Nottinghamshire Healthcare NHS Foundation Trust

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found services were safe. There was a learning culture where staff felt supported and were able to share practice with colleagues. Patient views were always considered when care and treatment plans were created and reviewed and during multi-disciplinary meetings. Staff managed risk well and were able to discuss and escalate risk when required. Staff had appropriate training in place and worked well with partners to ensure patients received holistic care and treatment.

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.

Staff told us during regular meetings about patient caseloads they were given the opportunity to and, encouraged to discuss shared learning practices. They received weekly communications and had sight in any trust wide incident learning. When talking to staff we found there was a strong sense of motivation to do the best for each patient.

The services had regular meetings and had systems in place to communicate any learning from incidents or shared information from within the trusts services. Opportunities for discussion were present including at regular supervisions for all staff. Communication channels were in place for staff to alert others on any issues or passing information onto each other. Team meetings were in place in each service along with de briefs and case discussions.

People we spoke with told us when they have needed to get support from other teams they have found this to be a positive process and commented the support from both the Intensive Community Assessment and Treatment Team (ICATT) and the community teams to be helpful and supportive. People told us they experienced care where the team “have gone above and beyond to support” their patients.

Staff told us how they supported patients in a holistic manner. They understood and commented on how important working with partners and provided safe transfers of care. They gave examples of positive discharges and how post discharge they continued to check in on the patient to maintain after care.

We spoke to a provider that supported a non-verbal patient under the ICATT team, they told us the support had been “very positive with positive impacts on the patient they supported”. They provided insight and suggestions to the team involved in the care.

The services have embedded strong links with others that provided services for their patients. We found evidence of effective partnership working and how the teams continued to communicate whilst supporting their patients. We reviewed care plans and observed risk meetings which showed these collaborative partnerships.

People we spoke with told us staff from the teams would ask about their safety and risks on every visit.

Staff we spoke with told us they accessed effective safeguarding training offered by the trust. They told us that safeguarding was high on priorities when discussing patient safety in weekly risk meetings at each service.

We observed a crisis meeting at the city north Intensive Community Assessment and Treatment Team (ICATT). All the team were involved in a detailed discussion regarding the urgent risk situation a patient was in. At the meeting they had captured the risk and involved the relevant people to support the patient through the crisis. The support was effective and timely, putting the patient at the heart of the process. This safeguarded not only the patient but the service they were in.

Safeguarding training figures showed that staff are compliant with this training. Leaders and managers gave examples on how safeguarding was a priority in risk meetings and discussions. We reviewed care records of patients which showed how safeguarding incidents were recorded and reviewed. Each service had strong relationships with local safeguarding teams and had access to the safeguarding team within the trust. We were informed that safeguarding supervision was also offered to staff.

People who we spoke with told us staff always asked them if they had any risks and if they had any worries or concerns. This showed the trust incorporated people’s choice and preferences when planning and delivering care. If patients were unable to communicate for themselves, people closest to the patient were included in these discussions. Patients and supporting teams felt listened to and understood.

Staff we spoke with were motivated to place the patient in the centre of everything they did. They gave us examples of how they included and implemented patient feedback and views in risk and care plans. We saw an example of this in notes where the team had captured a patient “to be happy again and to develop the same level of trust they had for others as they did the previous year”.

The patient care and treatment records we reviewed were holistic and person-centred. They identified and recorded risk and reviewed these in a timely manner and in accordance with the trust policy. Patient risks were discussed in weekly meetings and daily if risk escalated or new risks were highlighted. We found the patients views were included in all care plans and meetings.

Staff we spoke with told us if there are any issues found during patient home visits these would be reported to leaders and spoken about during risk meetings. Systems were in place to record this on patient records.

Safe systems were in place for staff to record any risks identified at a patient’s premises. These risks were then reviewed regularly. Alerts were placed on a patients record, which highlighted to staff as they opened their care and treatment records.

People that we spoke with told us they had not had any issues with accessing support in a timely manner. They told us they had experienced no cancellations in support and felt the teams were knowledgeable about what they were doing and the support they offered.

Staff we spoke with told us they felt supported by management and leaders. Each team we visited spoke about a positive culture within the team. Teams were supportive of each other and would look out for each other. Staff told us training and supervision were happening, and they could ask for more if required. Vacancies were low and managers and leaders told us that each team had an effective complementary multi-disciplinary team in their support for patients.

Whilst reviewing each team we visited we observed how each team was staffed. We saw how managers and leaders of each team monitored the whereabouts of staff to keep them safe, particularly when lone working. We saw how communication was continuous within the teams with use of online Microsoft Teams Channels. When reviewing how each service worked, we saw how staffing was utilised and at the time of our assessment teams were not struggling with managing caseloads and there was a low cancellation rate.

Managers and leaders had systems that monitored caseloads and work force issues. This was checked and spoken about weekly. Staf received monthly supervisions, where staffing needs were discussed. Each team had monthly team meetings and had regular planned weekly meetings that focussed on risk and identifying any additional support requirements on current caseloads. Managers and leaders explained that staff accessed mandatory training and could also request and access specialist training when required.

Staff we spoke with told us they had access to the correct personal protective equipment when visiting patient homes. They were knowledgeable about reportable incidents in terms of infection control. They told us how they would report any issues on the patients progress notes, so this information was passed on to colleagues.