Cheshire and Wirral 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 felt informed and involved in decisions around their care. There were good working relationships within teams and with external services and we observed a joined up approach to ensuring care for vulnerable patients. Staff knew patients and their needs well, however best practice could not always be followed due to the reduced psychology provision.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The majority of patients felt informed and involved in decisions around their care. Assessment and support with communication needs was provided where necessary. Patients were seen at home or at community locations depending upon need and preference. Support was also provided with seeking education or employment. Carers were able to access information that they needed around care and treatment. Carers and families were offered support and education around the mental health needs of their loved one. Formal carers assessments were undertaken where necessary. The involvement, recovery and wellness centre offered patients and families a range of different courses to support mental wellbeing.

Staff had a good knowledge of assessment and risk management. Risk assessments and Mental State Examination formed part of all interactions. Staff were knowledgeable about their patients’ individual needs and felt confident engaging patients in their care. They knew how and when to approach carers and what additional support they could offer to them if needed.

Appropriate systems were in place for the assessment and support of additional needs. Morning handover meetings held on each site allowed the responsive assessment of the risk and needs of the most vulnerable and high-risk patients daily. Discussions allowed staff to feel supported and clear plans were created for patients.

Patients reported being offered choice in their treatment and being provided with appropriate information about their options. However, difficulties accessing psychological support were raised by some patients. Observations of care showed people were treated in line with best practice. This included robust processes for physical health monitoring which was seen across all sites.

Treatment aimed to follow best practice. However, there were times when best practice couldn't be followed due to lack of resource, such as the reduced provision of psychology available. Prescribing guidelines were well adhered to and regularly monitored by a pharmacist. Clozapine pathways and health checks were monitored across all sites. HoNOS was used as an outcome measure in all teams.

All sites took part in clinical audit and some were also actively involved in research. There were notable QI initiatives including the introduction of the morning meeting and high risk board and trialling a system of SMS reminders for patients. Services also performed benchmarking exercises to provide an insight into areas requiring improvement. There had been challenges recruiting psychologists in to post. One site currently had no psychologist and others had a reduced complement resulting in waiting lists for support. This meant not all services were unable to meet NICE guidelines.

Patients were given information around their care and also supported to access other services such as advocacy, education and employment and physical health checks. However, patients said there was difficulty in accessing services due to centralised locations and the need for better communication between mental health teams and GPs.

Staff generally felt they had the information they needed to be able to do their job. They were aware of referral and transfer processes and how best to support patients during these. Staff had good working relationships with colleagues and also with other services. However, they did report inconsistency in documentation in referrals sent in. All teams reported delays in acute psychiatric admissions and teams supporting patients in crisis in the community for longer.

We observed a joined up approach to ensuring appropriate care for vulnerable patients. Staff teams worked well together and interacted well with external services when required. There was good communication with professionals around referrals and support was provided where necessary.

Appropriate systems were in place to allow for safe admission, discharge and transfers of care. There were robust physical health monitoring processes across all sites. Regular meetings were held within the MDT to support transitions.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.