Ellern Mede Moorgate Also known as Oak Tree Forest Limited

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

At our last inspection we rated this key question requires improvement. The service was in breach of legal regulation in relation to good governance. The service had made improvements and is no longer in breach of regulations. This meant people’s needs were met through good organisation and delivery. At this assessment, the rating has changed to Good.

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.

People we spoke with felt involved in their care and felt staff were understanding and supported them to make specific decisions for themselves, which involved relatives or advocates if requested. Young people could have copies of their care plans. Relatives told us that they were invited to relevant meetings and invited to events within the hospital setting.

Staff told us that collaborative support planning enabled them to respond to any relevant changes in the needs of young people, and that they were able to effectively manage risk due to robust care planning. The hospital had a multidisciplinary team to meet the young person’s needs.

We completed a tour of the ward environment during the onsite inspection which provided room where young people could go if they needed a quiet space. We observed good rapport between young people and staff.

The provider had systems in place to ensure young people had choice and control over their own care. Managers undertook regular audits, reviews, and meetings to ensure oversight over people's care and treatment. The service undertook audits which recognised the need to ensure people were at the centre of their care and treatment choices. Care planning reflected a young person’s protected characteristics.

Young people were encouraged to be involved in the development of their care and treatment plans.

Staff we spoke with gave examples of young people transferring to another service and the staff had peer meetings prior to discharge to ensure a quality handover and transfer of information. The service supported and fully involved young people in placement searches as part of their discharge. Completed assessment paperwork supported young person to complete self-reflections to find the best service to meet their needs, requested brochures and arranged visits.

We received feedback from the provider collaborative who told us they recognised the positive impact of the management presence within the service for the young people and the responsiveness of the hospital manager to relatives. However, the advocate we spoke with fed back that the service could improve its communication between the multidisciplinary teams and young people to be clearer about prescribed leave and treatment plans.

The service had processes in place to review individual progress on a weekly basis and investigate reasons behind any setbacks or lack of progression.

Young people we spoke with, told us they were provided with information and offered a copy of their care plans. Young people had easy access to advocates and had been given information on their section and medication. Relatives were happy with the level of information provided and the level of involvement in the young person’s care.

Staff told us they made every effort to tailor information and advice provided to meet their needs, for example written or visual feedback could provide a range of information and in a range of formats if required. The service involved families, advocates and interpreters were necessary.

The provider had processes in place to provide appropriate, accurate and up-to-date information. Weekly community meetings were in place. A patient survey was completed between December 2023 and January 2024. These results were analysed and used to inform the improvement action plans for the service.

Young people were encouraged to be involved in the development of their care and treatment and had access to independent advocacy. The service had also invited a previous young person back to the hospital to discuss introducing an expert by experience role and what this will involve.

Staff understood the policy on complaints and knew how to handle them. Young people said they could raise concerns with any of the team and they would try to resolve them as quickly as possible. Young people felt supported to make complaints.

Young people were involved in environmental improvements and taking care of the hospital guinea pigs. We observed that staff were visible and available for young people to speak to as and when needed. Information on how to raise a concern or make a complaint was displayed.

People had a range of ways in which they could give feedback such as community meetings, multi-disciplinary meetings, patient surveys and complaints process. Managers completed regular audits of feedback and investigated complaints and identified themes. In the last 6 months the service had received 5 complaints, 1 resolved, 1 upheld, 1 partially upheld and 2 not upheld. Managers shared feedback from these complaints with staff and learning was used to improve the service. The service also used compliments to learn, celebrate success and improve the quality of care.

Young people were encouraged to be involved in the development of their care and treatment. Relatives told us they felt involved in the young person’s care and were listened to.

Young people had access to a range of professionals including a dietician, psychologist, social worker, occupational therapist, and autism lead. Staff would refer young people to speech and language therapy if required. Staff supported young people with specific religious and cultural needs. Specific equipment was also available for young people who had accessibility needs. Documentation was provided in an easy read format and staff told us that interpreters would be made available if required.

Partners told us young people had access to a range of professionals and the service had made staffing adjustments to meet the needs of young people, including an additional layer of management support and described how these roles have improved the care and treatment provided.

Young people were actively involved in making decisions about the service through regular meetings. Young people were encouraged to give feedback informally when they wished. Young people were involved in making decisions about their care and could raise concerns or issues.

The 3 young people we spoke with felt they were treated fairly and equally and the 2 carers we spoke with confirmed that they were actively involved with planning care for their relative, if the young person had consented. No concerns were raised regarding discrimination and staff made every effort to ensure reasonable adjustments were in place to support equity in experience and outcomes. People told us that they had access to advocacy to meet the needs of people detained or those who lacked capacity. The advocate we spoke with confirmed they had a good relationship with the service.

Staff completed mandatory equality and diversity training and at the time of our inspection, the staff were 100% compliant with this training. Staff also completed training on learning disabilities and autism and staff were 92% compliant with this training. The staff we spoke with were alert to inequality, they gave examples of how they would link with local support and social groups to support someone who was LGBT+. Young people had access to a range of professionals to support their care and treatment. The provider had different modes of feedback in place and tailored the care, support, and treatment in response to this feedback. The service provided different communication aids to enhance the quality of life and independence of people.

Leaders told us they dealt with patient-on-patient discrimination, and they monitored incidents, analysed, and discussed incidents in regular meetings. The service also conducted regular surveys where people could voice any concerns. The most recent survey was conducted between December 2023 and January 2024. The service created action plans to make improvements based on this feedback.

Young people attended and contributed to decisions regarding their future care provision and discharge plans. Relatives were informed and involved in the options for the young people’s discharge. One relative told us they had some concerns about their relative not receiving an adequate and safe transition period due to the transformation of the service. Managers provided time and support to discuss any concerns.

Staff told us processes were in place to ensure all relevant individuals were involved in planning and preparing for discharges. This included social care, community teams, future placement, and family members if the young person consented to this. Young people were involved in discharge planning to ensure their choices and preferences were always accounted for.

Care plans were recovery focused, referred to discharge planning and multi-disciplinary meetings discussed and documented actions for discharge. They referred to therapeutic practice, goal setting and focused on independence. Since the last inspection, there had been several successful discharges and planning was in process for the remaining 4 young people.