- Independent mental health service
Ellern Mede Barnet
Report from 18 November 2024 assessment
Contents
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
Caring
Our overall rating of caring at Ellern Mede Barnet has improved and is now good. We assessed 5 quality statements. The service no longer used agency staff. Patients reported there were enough staff members and that knew how to meet their needs. Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs and preferences of patients. They actively involved patients and families and carers in care decisions and transition plans. There was a strong person-centred culture and within the service. Staff supported patients to keep in contact with family and friends. Staff said they felt positive and proud about working for the provider and their team. Staff were able to raise concerns without fear of retribution. Staff knew how to use the whistle-blowing process and about the role of the organisation’s Speak Up Guardian.
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.
Kindness, compassion and dignity
Patients told us some staff made efforts to engage them with activities and conversations during their observations, whilst some other staff did not. Patients reported most permanent staff were kind, thoughtful and supportive. At our last inspection patients felt some agency staff did not have the specialist training needed to support people with an eating disorder. At this assessment we found improvements. The service no longer used agency staff and permanent nursing and care staff had been appointed. Patients told us there were enough staff members, and this had improved since the start of 2024.
Staff spoke with understanding, compassion and empathy when talking about the patients they were caring for. Staff were passionate about their work. We observed positive interactions between patients and staff members. Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients. Staff we spoke to felt confident in raising issues with managers. Staff had received additional training on boundaries within therapeutic relationships.
We received feedback from the advocate who reported that the patients were able to express their needs and concerns with the staff, who were receptive and listened to any queries. We reviewed feedback that the service had obtained from commissioners. A commissioner reported ‘I cannot commend the team at Ellern Mede Barnet enough for their dedication and commitment to getting this patient well again’.
We observed staff interactions between patient and staff. Staff treated people with kindness, empathy and compassion and respected their privacy and dignity. There was a pleasant atmosphere in the service during our onsite visit. We observed that patients’ privacy and dignity was respected and upheld at all times.
Treating people as individuals
Patients told us they felt involved in aspects of their care planning. Patients were invited to the ward round meetings where the team discussed their progress and updated their care plans. Patients were also invited to give feedback to the meeting in writing each week. Staff told patients about the outcome of the meeting if they chose not to attend in person. The multidisciplinary discussion records were detailed, person-centred and looked at the holistic needs of each patient.
Patients received high quality care and support from a staff team that worked within a strong person-centred culture. Staff understood and respected the individual needs of each patient. Staff talked about valuing people, respecting their rights to make decisions, being inclusive and respecting people’s diverse needs. The staff demonstrated compassion and empathy when speaking to and about the patients. Staff we spoke with were knowledgeable about individual patients’ needs and gave examples of how they supported different patients according to their needs and preferences.
We observed staff treating people as individuals and made sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. At staff handovers and other multidisciplinary meetings, staff discussed patients’ individual needs in sufficient detail to ensure that they provided holistic support. Activity staff were able to tailor the individual patient activities to the individual interests, for example, trips to the cinema.
Care plans and risk assessments demonstrated a strong patient voice in a simple and clear manner. We saw and heard that patients’ individual preferences and needs were always reflected in how care was delivered. For example for one patient who required restraint for nasogastric feeding we saw that they had agreed to arm holds whilst having the feed. Staff had undertaken training in equality and diversity. This meant they understood people’s diverse needs. The provider had policies and procedures in place about equality, diversity, and discrimination.
Independence, choice and control
Staff involved patients in decisions about the service, when appropriate. For example, patients had been involved in deciding how to decorate the new summer house in the garden, and what games to get for the activity room. Patients told staff how they wanted to be supported if they required any restrictive interventions. Individual patient preferences were recorded in the Patient Inclusion in Least Restrictive Intervention Management Plan (PILRIMP) where patients were able to write in their own words the interventions that work well for them.
Staff made sure patients could access advocacy services. We saw posters on advocacy displayed on the wards. Staff supported patients to maintain their links with family and friends.
Care plans indicated that patients were involved in making decisions about their care and support and were written from their perspective. Patients were able to raise concerns or suggestions for improving the service directly to staff, through regular community meetings, and with support from an advocate if preferred. Children and young people were able to attend a school based at the provider’s nearby hospital location. If patients were not well enough to attend school, a teacher was able to attend the hospital to meet with them.
Responding to people’s immediate needs
The service anticipated people's needs and recognised distress and discomfort at the earliest stage. Where people required support, we saw staff offered support in a sensitive and respectful way.
Staff told us that they knew patients well and could recognise when people were at risk of harm or felt unsafe. They told us that they had undertaken training in positive behaviour support and were able to recognise when patients were uncomfortable with staff or the environment.
We observed staff responding to patient’s individual needs sensitively and in a calm manner.
Care plans detailed patients’ individual preferences and how they wanted to be supported. Care plans were kept in individual bedrooms so that all staff had easy access. Discussions at handover meetings involved feedback on staff interventions that had worked well or not worked well for individual patients. All staff had undertaken autism training and used this to support patients to communicate their needs and to share their feelings. Staff were aware of individual sensory needs and preferred routines.
Workforce wellbeing and enablement
Staff said they felt positive and proud about working for the provider and their team. Staff said they could raise concerns without fear of retribution. Staff knew how to use the whistle-blowing process and about the role of the organisations Speak Up Guardian. All staff spoke about the extensive training the service offered. Staff confirmed they were supported with continuing professional development.
Managers considered the wellbeing of staff. Staff had access to support for their own physical and emotional health needs. The organisation provided an employee assistance programme where staff could access counselling, legal and financial advice. Staff also accessed the providers occupational health services when needed. The provider recognised staff success within the service, for example, through the monthly staff ‘extra mile’ awards. For these awards, staff nominated a member of staff for their exceptional care and support. Staff received regular supervision, reflective practice and debriefs to discuss well-being and any support needs.