Coventry and Warwickshire Partnership NHS Trust

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

Most people felt they were treated with kindness, compassion and dignity in their day-to-day care and support. People’s individual needs and preferences were understood, and these were reflected in their care, treatment and support. People had access to activities and the local community to promote and support their independence, health and wellbeing. Staff were alert to people’s needs and took time to observe, communicate and engage people in discussions about their immediate needs. People benefitted from staff who had regular opportunities to provide feedback and raise concerns. However, staff facilities on Malvern ward were not adequate.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People on Malvern ward told us staff were kind, gentle, good to talk to and quick to help. They also said staff made them feel cared for and listened to. A person at Janet Shaw Clinic told us that “the permanent staff, they helped me a lot. I really like them.” One person on Onyx ward told us that staff looked after them. However, another person on Onyx ward said some staff were rude and the doctors did not help them. One person on Eden ward told us “The staff were really caring, although they sometimes stripped my bedroom when it wasn’t needed”. Another person on Eden ward told us staff were caring, supportive and kind-hearted. Two people on Eden ward told us they didn’t feel supported by staff and often felt anxious. We reviewed ‘I want great care’ responses received between 1 September 2023 and 31 August 2024. The service received an average of 88% positive feedback, Onyx scored the highest with 100%, then Janet Shaw Clinic with 96%, Malvern with 78% and Eden with 76%. The carer of a person described the positive support provided to their relative during end of life care.

A staff member on Malvern ward said they try and put themselves in peoples’ shoes and try to make people feel ok. They described supporting a person following a bereavement and fed back that the person thanked them for their support. The provider advised that advocates visit the wards regularly to support people to resolve any issues with their care. The manager of Janet Shaw advised they introduced ‘patient at a glance’ documents, which included likes, dislikes and conversation starters. They also used the green, amber and red detail in people’s positive behaviour support plans and created one document attached to people’s observation boards. This allowed staff to easily check the right response if a person was showing a certain behaviour which really improved the relationship. The head of nursing talked about the ‘Culture of Care project’. Eden was identified as the ward that would most benefit from this. The launch event involved people with lived experience talking about what made a difference to their time in hospital and people said the biggest difference was made by staff caring about them.

The most recent NHS Patient Led Assessment of the Care Environment reported an improvement from 94% in 2019 to 100% in 2023 for ‘privacy, dignity and wellbeing.

We observed staff on Malvern ward speaking about the people in their care in a positive way and demonstrating that they knew the people they were looking after.

One person at Janet Shaw Clinic told us that “It’s peaceful here, I like the staff as they talk to us, and I can play pool, or I can play on my games console.”

The provider shared responses from queries raised by advocates which demonstrated a good understanding of peoples’ individual care needs. Staff told us about the patient council in place across the services where people could raise issues and discuss solutions.

At Janet Shaw clinic we observed a person with bespoke lights fitted in their bedroom. The lights formed a pattern on their ceiling, which the person found calming.

From reviewing care records on Malvern ward, we could see that staff were knowledgeable about the people they were supporting. Staff detailed in one care record how they recognised a person was struggling and they used known de-escalation interventions, including a foot massage, to help the person relax. We reviewed the provider’s treatment pathway for people on the secure wards. Treatment options were tailored to individuals’ needs and people were offered a combination of group and 1-2-1 therapies. People were also offered the option of all interventions being delivered on an individual basis, if this was best for the person. Staff supported people to deal with trauma that may be impacting on their ability to engage in the treatment programme. Psychologists worked with the care teams to explore ways to help people engage who were struggling with this.

People spoke positively about the choices they had regarding activities. On Malvern ward one person told us that they enjoyed gardening, arts and crafts, cooking, sports and dancing. Another told us that they were “having a really busy day, I went out this morning, I went to the dentist, now I’m having lunch and then I have woodwork.” On Onyx ward one person told us they liked cooking their own meals, especially birthday cakes. Another person on Onyx was able to engage in art activities and created a piece of art on the wall of the ward. A person at Janet Shaw Clinic told us “I have horticulture once a week and craft twice a week and I also go to the airport on one of my visits out, where I watch planes go overhead. I really enjoy it all.” A person on Eden ward said they got to do lots of activities. People had access to their friends and family while they were using the service. One person at Janet Shaw Clinic said, “my brother visits and I meet him in the seminar room.” Another told us “Dad comes every two weeks. We go into the meeting room, which is fine. We can't buy drinks though, so it's not that great. And it's not that comfortable to sit in there. I get an hour visit. I wish it was longer.” One person on Eden ward said they hadn’t seen their mum for 2 months, due to them living a long distance away. Carers spoken with told us they were able to visit if it was arranged in advance. Most people were not happy about the food. One person at Janet Shaw Clinic told us “The food’s not too good. I can't have (certain) food as I've got (a medical condition). The food is very repetitive on the menu. I feel the portion control is being forced on us. I am old enough to decide if I want to diet or not.” Other people told us the food was carbohydrate heavy and there was a lack of healthy options. Two people on Eden ward said they would prefer freshly cooked, healthier food choices. The provider told us there were 3 choices for each meal and dietary needs were catered for.

