.

Staff told us they recognised people by their preferred pronouns and gender identity. Staff took patients' cultural or religious needs into account when developing their care plans.

There was a Patient and Carer Race Equality Framework Accountability Group within the trust. Managers described how the group aimed to ensure that the Trust met its commitments to race equity, co-production, and culturally appropriate care.

Patients and carers told us they were involved in decisions about their future care and treatment. They were supported to access advocacy and were referred to healthcare professionals to manage their mental and physical healthcare needs.

Staff held regular care programme approach meetings involving family members and their wider network. Care records showed that discharge planning started soon after admission, in line with best practice. The multidisciplinary team considered a range of possible outcomes for each patient based on their individual needs.

We saw evidence in care records that staff actively discussed and planned for discharge from the service. Care plans referred to getting well, therapeutic engagement and goal setting.

Patients were involved in discharge planning meetings, and a detailed plan was developed with patients and carers.