Leeds and York Partnership 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

Patients told us they were involved in their care and treatment through attending ward rounds. Staff completed comprehensive patient assessments including regular physical health checks and delivered evidence-based care and treatment. Staff attended multi-disciplinary meetings where patients were involved in discussions about their care in a co-ordinated way between different services including external partners. Patients had access to various therapies and activities including occupational therapy, psychological therapies, and assistance with daily living activities.

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 told us they felt involved in their care and supported in ways that allowed them to do the things that were important to them. Patients and their partners were invited to multi-disciplinary meetings, every week, and people thought staff took a ‘whole family’ approach with lots of feedback to partners and significant others. People mentioned the peer support workers and how brilliant they were. One partner of a patient had received specific mental health support and thought the peer support sessions were very valuable. Another patient told us that the junior doctor spoke the same language as her, so it was much easier to communicate her needs and wishes.

Staff told us they completed a comprehensive assessment for each patient on admission to the ward. They used information from referrers at the pre-assessment stage to gather relevant information and spoke with patients during the admissions process.

We reviewed 4 care records, which all contained a comprehensive and timely assessment including mental and physical health, medicines, psychosocial and psychological needs. Where appropriate, patients had a safety plan in place. All the records we looked at contained a care plan, which had been reviewed but not all records were completely up to date. For example, one care plan mentioned the interpreter visiting daily but this had reduced to twice a week but not updated in the record. Some care plans were not reflective of the care that was being delivered. For example, one person did not have a communication care plan in place despite English not being her first language. She did, however, have an interpreter involved with her who attended MDT reviews. Managers had plans in place to improve care planning for all patients. There was evidence that patients were offered a copy of their care plan, and they signed to say whether or not they wanted one. Physical healthcare plans were in place for those that required them. For example, one person had a diet care plan in place as she was gluten and dairy intolerant.

People said there were psychological therapies on offer as well as activities, such as mindfulness, yoga, crafting, massage and baby massage. Patients had access to ‘baby-free’ time which they welcomed.

Staff had co-produced a leaflet aimed at siblings called ‘my mummy and my new baby are in hospital’ aimed at helping siblings understand what was happening and encouraging them to be involved. The service had a peer mentor that worked specifically with fathers/significant others and offered tailored support to meet their needs. Patients had access to easy read material and baby books in different languages, which the ward manager said they would ensure was equally accessible to everyone on the ward.

The service had an operating model, which was written down and based on appropriate legislation and good practice guidelines. Staff supported patients to understand their treatment plans and demonstrated a good knowledge of the communication options available, including the access to interpreter services. Patients had good access to psychological therapies, occupational therapy, social work, peer support and activities. They could attend a weekly compassion focussed therapy group facilitated by a psychologist and staff changed the activity timetable regularly to reflect the needs and of current patients.

Staff worked effectively together to share information with each other. For example, all the members of the multi-disciplinary team, including nursery nurses, OT’s doctors, psychologists etc had input into the same care plan. One partner of a patient told us there was a free exchange of information whenever this was needed.

Staff work closely with community teams especially regional perinatal community teams, with whom they had regular online meetings. Staff told us if a patient needed access to a specialist that was not within the existing team, for example speech and language therapy, they would facilitate this to meet patients’ needs. Managers were looking at ways to employ their own physiotherapist across the different services at the trust. We observed a handover between staff and saw how they shared information effectively with each other. Allied health professionals attended multi-disciplinary meetings and inputted directly into the people’s care plans.

We observed good quality interactions between staff and patients. Staff were always present and available for patients offering a range of activities on the ward. Information was displayed on ward notice boards relating to care, advocacy access, activities, communication needs and feedback on care. We saw staff escorting people to external health appointments in order to facilitate the flow of information between patients and other health professionals.

The trust had a perinatal mental health multi-agency & multi professional pathway in place that described what support was on offer to mothers with mental health problems during pregnancy and the first year after birth. We spoke with several internal and external stakeholders, who told us staff shared information appropriately with them and they could attend MDT’s and other patient meetings in person if that’s what the patient wanted.

People told us they were encouraged to go out for walks, and they were given healthy options at mealtimes. They said there were still menu options like chips and puddings, but that they could cook their own food if they wanted. One patient said they would have liked more access to exercise equipment on the ward.

Managers told us some staff were taking on a quality improvement project to include healthy lifestyle information in care plans. Patients had access to healthy lifestyle information on the ward.

Patients had access to a trust-wide healthy living service, and were supported with smoking cessation, where appropriate. There was a smoking cessation champion on the ward who could prescribe nicotine replacement therapy. There was a regular walking group, and some staff were trained as walk leaders.

People confirmed that staff spoke with them about progress and what the next steps would be. One father told us the staff encouraged him to attend ward rounds and input into discussions about progress.

On admission staff completed various outcome measure tools including a post-partum bonding questionnaire. Staff were involved in a quality improvement project to help embed these outcome measures into routine practice.

The clinical outcomes data we looked at showed improvements in people’s scores across the various measures. Staff looked at ways outcomes could be improved by identifying themes from patient feedback.

Informal patients confirmed that they could leave the ward whenever they needed to, and there were notices on the ward telling them this. One detained person mentioned that she had been told about her rights and how to appeal. She had been told about the process and her partner was also given some information. Patients knew their rights and were informed of them regularly. They had access to an independent mental health advocate who attended the service as needed.

Staff demonstrated good knowledge of the Mental Capacity Act and the Mental Health Act, and consent to treatment. On admission, medical staff assessed patients’ capacity, and if they had concerns around patients’ capacity to consent, they knew what action to take.

We reviewed a sample of patient care and treatment plans, and found consent to treatment documentation was in place. We also looked at Mental Health Act records, and found that appropriate patients had received their rights about being detained under the Mental Health Act, and had been scheduled to have their rights explained at regular intervals.

Information about access to independent mental health advocacy was displayed on the ward and contained in the patient information booklet given to patients on admission.