The provider reported 1,773 activities were offered across the four wards between May-July 2024 and reported an average attendance rate of 69%. Staff on Malvern told us they were proud of the activities offered to people, for example, discos, dinners, cooking sessions, ‘Sunday funday’. There was something different to do every weekend. The manager of Janet Shaw clinic said staff provided daily cooking sessions. People decided what they wanted to cook, and staff supported them to buy the ingredients. Staff were helping people to create recipe books of their favourite meals that they could take when they moved on from the service. Staff on Malvern ward shared an example of careful planning and support provided to a person following the death of a relative to enable them to attend the funeral. The plan included support arrangements for before, during and after the funeral. Staff took the person to a memorable place for them and their relative after the funeral. The provider told us they had carer engagement strategies in place with individualised care plans to support carer communication and involvement. The lead psychologist for Malvern and Janet shaw Clinic set up a carer’s forum. This took place online in the evenings following feedback from carers. Staff created a new visiting room for carers to meet their loved ones after feedback that there was nowhere nice to meet up. One ward manager said no one liked the food as it changed from being freshly cooked on the premises to cooked/chilled meals that were reheated. This wasn’t ideal for people on long stay wards and resulted in people filling up on unhealthy snacks.

Onyx ward was equipped with an activity room for arts, crafts and gardening. One person enjoyed gardening and planted herbs, tomatoes and other plants in the unit garden. There was a spacious communal area with comfortable seating, a dining area and a pool table. We observed staff playing pool with a person using the service. There was a visitor’s room where people could meet family and friends. We observed people on all wards engaged in ward activities and accessing leave off the ward and in the wider community. We saw staff supporting a person in long term segregation on Eden ward to engage in arts and craft activities of their choice.

Daily and weekly meetings took place across all wards to support people to make decisions about their care and activities. We reviewed care plans on Eden and Malvern wards that evidenced staff planning a person’s leave to enable contact time with family. Staff on Eden ward supported people to choose activities both on and off site and reflected these choices in their care plans. We reviewed an incident where many family members turned up to visit a person unexpectedly. This was technically a security breach; however, staff managed it with kindness and ensured the person was able to see some of their family. The provider had an up to date section 17 leave policy that ensured people detained under the Mental Health Act were able to access leave. However, we were concerned about an extract from Eden ward governance meeting minutes for July 2024 that stated, “Discussed and agreed that nail training is not needed as patients earn leave to go to the community to get their nails done at a salon.” Leave is not something that is earned, it is a right afforded to people detained under the Mental Health Act.

Most people told us that staff were always ready to support and respond to their needs.

Staff described how they responded to people’s immediate needs. Staff told us how they used peoples’ positive behaviour support plans to ensure they were responding in the best way for that person.

We observed staff on all wards responding immediately to requests for support or queries from people. We observed kitchen staff on Malvern responding to a person’s specific dietary needs and finding ways to give them food they liked that was also safe for them to eat.

We reviewed positive behaviour support plans staff created with people. These plans detailed how the person would like staff to respond to them when they were distressed. Staff ensured they reflected people’s preferences and included supportive interventions, for example, foot massages, encouraging someone to have a shower, talking to people or giving them space.

Managers told us staff accessed reflective practice sessions and were encouraged to debrief and support one another after incidents. One staff on Onyx said they were 100% supported and the team were really welcoming when they started. They ensured they supported new staff in the same way. Managers supported them and sought further support following a family bereavement. Staff on Malvern felt supported by managers. The restrictive practice lead hosts weekly informal drop in sessions for staff to have a cuppa and a chat. The Malvern ward manager said there was not much space for staff to take breaks. This was discussed recently and there is no space available in the building. The manager ensured staff took regular breaks. They told us about additional support available to staff, for example, counselling and bereavement services. They would try and support staff individual needs, for example, reducing hours or increasing hours. One staff on Malvern raised concerns about staff facilities. They told us there was no staff toilet and staff must use the ward based toilet which in their view impacted on their privacy and dignity. Senior leaders told us they needed to create a staff area for staff to get away from the ward and have a proper break. The manager of Eden ward told us staff stay on the ward for years and don’t recognise when they are getting burnt out. They recognised staff needed a change and started swapping staff with other wards for a few weeks then returning to Eden. Staff found this beneficial, and the manager swaps a member of staff every 8 weeks.

We reviewed ward governance meeting minutes which evidenced staff had regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences.