St Mary's Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all 5 quality statements in the caring key question and found it to be good. The service had not been previously inspected and this domain had not previously been rated.

Staff treated clients with dignity, respect, compassion and kindness. They respected their privacy and followed appropriate policies to maintain confidentiality. Patients were involved in the running of the ward through weekly community meetings and were able to feedback in a variety of ways.

Staff were knowledgeable about individual patients and understood patient need. There were different ways for patients to be involved in their care. However, not every patient we spoke with felt involved. The service had delivered co-production training to staff to help with this. Patients had access to information they needed on their care and treatment. Information was available in a range of different formats.

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.

Patients we spoke with were positive about staff. They told us that staff treated them with kindness and compassion and respected their privacy and dignity. Patients told us that staff were available when they needed them and supported their emotional wellbeing. Patients we spoke with did not raise any concerns regarding confidentiality.

Staff treated patients with compassion and dignity. Staff we spoke with discussed patients in a respectful and caring manner. They were able to describe individual patients and discuss their care and treatment. Staff understood patients and their preferences, wishes and personal histories. They were able to describe personalised interventions for individual patients and tell us how they protected patients’ privacy and dignity. Staff were aware of policies and procedures around confidentiality and were able to give examples of how they maintained this, for example ensuring patient information boards in staff offices were covered when not being used.

We contacted stakeholders for comment, but they did not raise any issues.

Staff treated patients with compassion and kindness. Staff and patient interactions we observed during the assessment were respectful and conducted in a caring manner. Staff were discreet, respectful, and responsive when caring for patients. They respected patients’ privacy and dignity. Staff protected patient confidentiality and followed relevant policies and procedures.

Patients we spoke with told us that staff treated them as individuals and knew there likes, dislikes and interests. Some patients gave us examples of conversations they had had with staff around topics like the football team they supported or the music they liked. Patients felt supported to manage their own health.

Staff understood patients’ individual needs and preferences. They were able to describe the personal, social and religious needs of individual patients and explain how these would be identified and captured in care plans.

Staff and patient interactions we witnessed demonstrated that staff understood and respected the individual needs of each patient. Multidisciplinary patient reviews we observed were person centred and holistic. We observed holistic and person-centred interventions between staff and patients. However, not all of the records we reviewed reflected this level of personalisation. Managers we spoke with acknowledged this and were able to describe work being undertaken in this regard.

The service’s governance and assurance processes had identified that care records were not always as personalised as they could be. The service was involved in a range of projects to improve this including the delivery of co-production sessions by an individual with lived experience and work around the design and number of care plans in use.

Patients we spoke with were generally positive about their care and their involvement. However, not every patient we spoke with felt involved in decisions about their treatment. Patients we spoke with were aware they could attend weekly patient review ward rounds but not all patients chose to attend. They told us staff would encourage them to contribute either through providing the staff with feedback or by completing a form which captured relevant information and the patients’ viewpoints.

Patients we spoke with attended weekly community meetings on the wards where they were able to feedback on the service, influence activities and make suggestions.

Staff described how patients would be supported in being involved in decisions about care and treatment. Staff told us that assessment and care planning was a collaborative process. Some staff we spoke with had completed co-production training to help facilitate this. The training had been delivered by an individual with lived experience of mental health services and detention under the Mental Health Act.

Staff invited patients to attend ward rounds and supported them to do so. Where patients did not wish to attend they could submit information for consideration. Some staff we spoke with talked about work that was ongoing to help make ward rounds a more welcoming and patient friendly experience.

Staff supported patients to maintain relationships that were important to them. Patients were able to access phones and tablets to stay in contact with loved ones. There was a family friendly visiting room away for the ward. Where appropriate staff encouraged family members and loved ones to take patients out on community leave.

Staff were able to help facilitate patient involvement and choice by providing information in different formats as appropriate including translation services, easy read and large print. Staff were aware of Independent Mental Health Advocacy services that visited the ward and how to refer patients to them.

Patients were supported to maintain relationships and networks that were important to them. There was access to visiting facilities including a family room for patients with young children or relatives. We observed staff supporting section 17 community leave and helping patients to visit shops and cafes.

We observed patients taking part in a range of activities including music and art groups. There was equipment and resources to help staff provide activities 7 days a week. Patients were involved in choosing activities during community meetings.

Patients had access to Independent Mental Health Advocacy services to support their involvement in decisions about their care and treatment. The service held weekly community meetings where patients had the opportunity to feedback and make suggestions or a choice around planned activities.

Patients we spoke with told us that they were able to access staff when they required them. They told us that staff were responsive to their needs.

Staff demonstrated a good knowledge of the patient group and were able to describe individual risks and how they would respond to immediate need. Staff were able to describe risk management plans and explain how daily observations, named nurse sessions and ward rounds fed into these. Individual information and updates were also shared at shift handovers to ensure staff understood potential needs and the most appropriate and effective responses to them.

We observed staff providing care and responding to patient’s needs appropriately. Staff were responsive to requests for support We observed staff proactively engaging with patients to address their needs, for example by asking about their mood or offering drinks and snacks. Care records demonstrated staff were responsive to physical health needs.

There were appropriate systems and guidance in place to support staff in responding to immediate needs. There were nurse call alarms in bedrooms and staff carried personal alarms to summon help when required. Staff had access to emergency medical kits and a defibrillator if required.

Staff were proud of their role and the care and treatment they provided. Staff we spoke to felt supported in their roles. They described a supportive culture with a focus on staff wellbeing. Staff were happy in their roles and felt that their workload was manageable. Staff we spoke to noted an improvement in staff morale, job satisfaction and workload since the ward had changed purpose from a learning disability and autism ward to an acute mental health ward. They told us that there was less acuity on the ward and better staff and patient relationships. Staff had access to support services through the provider organisation.

Staff had good working relationships with colleagues and felt valued. They were able to raise concerns and give feedback where appropriate.

There were processes for staff to feedback, raise concerns and suggest ways to improve the service. This included through supervision, team meetings and staff surveys. Staff had access to support services including occupational therapy. Staffing levels were sufficient to enable staff to take planned breaks and annual leave.