Derbyshire Healthcare 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

Effective - 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 good. At this assessment the rating has remained good. This meant people’s outcomes were good, and people’s feedback confirmed this.

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 were given the opportunity to be involved in the writing of their care plans and given copies of them. Patients also had one to one time regularly with their named nurse to discuss their care and update care plans if needed. Patients confirmed this. There were some patients who did not want to be involved or were too unwell to be involved. This was clearly documented within the patient care records and staff continued to encourage them to be involved. We reviewed 18 care plans and found that they had all been completed fully. Interventions were in place for physical and mental health issues. Occupational therapists and psychology teams inputted into the care plans. Care plans were reviewed regularly and updated. At the last assessment staff had found it difficult to navigate the electronic case records. We noted an improvement at this assessment. Staff felt more confident and could find patient information easily. The trust had offered the staff more training and had put super users in the service for extra support if needed. Ward rounds were attended by the multidisciplinary team and patients. They reviewed each patients’ individual needs and documented them in patient care records and updated care plans and risk assessments if required.

Patients had access to a variety of evidence based treatment from occupational therapy and psychologists. They reported that, “groups are quite good and as well as being helpful, they take our minds off the day to day stuff”. We also heard that ward based sessions were good but the sessions offered in The Hub at the Hartington Unit and Jackie’s Pantry were great. Occupational therapy and psychological assessment were completed to support the treatment plans for patients and the session were planned for each individual. There was a variety of one to one and group sessions.

Patients and staff worked together to discuss not only concerns they had about the wards but also ideas on how the ward could be improved in community meetings. Patients were supported to maintain contact with their community mental health teams, social workers or GPs throughout their admission through the multidisciplinary meetings. Staff had positive working relationships with the community mental health team and social services, information was shared across these teams through handover, rapid review meetings and wards. When patients were planning for discharge, the ward team had links to a housing office and a discharge co-ordinator who supported with social barriers to discharge. If required when a patient was planning for discharge occupational therapists would support the discharge by going on home visits with the patient and completing cooking, budgeting and road safety skills assessments and then support patients to upskill in this area of needed. This information would be used to make sure that patients discharge was a success.

Patients had lots of information that was displayed on ward notices boards or given to them by staff to support a healthier lifestyle. A variety of activities and support sessions were in place to support people to live healthier lives. Walking group, breaking bad eating habits and smoking cessation advice and support. If required staff would referral patients to dieticians. Patients not only had access to gym session but exercise classes and even tai chi. The ICB had raised concerns with the service in relation to physical health assessments. We checked 18 case records and found that staff had completed physical heath monitoring, routine bloods monitoring had taken place, with follow up if the results had been abnormal. Electrocardiograms had been completed and interpreted. If specialist support was required, then referrals were made. For example, diabetes and epilepsy management.

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.

Patients had their Mental Health Act (MHA) rights read to them by staff if they were detained under the MHA. For patients that were informal staff told them that although the doors to the ward were locked that they could leave at any time, if safe to do so. Staff read patients their Section 132 rights on admission then monthly or when their section or consultant or treatment plans changed. If patients did not understand their rights staff would read them to patients regularly to improve their understanding. A robust process had been put in place to ensure that patients had their Section 132 rights read to them with 2 days of they being detained under the act. The process also monitored the rereading of rights as per the MHA Code of Practice or if staff needed to re-read them due to the patient not understanding them fully. This was an improvement since the last assessment. Staff recorded the reading the of Section 132 rights in the patient care records. This was an improvement since the last assessment. Mental capacity assessments had been carried out and recorded in patients care records. This was improvement since the last assessment. Consent to treatment in regard to medication, T2 and T3 forms were in place for those patients that required them. We found no issues with the forms.