Black Country Healthcare 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

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 generally met through good organisation and service delivery.

Patients had access to information, advocacy and support services, and there was evidence that feedback informed service improvements. The service demonstrated an understanding of the diverse needs of patients and local communities and generally provided information and support in accessible formats. However, some aspects of care planning, accessibility and future care planning were not consistently personalised or responsive to individual needs.

This service scored 64 (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. The service did not always ensure care and treatment were personalised or that people were meaningfully involved in decisions about their care.

Although some patients told us their individual needs were not always fully met, particularly in relation to accessing spiritual and religious support, several patients told us their cultural, religious, dietary and individual needs were recognised and respected. We also saw examples of staff working collaboratively with patients, families and carers to understand and respond to individual circumstances.

However, this was not consistent across all sites and wards. Several care plans and risk assessments appeared generic and lacked clear evidence of meaningful personalisation or co-production. Although records frequently stated that patients had been involved in care planning, supporting evidence was not always available. Some patients also told us information about their care and treatment was not always provided in a way they could easily understand.

These findings reduced assurance that care planning and decision-making were consistently personalised and centred on what mattered most to individual 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.

Care and treatment delivered to patients by the service demonstrated a good understanding of the diverse health and social care needs within its local communities. Interpreting services were arranged when required to support clear and effective communication with patients from all backgrounds.

Patients told us they knew they could involve their families in their care if they wished, and that their decision would be respected if they did not want family involvement. Staff facilitated family contact through face-to-face meetings on the wards or in designated visitors’ rooms, as well as through telephone and video calls.

We saw evidence of regular multidisciplinary team (MDT) ward rounds taking place across the wards. During the MDT meetings we observed, staff discussed patients’ individual needs and wishes, including any reasonable adjustments required to support their care.

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

Patients had access to a variety of leaflets in patient areas, including information about safeguarding, advocacy, medicines, spiritual care and carer resources.

Although we did not see leaflets displayed in a variety of languages, staff said these could be reproduced in alternative languages when required. Interpreters could also be booked to attend meetings with patients or their families.

On admission, patients were provided with a ‘Welcome to the Ward’ induction booklet, which contained relevant information about their admission. This included signposting to various internal and external organisations, including information about how to make complaints, patients’ rights and advocacy services.

Most patients we spoke to felt they received sufficient information about their care and treatment, including their medicines. Most carers and family members we spoke with also said they felt well informed and were regularly updated about their relative’s care and progress.

The evidence showed a good standard. Patients generally knew how to raise concerns and complaints, and there were examples of feedback leading to positive changes. However, the provider could not consistently demonstrate how patient feedback was routinely analysed and used to drive service improvement.

Patients generally knew how to make complaints, including who to raise concerns with. Patients told us staff listened to their concerns, took them seriously and usually acted upon them. Posters and notices displayed throughout patient areas provided information about the different ways patients could raise concerns or make a complaint.

Between 1 January and 1 June 2026, the five services collectively received five formal complaints. Two complaints related to Brook Ward, with one complaint each relating to Dale, Clent and Friar wards. Complaints concerned unmet care needs, access to leave, the timing of discharge, medication and the accuracy of health records. At the time of our inspection, three complaints remained open and two had been closed. Of the closed complaints, one had been upheld and one partially upheld. During the same period, the services received 69 informal complaints.

Staff were able to describe examples where concerns raised by patients had resulted in action being taken. For example, one patient reported feeling uncomfortable because a member of staff appeared to be staring at them. The concern was addressed promptly, and the staff member was replaced. However, another patient told us they had previously raised a complaint but did not feel any action had been taken or that they had received a response.

Patients across all sites consistently raised concerns about the quality of hospital food, including limited choice, poor quality and portion sizes they felt were too small. The trust had responded to this feedback by appointing a new catering provider and developing a revised menu, which was due to be introduced shortly after our inspection. The new menu had been informed by patient feedback and included a wider range of meal options and greater flexibility around portion sizes, including additional portions where required. This demonstrated that the trust had listened to concerns and taken action to address them.

The trust had governance processes in place to review patient feedback. Feedback was included in monthly business intelligence reports, divisional quality and safety reports, and quarterly governance meetings. Staff told us community meetings were held regularly on wards to gather patients' views and discuss issues affecting the ward environment.

However, there was limited evidence to demonstrate how patient feedback was routinely collected, analysed and used to drive wider service improvements. Community meetings were not formally documented, meaning it was not always possible to identify the concerns raised by patients or understand how services had responded. Although records of community meetings were not available, staff meeting minutes contained some examples of action being taken in response to patient feedback. For example, patients on one ward requested additional garden benches and bins, which staff confirmed had been ordered.

We reviewed patient feedback data from 165 responses to the question, "How was your experience of our service?" Overall, 53% of respondents rated their experience as good or very good, 5% as neither good nor poor, and 41% as poor or very poor. While the trust had processes to review feedback, we found limited evidence of a systematic approach to demonstrating how themes and concerns identified through patient feedback were translated into measurable service improvements.

The evidence showed some shortfalls. The service did not always ensure people could access the care, support and treatment they needed when required.

The service generally met the needs of patients with mobility difficulties. Walking aids, wheelchairs and accessible shower facilities were available when required, and most communal areas were wheelchair accessible. However, there were only a limited number of wheelchair-accessible bedrooms across the wards, which may have reduced flexibility to accommodate patients with mobility needs if the available accessible rooms were already occupied.

The occupational therapy team developed communication passports to support patients with additional communication needs, including people with a learning disability. Staff described how reasonable adjustments were made to meet individual needs. For example, a patient with a learning disability was transferred to a quieter ward environment, which staff said had a positive impact on their wellbeing and progress.

Patients had access to appropriate support following discharge, including section 117 aftercare, community mental health services and crisis services.

Many bedrooms did not have en-suite facilities, which patients frequently identified as a concern. For some patients with accessibility needs, this meant transfers to other wards were required to access more suitable facilities.

The trust risk register identified significant challenges in meeting the needs of patients requiring bariatric care. Across all 11 wards, doors were not wide enough to accommodate bariatric beds, and there were shortages of suitable equipment, weighing facilities, furniture and shower provision. These limitations had the potential to affect patients' dignity, safety and quality of care and could result in people being admitted outside their local area.

Some staff also reported difficulties contacting ward doctors promptly, which they said could delay aspects of care, including routine assessments following admission.

The evidence showed a good standard. The service had systems and processes in place to identify and respond to the needs of people who may experience inequality.

Compliance with Equality, Diversity and Human Rights training was 96%.

Many patients told us they felt involved in decisions about their care and treatment and spoke positively about the support provided by staff. Patients could access items to meet their religious and spiritual needs, such as prayer mats, and independent advocates visited wards regularly to provide additional support.

The trust promoted equality, diversity and inclusion through its Equality, Diversity and Inclusion (EDI) Team, which provided staff training, policy development, support and awareness activities. Equality, diversity and inclusion training formed part of staff induction, and regular events, communications and staff networks promoted an inclusive culture. The trust also planned to strengthen local leadership through the introduction of departmental EDI champions.

The Health Inequalities Team led implementation of the Patient and Carer Race Equality Framework (PCREF). An action plan, developed with community ambassadors, aimed to reduce health inequalities and improve outcomes for people from diverse communities.

The trust monitored workforce diversity across a range of protected characteristics, including age, ethnicity, nationality, gender, disability, religion and sexual orientation. Equality impact assessments were also completed for policies and procedures to reduce the risk of disadvantage for vulnerable people and those with protected characteristics.

The evidence showed some shortfalls. Future care and discharge planning did not always reflect patients' individual wishes, preferences and support needs.

Most records showed evidence that staff supported patients to discuss future care, treatment and discharge arrangements, and several patients confirmed they had been involved in these discussions. Staff generally ensured relevant healthcare professionals and partner organisations were involved when planning care for people with complex needs.

However, this was not consistent. Some patients did not feel sufficiently involved in decisions about their future care, and records did not always demonstrate that patients’ wishes and preferences had been considered. Where discharge planning was documented, plans were sometimes generic and lacked a personalised approach.

Consequently, the service could not always demonstrate that future care planning reflected patients’ individual goals, preferences and support needs.