Derbyshire Healthcare NHS Foundation Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive - this means we looked for evidence that the service met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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 happy that their care was planned around their needs, likes and dislikes. Staff supported them to be involved in the planning of their care as soon as they were admitted to the ward. Patients were supported within a person-centred framework and the 18 care records reviewed were comprehensive and recovery focused. Ward round meetings were person centred, where discussions took place regarding patients care including discharge planning

Patients knew that if they wanted their family to be involved in their care then they could be. But they also knew that if they didn’t want them to be this would be respected by the staff. It was their choice. If patients had family or carers involved in their care, they this would continue throughout the patients admission. This included community mental health teams. If they could not attend in person, then a video conferencing would be used. The trust had various processes in place including weekly multi-disciplinary ward rounds and care programme approach meetings to ensure appropriate care provision was in place.

Patients had access to a variety of leaflets in several languages and interpreters could be booked to attend meetings with patients or their families. Patient notice boards were full of useful information. For example, healthy eating. Staff took a proactive approach to meet individual patients’ communication needs so that information was provided that was understood. A patient who was deaf told us, “I’m deaf, a lot of the staff have learned a little sign language, greetings and things like that, the OT has also made me communication cards which I like, I have always got a pen and paper if I’m in a rush. A signer is always booked for my treatment reviews (OT assisted with interview)” . This was an improvement since the last assessment. The trust used information leaflets produced by the Department of Health for patients detained under the MHA. These were available in different languages and staff knew how to access them when required. Staff could book interpreters for patients’ meetings. In the event that the trust did not have a particular language needed, it firstly contacted neighbouring NHS trusts to see if they have the shared resource and, failing that, had a leaflet translated via the trust’s translation services.

Patients would feedback about their experience of care in the weekly community meetings. They were also aware of the complaints process and that staff would support them to make complaints. They felt that staff always listened to them and took action on the complaints they raised. Managers shared the outcome of complaints in their team meetings with staff to improve practice on the wards. Depending on the nature of the complaint that had been raised the outcome would be shared community meetings . Staff supported patients to make complaints. This was an improvement since the last inspection. It was evident that staff listened to patients and involved them where they wanted to receive their care. The conditions placed on the trust registration was to not admit any patients to ward 33 or 35 without prior written consent from the commission. It was evident in the requests made to the Commission that the patients had been fully involved in the admission or transfer process. For example, we had multiple requests to move from the Hartington unit to the Radbourne Unit or vice versa because the patient had requested to be closer to family or their support networks.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Patients felt involved in their care and treatment. They spoke positively about the support they received from staff and their experience of care. During their admission patients had access to individual religious items, such as pray mats and members of the chaplaincy teams from different religious faiths visited patients on the wards weekly. Patients had access to an independent advocate. The advocates visited the wards on a regular basis. Within the multidisciplinary and CPA meetings, teams would ensure that patients had the same opportunities regardless of their background, beliefs, or where they were born to access their treatment and therapeutic interventions. For example, communication cards, the use of interpreters in meetings and activities. Since the last assessment the Commission closely monitored the outcomes for people using the service. Trust data clearly highlighted that staff had built therapeutic alliances with patients to develop and implement patient centred risk management plans which positively impacted on the patient experience. Data provided from the trust showed that the number of incidents of seclusion remained below the target of 19 per month from June 2024 to October 2024. Incidents involving physical restraint had continued to decline since May 2024 from 120 to 55 in September 2024. The number of incidents increased in October 2024 due to some very challenging admissions to the service. The use of prone restraint had also reduced in the same time period from 18 to 5 incidents. The number of ligature incidents have reduced from by 19%.

Patients were fully involved in their discharge plans. They discussed and worked with staff to a make sure their discharge plan met their holistic needs. Staff would involve other agencies in the discharge process, for example social workers, occupational therapists and housing officers. Discharges were planned with multidisciplinary and partnership working with external stakeholders through the care programme approach.