Midlands Partnership University NHS Foundation Trust

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• 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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question 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.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We reviewed 19 patient care records across all 6 wards. Staff completed a comprehensive mental health assessment of the patient at, or soon after admission. Staff developed care plans that met the needs identified during assessment. They were comprehensive, personalised and holistic. Staff discussed patient care and treatment regularly and updated the care record following incidents and multidisciplinary review, however care plans were not always updated to reflect any changes made. Six patient’s care plans had not been reviewed in line with the trust’s care planning policy. Care plans mostly incorporated assessed risks and associated management plans. However, we found 2 care plans on Brocton ward that did not fully detail how assessed risks were to be managed. Staff assessed and monitored physical health well.

Ward teams had access to the full range of specialists from different disciplines and completed assessments and planned care and treatment that met their psychological, medical and physical health needs using a range of assessment tools. Staff assessed and monitored patients’ physical health well. Patients had good access to physical healthcare, including access to specialists when needed. Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patients. New starters received a trust induction and training. Activities were available across all the wards. The occupational therapy teams and activity coordinators assessed and participated in activities. We observed a range of ward-based activities including board games, x box, yoga, live music and panini making. An allotment was available at St George’s hospital. Arts for Health therapeutic activities programme attended the 2 hospital sites for up to 16 hours each week. Staff undertook clinical audits such as infection prevention control, resuscitation equipment, nursing observations, environmental and physical health. Weekly named nurse audits ensured all elements of the patient care record were completed. Quality leads completed spot-check audits for patient care notes and results were discussed with staff in supervision. The trust had embarked on a transformation project to improve the quality and consistency of care planning practice. The project consisted of reviewing and agreeing core standards, audit and development of training and was ongoing with standards being embedded across the staff group. Quality varied across the wards and managers focused on areas that required more attention. Monthly audits assessed progress and identified areas for improvement. Staff received monthly supervision and an annual appraisal. In the 12 months prior to 31 December 2024, 86% of staff had received an appraisal and 98% had received supervision.

Staff from different disciplines worked together as a team and attended regular multidisciplinary team meetings and daily risk meetings to plan, monitor and make decisions on care and treatment plans. Staff shared information about patients at effective handover meetings. We observed multidisciplinary meetings and saw staff effectively communicating with each other and sharing knowledge regarding all elements of current patient risk, care and treatment. Patients told us they were supported by the staff team and attended multidisciplinary team meetings.

Staff reviewed items that could impact on patient safety in the morning risk meetings; for example, staffing, incidents, environmental concerns, safeguarding, specific patient risks including nursing observations and physical health concerns.

Patients had access to other healthcare specialists and other relevant teams within the organisation such as care coordinators and the crisis team. Staff worked well with external partners and they attended multidisciplinary treatment reviews to enable continuity of care and support for discharge.

Patients’ physical health needs were assessed and documented within care plans. These were routinely monitored and reviewed.

Staff told us they understood the importance of ensuring patients’ physical health needs were met. Staff had appropriate training to ensure that they were able to effectively assess and monitor physical health needs and had access to other healthcare professionals. Health and wellbeing activities such as yoga, gym, football and mindfulness sessions were available.

Patients had access to healthy snacks and drinks. Sporting equipment was available on the wards and Norbury PICU had a dedicated gym.

Staff did not routinely use recognised rating scales to assess and record degree of illness or progress made. Within the patient care notes we reviewed, a small number had a Health of the Nation Outcome Scale score or Dialog score but staff said they did not routinely use these.

Staff used monitoring tools for aspects of patients’ physical health, such as Waterlow scores for pressure sores, National Early Warning Scores 2 to record physiological measurements such as blood pressure and temperature or Lunsers for possible side effects from medicines.

Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. We reviewed care records for 1 patient who lacked capacity and saw staff had made decisions in their best interests.

Staff said they always ensured that patients understood what their rights were under the Mental Health Act and repeated these regularly. Staff completed Mental Health Act audits to ensure correct authorisation for detention and capacity to consent for medication paperwork was in place. Staff had a good working knowledge of the Mental Health Act and Mental Capacity Act.