St Andrew's Healthcare - Birmingham Also known as 1-121538294

On this page

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

People told us their views were not always listened to or respected by managers.

People told us that permanent staff treated them with kindness and compassion but when bank or agency staff did not know them well, they did not engage with them. People said some staff did not respect their individual preferences. This made them feel that staff did not care about them.

People said there were not enough activities due to staffing which meant they were bored.

People gave mixed feedback about how staff responded to their immediate needs, one person said staff did not always respond whilst others said staff always responded immediately.

Staff did not feel their wellbeing was valued by the provider and this affected their morale.

However, people’s relatives told us staff treated them with compassion and kindness. People were supported to keep in contact with their relatives and friends. People chaired the ward community meetings.

We observed staff responding to people’s immediate needs and staff used de-escalation to diffuse situations of conflict and support people.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said their views and wishes were not always considered. They told us they had to keep raising issues about their toilets not working and not having running water in their ensuite and their views were not listened to or respected. They did not think managers considered their wishes and views.

People gave us mixed feedback about how caring staff were. Some people said some staff just sit and stare at them when doing observations and did not engage with them and they felt staff did not care about them. Some people said that staff particularly permanent staff were caring and kind. People’s relatives told us that staff were kind and caring.

Some people said that staff did not respect their privacy and dignity as they just walked into their bedroom without knocking on the door.

We observed that people had raised issues at community meetings and staff acknowledged these but were unable to ensure that issues about the environment were acted on. This meant that people did not always feel that their care and treatment was delivered in a kind and compassionate way.

People gave mixed feedback about how they were treated as individuals. Some people told us they had food that met their cultural needs however others said they had limited choices of these. People told us about how they received spiritual support from visiting Chaplains, and we saw information about the service displayed. However, some people said staff were not aware of their preferences and cultural needs and backgrounds and had not asked them about these.

Some staff were aware of how to meet people’s individual needs and respect their preferences. They told us about people’s positive behaviour support plans. However, some staff were not aware of these and did not have information about people’s individual needs.

Some records showed that staff involved the person in their care and treatment and supported them to meet their individual needs. One person’s records clearly showed staff how to deescalate the person when they were upset, and we observed staff doing this.

Positive behaviour support plans detailed the person’s individual needs and how they might respond in certain situations and how staff should support them. However, not all staff were aware of these so did not know about people’s individual needs and preferences.

People were supported to maintain relationships that were important to them. People told us they could keep in touch with their families if they wanted to. Relatives told us they were involved in meetings via video calls if they could not attend in person. Relatives said they could keep in contact with their relative and when they phoned the ward, they were able to get through and speak with staff for an update.

People told us they did not have enough access to activities due to not enough staff. They said they were bored and there was nothing much to do. One person told us they chose what music videos they could watch in the lounge and enjoyed this.

People said they were encouraged to be as independent as possible and encouraged to clean their own bedrooms. Some people said they could not do as much cooking as they would like due to lack of staff availability to support.

Staff said they did not always have time to support people with activities to promote their independence such as cooking and escorted leave. Staff told us how they supported people to maintain contact with their family through video calls, phone calls and visits.

We observed that people were offered opportunities to have choice and control over their own care. In the community meeting on Northfield ward a person using the service chaired the meeting. There was a set format to the agenda agreed by people and staff and there was an open atmosphere with an opportunity for all to talk freely.

On Moor Green ward we observed there was a Patient experience group. This was trialling with a few people completing a weekly summary to add to their records. It included information about their thoughts, their mental state and what had been good or bad during the week. The ward manager told us this was to promote people’s ownership of their care and treatment.

People’s care records showed staff how to support them to maintain contact with their family. There was a carers group within the hospital facilitated by the social work team.

Staffing levels did not always ensure that people had access to regular activities to promote their independence.

People gave mixed feedback as to how staff responded if they needed urgent help or were in distress. One person told us they felt their needs and wishes were not a priority to staff. Other people said staff would respond if urgent and others said staff always responded to them and supported them.

Staff gave us examples of how they had verbally deescalated people when they got upset and demonstrated they used a gentle approach and offered support to the person. Staff said they responded immediately to people when they were distressed and used de-escalation techniques.

Staff gave examples of how they responded to people who had tried to harm themselves focussing on the immediate physical health needs but then ensuring they responded with compassion. They gave people time to talk about the positive things in their lives and used music to help the person calm down if they knew this helped them.

We observed staff responded to people when they asked for anything throughout our visit and saw people’s needs as a priority. We observed staff anticipated when a person was beginning to get upset and distracted them. They supported them to go into the garden and spent time talking with them.

The provider trained and supported staff in basic life support to respond to people in an emergency.

Staff told us their wellbeing was affected by the lack of staff which caused them to feel ‘burnt out’. Staff told us they felt valued by ward managers and their colleagues but were not valued in the same way by the provider. Ward managers told us they had asked if staff could be given an incentive to work at the hospital, but this was not given. The provider had stopped enhanced pay on weekdays, and this was only given at weekends so at weekends they were fully staffed. On weekdays this was a negative impact on permanent staff as there was a reliance on bank and agency staff who were not always familiar with the wards. Staff described feeling uncared for, disrespected and under-valued. They felt that the provider would rather have bank and agency staff filling shifts than substantive staff.

Staff told us they did not have an opportunity to feedback or raise concerns about the service. They said the acuity of people using the service was high and they did not have an opportunity to say if they thought the person’s needs could not be met there. However, the provider evidenced several opportunities provided to staff.

Staff felt valued by their ward managers and colleagues. They said they had their breaks which were planned by the team. Staff told us the teams they worked in were diverse, inclusive and that they were able to bring their whole selves to work. They felt the ward culture was open and transparent.

Staff were unhappy about the security measures in place when they came into work with the metal detection system. They said they were told this was to look for illicit substances, however metal detection did not identify drugs. This system delayed them arriving to the wards on time for their shift and they were unhappy with the approach and attitude of the security team towards them.

The provider had an engagement strategy and people plan. They had a full staff survey in June 2024 and at the time of our visit were working through their action planning process from this. The overall Charity response rate to the survey was 60% which was an increase on previous years. The response rate at Birmingham was 45%. Local action planning was underway and discussions taking place locally. Actions identified will be placed on the ward and divisional Quality Improvement Plans to ensure ongoing oversight.

The provider evidenced several opportunities provided to staff such as staff surveys, Open Door Fridays, visits with Senior Leadership team and access to Freedom to Speak Up Guardians.