Kings Norton Hospital

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

We rated effective as good. People received care and treatment in line with good practice standards. People were supported to exercise to promote a healthier lifestyle and there were plans to have a gym onsite. Psychologists and occupational therapists used recognised tools to measure people’s outcomes following therapeutic interventions and involved the person and their relatives in these.

People’s capacity to consent to their care and treatment was assessed and recorded.

Psychologists and occupational therapists showed that therapies offered were evidence based and in line with good practice standards.

However, people were not always involved in the assessment of their needs. People’s records did not always show that concerns about eating and drinking were escalated to the doctors so their physical health needs could be met. Some people did not know about advocacy services.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always involved in the assessment of their needs and support was not always given to maximise their involvement. Some people said they were not told when their ward round meeting was in advance, so they did not have an opportunity to prepare for this. People said the ward round meeting could be quite daunting due to the number of people in the room and others via video call. People said they did not always feel heard with everybody in their meeting.

Some people told us they had not seen their care plan or been involved in it.

People’s needs were appropriately assessed by staff. Staff told us that before admission a comprehensive assessment of people’s needs was completed. Referrals were screened by the multidisciplinary team that included nursing staff and further information was requested when required. Staffing numbers were increased where needed to support people. Staff said they supported people in their ward round meeting and tried to involve them in this.

People were not always involved in the assessment of their needs. People’s needs were reviewed weekly in the multidisciplinary team meeting and the person was involved in this. However, 4 people’s care plans did not show involvement of the person in assessing their needs.

People received care and treatment in line with good practice standards. Two of 8 people said there could be better therapies and activities provided, and they sometimes felt bored on the ward. However, they sometimes attended cooking sessions and went out for a walk most days. Some people said that the therapies were generally quite good, and the occupational therapist engaged them in a range of activities. The provider showed us the timetables for each ward which showed a range of therapies and activities were provided.

Staff were encouraged to learn to improve the way the service delivered care. Support workers said if they wanted to, the provider trained them in doing blood tests and taking electrocardiograms. They said this helped to ensure that people’s physical health needs were met.

Psychologists told us about therapies they used based on evidence based treatment. These included gradual exposure therapies to encourage people to reintegrate into the community and sleep in their bed to aid their recovery. They trained nursing and support workers to get involved in these so that therapies continued in the evenings and weekends.

People’s nutrition and hydration needs were not always met in line with current guidance. Three people’s records showed there were concerns about the amount they ate and drank. However, there was no evidence that staff were monitoring this and there was no guidance for staff to follow if this needed escalating.

However, people’s records showed they received treatment from occupational therapists in line with evidence based practice. Records showed that occupational therapists were involved in people’s assessments and set goals for people to achieve during their stay in hospital to prepare them for discharge. Care plans had relevant goals which were recovery orientated.

Information was not always shared between teams to ensure continuity of care. Nursing staff said occupational therapy staff did activities and therapies with people as much as possible, but more activities would be beneficial. Nursing staff did not always have the time at evenings and weekends to continue activities and therapies. Occupational therapists said they signposted nursing staff to activities they could do at weekends and provided ‘weekend packs’, they also encouraged support workers to use their resources and budget at weekends. It was not clear this was effective and that teams worked together.

Staff were observed to work with other teams outside the service to plan for people’s discharge.

Psychologists worked with people on the wards, and they were involved in assessing and delivering people’s care and treatment. The multidisciplinary team worked together to understand and meet people’s needs.

People said there were less activities in the evenings and at weekends when the occupational therapists were not there.

Plans for people’s discharge did not always consider people’s individual needs and ongoing care arrangements. People’s records showed that staff had referred people to housing and substance misuse services during their admission to prepare for their discharge back to the community. However, some people’s records did not evidence further discharge planning.

A discharge letter was completed by the doctor on the person’s discharge from the hospital. This was forwarded to the team who were taking on the person’s care such as the community home treatment team.

People told us they needed further support to help promote and maintain their health and wellbeing. People said they would like the hospital gym to be open as they could not always get out for exercise daily depending on the weather and a gym onsite would improve their physical and mental health. Following our assessment the provider told us that work had been agreed for 2025 to build a gym on site which will allow increased access to exercise for people on all wards. People were supported to go to a local leisure centre once a month to use a gym, but this was not often enough for people who needed staff to escort them. The provider told us that group sessions are monthly but individual sessions are planned based on people's needs.

Records showed that people were encouraged to manage their own health needs. People were involved in reviewing their health needs where appropriate. Records showed that staff encouraged people to make healthier choices to promote their health and wellbeing.

Staff said they did not always have time to escort people to use the local gym to promote exercise and live healthier lives. They did try to escort people for local walks to help them to increase their exercise. However, the provider told us that occupational therapists escorted people to the gym and there were 4 staff to do this. The provider also told us that since our visit they had worked with staff on shift planning and allocation of staff so this is more effective in supporting people.

People told us the hospital had links with a local professional football team where they had a weekly football session and links with a local boxing club. They said this improved their wellbeing and gave them access to activities they had not tried before.

Staff used effective approaches to monitor people’s care and treatment and their outcomes. Staff told us they discussed with people outcomes of their care plan in their multidisciplinary team meetings and with other staff at handovers between shifts. Staff monitored outcomes through reduction of people’s risk and their use of unescorted and escorted leave from the hospital. Psychologists and occupational therapists told us they used recognised tools to measure people’s outcomes following therapeutic interventions and involved the person and their relatives in these.

People’s records did not always show that people’s care and treatment was effectively monitored. Four people’s notes recorded when the person was offered food and that sometimes they declined. In 1 person’s records it stated 'has not been seen drinking enough fluids' however there was no evidence that this was monitored or escalated to the doctor.

Most records reviewed included a comprehensive assessment of the person’s physical health needs on admission. However, 2 did not show a baseline of their physical health observations on admission. Therefore, it was not clear how staff could monitor these during their stay.

People did not have all the information they needed to understand their rights around consent to care and treatment. Some people told us they did not know about advocacy services and information about this was not displayed in communal areas of the wards. However, people knew about the Mental Health Act Tribunal process and were aware of their rights if they were detained. They had access to a solicitor. They met with their doctor regularly and had leave from the hospital when possible.

Staff told us they spoke with people about their risks on admission and asked to look at their belongings to ensure there were no items that would pose a risk to them or others. Room searches were completed after discussion with the nurse or ward manager and as much as possible with the person’s consent.

We observed staff checking people’s understanding and gaining verbal consent before undertaking any activities or therapies.

The systems and practices to ensure people understood the care and treatment offered and to assess their capacity to consent were effective. On admission people signed a consent form and staff assessed their capacity to consent based on their historic risk information and information in their referral if the person was not able to tell them.

People’s records showed that staff had discussed consent to involve the person and their family in their care and treatment.

Medicine records did not always document that the person consented to their medicines. The consent to treatment records were not all up to date on the electronic medicine records system. Staff said if they have not been uploaded onto the system the Mental Health Act administrator would add a note. However, in 1 person’s record there was no form uploaded and no note about the person’s consent to treatment. Following our assessment site visit the provider showed they had improved these processes and managers had increased their oversight of this.