Sheffield Health Partnership University NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question as Requires Improvement. At this assessment the rating has changed to Good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff assessed the physical and mental health of all patients on admission. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Staff from different disciplines worked together as a team to benefit patients. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

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.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

As part of this assessment, we looked at 15 sets of care records. We found out of the 15 sets of records we reviewed; 6 patients care plans were not updated as needed and were not always holistic in nature. Plans were not always enacted by staff and were not always regularly reviewed when patients' needs changed. However, patients and relatives that we spoke with told us that the service involved them in decisions about care and treatment. They felt involved in the development of care plans and risk assessments.

Each patient had a named nurse who was responsible for completing these on a regular basis.

Staff assessed patients’ physical health needs in a timely manner after admission. We saw evidence observations such as blood pressure, pulse, oxygen saturations, respirations and temperature being taken as well as bloods being taken.

Staff told us processes were effective. Staff told us that the multi-disciplinary team was very robust and diverse, with a discharge focussed approach.

Staff told us there can be delayed discharges due to lack of social care provisions, access to social services and availability of care co-ordinators.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Patients had access to art therapy, occupational therapy and activities that are facilitated by activity co-ordinators. There was no psychologist in post at the time of this assessment, but psychological input was being delivered by an associate clinical psychologist. The trust informed us that a psychologist had been recruited into post and was due to start in the next month.

Staff held weekly mutual help meetings and patient voice meetings for patients and ensured patients had access to activities and local community groups.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group and managers provided new staff with appropriate induction, using the Care Certificate standards as the benchmark for healthcare assistants.

Staff followed the National Institute for Health and Care Excellence guidance, and staff provided a range of care and treatment suitable for the patients in the service in line with best practice and national guidance.

Staff identified patients’ physical health needs and recorded them in their care plans. Staff made sure patients had access to physical health care, including specialists as required. We saw within care records that patients were being supported by specialist's external to the service including the tissue viability and district nursing team.

Staff took part in clinical audits, benchmarking and quality improvement initiatives. Local audits took place such as audits of clinic room fridge temperatures, compliance with malnutrition screening, and infection control.

Managers used supervision and appraisal sessions to identify the development needs of staff within the service. Staff compliance for supervision was an average of 78% across all 4 wards. Staff expressed issues with inputting supervision data onto the newly adopted electronic staff record system (ESR). Staff compliance for appraisals was an average of 89% across all 4 wards.

Mental Health Act

Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. At the time of the assessment, compliance for Mental Health Act training was 85%.

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice, stored on the trusts electronic systems that staff have access to.

Patients had easy access to information about independent mental health advocacy. We observed information boards on the wards with various posters, including how to access advocacy.

Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted and Section 17 leave was rarely cancelled due to staffing levels.

Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits, including work around access to Section 17 leave.

We saw evidence in 4 out of 15 care records we looked at, that staff did not always record they had read patients their Section 132 rights on admission.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Patients were invited to attend meetings about their care. Relatives we spoke with felt involved and gave feedback that they were invited to meetings.

Staff felt that meetings held within the service were effective for sharing information internally. The service had meetings in addition to shift handovers such as the daily and Purposeful Inpatient Admission meeting and safety huddles.

The service had effective working relationships with external teams and organisations.

We received feedback from independent advocacy. Overall, there was a positive working relationship between staff and advocates. However, it was reported that advocates were not always informed of any changes to multi-disciplinary team meetings and that contacting the ward via telephone can be difficult.

During our assessment we observed 1 multidisciplinary meeting which was attended by a range of professionals including doctors, nurses, a social worker, children’s social worker, occupational therapist, pharmacist and discharge coordinator. The meeting agenda included updates from the nursing team regarding previous incidents, mental state examination, interactions, sleep hygiene, nutrition, medication and plans going forward. We observed effective and efficient delegation of roles. The meeting was discharge focussed, and staff contributed to the meeting in a respectful, caring and person-centred manner.

We reviewed minutes of meetings from handover meetings, and mutual help meetings. Case notes indicated evidence of external appointments and patient participation in occupational therapy, and input from other appropriate services. Discharge planning was collaborative with the patient and their relatives where appropriate.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported patients to live healthier lives – for example, through participation in smoking cessation schemes, healthy eating advice, managing cardiovascular risks, screening for cancer, and dealing with issues relating to substance misuse.

Ward activities helped promote a healthy lifestyle for patients – for example walking groups, sports activities and cooking healthy meals.

We found evidence of a planned Peak District Walk and staff attempting to facilitate an individual’s attendance at a local martial arts gym.

Staff we spoke with understood the importance of ensuring patient’s health needs were met. Patients had access to physiotherapy, dieticians, occupational therapists, advocacy, activity staff, and doctors.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record patient outcomes. Staff used a variety of recognised tools to monitor patients depending on their needs, these included Health of the Nation Outcome Scales and National Early Warning Score 2. These were recorded in the patients’ care records and used to review and direct their care. Staff also monitored progress and outcomes at the point of discharge and there were examples of positive treatment episodes where patients had moved on to new placements or into the community.

Staff discussed clinical audit findings in a monthly governance meeting and shared findings and learning across the service group. Managers used results from audits to make improvements and discussed these with staff at team meetings.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Patients had access to independent advocacy and culturally specific advocacy across all 4 wards, with a good amount of signage indicating how to access them outside of planned visits.

Staff we spoke with had a good understanding of consent including the Mental Capacity Act. Patients were supported to communicate and make decisions to enable the service to deliver person-centred care and treatment in line with their specific needs.

At the time of our assessment, the compliance figure in relation to staff completing their training in Mental Capacity Act was 96%.