Leeds and York Partnership 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

Patients were at the centre of their care and treatment choices. Decisions were made in partnership with them and their partners/significant others. They were provided with information about their condition, care and treatment options in ways that were appropriate for them. Staff encouraged and supported patients to provide feedback on their care and responded to feedback given. Staff were aware of cultural needs and managers had systems in place to support patients to access the service. Staff worked well with patients and external partners when it came to planning for the future.

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 told us they felt their care was coordinated and staff worked well with them. They were encouraged to be involved in their care and treatment plan and knew who they could approach to request information from if needed. Staff knew patient’s individual likes and dislikes, and these were respected. The partners/significant others we spoke with said they had specific support for their own needs and the care was not just about the mother that had given birth. They also said they were involved the care planning process through ward rounds.

Staff completed various nationally recognised tools and assessments when development treatment plans. Patients had access to information leaflets regarding medication and treatment plans if they required them.

We observed staff engaging with patients in a person-centred way, adjusting their approach according to the patient’s needs. Information was displayed around the ward informing patients of different treatment, care, and therapeutic options along with how to give feedback on care. All care and treatment plans we reviewed showed patient involvement.

Patients were involved in creating and reviewing their care plans in collaboration with medics, staff and family members (if the patient had consented to this). We saw records that showed patients had access to regular one to one time with a named nurse or key worker.

Partners/significant others and patients told us they were shown round when first admitted. One partner described how they could visit the ward prior to their partner’s admission, and one person said they had built up strong relationships with staff on the ward. Patients confirmed they were supported in relation to discharge planning, where this was relevant, and knew the steps they had to take to progress towards discharge.

Staff sent discharge summaries to all the professionals involved with the patient, e.g. health visitor, care co-ordinator, community teams. They were agreed with patients at multi-disciplinary reviews.

The stakeholders we consulted confirmed that care provided was joined up and flexible. However, one stakeholder commented that care coordinators were not always routinely invited to Multi-disciplinary reviews and care programme approach meetings, and that sometimes, there could be a delay in them receiving information about an admission. However, most stakeholders thought communication and continuity of care was very good.

Patients had access to a patient information booklet and there were pathways in place with other services, for example, early interventions teams. We looked at previous discharge summaries which contained a discharge plan covering, the immediate plan of care, medical prescribing responsibility, early warning signs and crisis plan. Staff recorded details about patient transfers, refusals, waiting lists and the length of prior admission to an adult psychiatric ward. This is in line with guidance issued by the perinatal quality network issued by the Royal College of Psychiatrists.

Patients knew how to request information regarding their care and treatment. Resources including leaflets and interpreter services were available to ensure the patients understood their treatment and medication plans. Patients were able to attend ward round meetings and speak to staff at their 1 to 1 meeting where they could discuss their treatment plans and preferences in detail.

Managers told us the trust were working on the service website to make it more accessible by having sign language embedded into it.

On admission patients received a welcome pack consisting of information about the ward and the care provided at the service. We saw information boards around the ward area displaying information about patient rights, advocacy services, interpreter services and how to give feedback on care.

Patients told us they would feel comfortable in raising concerns and one person said there was lots of information on the ward about raising concerns. Some people had also been given information about the trust’s PALS, (patient advice and liaison), service.

Patients and their partners/significant others could give feedback about their care and were listened to when they voiced their preferences and asked questions about their treatment or medicines. They attended weekly ward community meetings and had access to an independent advocate. Patients had regular 1 to 1 time with named key workers and could input their views into the discharge process.

On the ward, we observed specific information about how to complain and how to contact CQC. Patients also had access to regular community meetings, and we saw a ‘you said we did’ board in the patient lounge.

There was a variety of ways patients and their families could provide feedback, including easy read cards with a freepost address, and completing on-line surveys. The service also carried out an annual feedback survey to patients based on questions suggested by the Perinatal Quality Network, and they received feedback from a large proportion of patients using this method. We looked at some recent feedback, which was broadly positive with a few ideas for improvement suggested. The service had not received any formal complaints in the past 12 months.

Patients had access to a range of professionals including a doctors, nurses, psychologists, occupational therapists, social workers, health visitors and support workers. They were able to work with patients individually to help deliver holistic treatment. Some partners we spoke with thought the service should have facilities so they could stay with their loved ones, particularly if they had to travel longer distances to visit.

Staff made reasonable adjustments for people with a disability and had accessible rooms for people with restricted mobility. Patients had good access to interpretation services and information in different formats and languages.

All the stakeholders we spoke with thought the service was accessible and that the new centralised referral system would ensure equity of access for patients from across the region. However, some stakeholders acknowledged the barriers facing patients travelling, for example, from rural locations across the region.

The service had set criteria for admission and clearly documented the reasons where referrals were not admitted. In the 6 months prior to our inspection, 17 referrals were denied admission, and the reasons were connected with clinical issues and not meeting the referral criteria. In the 12 months from September 2023 to August 2024, a total of 53 patients were admitted to the service from across the Yorkshire & Humber region, and 30% of admissions were from the Leeds area.

None of the patients/significant others we spoke with had experienced any discrimination or unequal treatment on the ward. None had experienced any barriers or inequalities in their care, except that some people thought there should have been facilities for partners to stay with their loved ones especially if they had, had to travel outside of their local area. The partners/significant others we spoke with said they had specific support for their own needs and the care was not just about the parent that had given birth.

Staff were committed to reducing barriers to accessing the perinatal mental health service for patients who have protected characteristics, and as an example of this staff told us about their work to celebrate Black Maternal Mental Health Week. The speciality doctor had previously had a patient with a likely diagnosis of autism and staff made adjustments including moving them into a room away from noise, keeping meetings small and manageable and implementing and adjusting a personalised eating routine.

Staff collected data about referrals and looked at patient feedback to identify any concerns in this area. The ward collected data about referrals including source of referral, ethnicity, religion, gender and sexual orientation. The results were discussed bi-monthly at the trust’s quality & performance meetings. This data was then used to inform work to reduce barriers to access to the service. The trust had a health inequalities action plan jointly with the community perinatal teams and used monitoring data to inform the plan.

The patients we spoke with said they were supported to make decisions about the future and things were discussed with them and their families as appropriate. They said they knew what steps to take to demonstrate progress.

Staff arranged discharge planning meetings, and everyone who was going to be involved with the care of a patient post discharge was invited. Staff told us there were processes in place to support patients with the transition from in-patient to home, for example, having more home leave, rescinding section and remaining on the ward informally and setting out targets and goals for discharge.

Staff completed a 3 day follow up call after discharge, and patients could ring the ward anytime up to a month after discharge. Staff told us a lot of patients kept in touch and sent email updates and photos after they had left. We saw lots of thank you cards on the ward from former patients and their families. Where patients were ready for discharge, care records contained detailed discharge plans covering, the immediate plan of care, medical prescribing responsibility, early warning signs and crisis plans. Patients were involved in discharge planning in collaboration with external stakeholders including care coordinators, and family members.