Essex 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

We rated effective as good because: Staff planned and delivered patients’ care and treatment with them. Staff followed evidence-based good practice and standards when providing care in a secure setting. Patients had access to appropriate therapeutic, medicines and physical health monitoring to ensure effective treatment. Patients were supported to live healthier lives and staff monitored patients’ physical health. Staff worked effectively across teams and services to support people. The multi-disciplinary team met weekly to discuss patients care and treatment with them. Staff worked with external services to ensure patients had a smooth transition of care.

However, whilst patients had access to a range of activities, they said that these activities were often cancelled due to a decrease in dedicated activity coordinator staff.

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.

Psychologists based treatment pathways on best practice guidelines, including psychological therapies. Medical staff used best practice to inform their treatment pathways for managing patients with severe trauma, self-harm, anxiety, and depression.

Staff said there was a pre-admission assessment completed on all patients. Care plans were updated within 72 hours of admission. An assessment of a patient covered their mental health, physical health, social circumstances, and support. Patients’ physical health was monitored daily or more often according to the patient’s needs. Staff said patients were involved in reviewing their care and treatment in multidisciplinary team meetings and during one-to-one sessions with staff.

We reviewed 13 patients’ care and treatment records. Staff completed a comprehensive mental health assessment of each patient either on admission or soon after. Patients had their physical health assessed soon after admission and regularly reviewed during their time on the ward. Staff developed a comprehensive care plan for each patient that met their mental and physical health needs. Whilst staff completed care plans with every patient, they were not always personalised, containing the patient’s voice. For example, care plans lacked patient voice and were very long. Care plans showed that where patients needed a referral to other health professionals this was completed, and staff supported patients to attend appointments. On admission patients had a physical health assessment, and physical health was then regularly monitored.

Staff said they followed evidence-based good practice and standards. Patients received appropriate therapeutic, drug and physical health monitoring. The service used My Shared Pathway, and all the multi-disciplinary team were involved. Patients had access to psychological therapies. However, staff said there was not a lot of ward activities, and that patients were sometimes bored. Staff on Forest ward said staff did not always engage patients very well in activities. Staff said there were 2 occupational therapists across the service and there used to be activity coordinators on each ward but that was stopped. Activities included, table tennis, pool, gym, video games, football, gardening, walks, cooking. Patients were asked what activities they would like to do, and staff facilitated them where possible.

Psychologists based treatment pathways on best practice guidelines, including psychological therapies. Medical staff used best practice to inform their treatment pathways for managing patients with severe trauma, self-harm, anxiety, and depression. Staff used recognised rating scales to assess and record the severity of patients’ conditions and care and treatment outcomes. Staff used the Health of the Nation Outcome Scales (HoNOS) and My Shared Pathway. Staff used these tools to report certain outcomes for patients such as social skills and self-care. Staff took part in clinical audits, such as care planning, seclusion, risk assessments and the Mental Health Act paperwork. These

audits helped staff to look at the results and learn from them.

Patients felt that staff listened to them and knew what there needs were. Patients attended their multi-disciplinary team meeting to discuss their care with all the staff involved. Staff clearly shared information with patients about their care and if they were moving between services.

The ward teams worked effectively together and across services to support people. Each ward had a multi-disciplinary team (MDT) meeting once a week. Patients, nursing staff, doctors and psychologists attended these meetings. Nursing staff felt that their voices were heard in the MDT. Staff felt that teams and services worked well together, including advocacy and the social worker. Nursing staff handed over after each shift and discussed pertinent patient information.

The hospital had effective working relationships with each other. Staff on the ward met every month to discuss business continuity and complex cases. Minutes for patient ward rounds showed staff discussing patient risk, their care plan and input from the patient and their loved one or carer where appropriate.

Staff held regular multidisciplinary meetings to discuss patients and improve their care. The consultant psychiatrist held a weekly ward round, which consisted of nursing staff, ward doctors and therapists. These meetings reviewed the patients’ care and treatment including risk, recovery goals, capacity and medicines

Patients said they were able to go outside and had good amounts of leave. Patients said they could access the gardens. Patients on Aurora ward said they could make hot drinks and snacks 24/7, they said they had their own kitchens and did their own shopping. However, patients from other wards said it was more difficult to access hot drinks and snacks at night. Three patients said they were not supported to live healthier lives, with one saying they had gained 20lbs since arriving. Patients also reported that the basketball court was closed at the time of the assessment.

Staff supported patients to access the local leisure amenities in the community and at the onsite gymnasium. Staff supported patients to quit smoking by supplying nicotine replacement therapies.

Nutrition and hydration were monitored in progress notes. The hospital site was smoke free.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.