Providence House and Moira House

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

We assessed all the quality statements from this key question. The rating from the last inspection, was requires improvement. Our rating for this key question is good. Young people were always at the centre of how their care was planned and delivered. Care co-ordinators with parental responsibility were involved in developing the young people’s care plans. The young people we spoke too told us they knew how to complain, and they felt that they could make a complaint if they needed to, and that staff would take their complaint seriously. Staff understood how to support young people to make a complaint, and managers investigated and responded to complaints in line with the providers policy. We saw that young people could always access the care and support they needed. Individual needs were recognised, and young people were support with those needs, for example, needs relating to diet, sexual orientation, gender and protected characteristics were addressed Reasonable adjustments and support were available to autistic people and people with a learning disability.

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.

All the young people had care plans, and these reflected their needs. All of them were aware they had a care plan and all of them felt involved in the development of their care plan. Those with parental responsibilities were invited to meetings, and we saw evidence they were consulted when changes to care were being considered. Young people understood their prescribed medicines. They told us they had community meetings. They also told us that their care and discharge was discussed in weekly multidisciplinary meetings with those involved in that decision making present to support transitions of care.

Staff gave us examples of how they supported patients in a person-centred way for example one staff member told us they supported a patient who had difficulty communicating by using a photobook and flashcards. Staff supported people to attend places of worship and with dietary requirements. Staff told us that there were leaflets and information available in the patient’s own language. Staff told us patients could express their likes and dislikes through care plans and in the ward round.

We saw staff constantly engaging with young people, these were busy wards with lots of actviity. We saw young people were constantly going out on community visits.

Staff supported young people to attend places of worship and with dietary requirements. Staff told us that there were leaflets and information available in the young persons own language, if required. Staff told us the young people could express their likes and dislikes through care plans and in the ward round. We saw in care plans that the provider had worked with those with parental responsibility when changing plans to reflect the needs of a young person. One young person wanted to change their appearance, and we saw this was agreed with the local authority care co-ordinator before the change happened,

Young people admitted to the service came with different needs. They told us that the service had helped them as well as organising support from external providers for example the local community drug and alcohol service. They also confirmed they attended the local GP practice and other community health services. All young people felt the care they received, especially the therapy sessions reflected their needs.

Staff talked about individual young people and the diverse nature of their needs and interests. Young people had presented with issues around food and body dysphoria and staff could describe supporting those young people and the challenges they had faced. Managers had supported staff to attend course for additional qualifications. All staff had attended Supporting Trans, Non-binary and Gender Diverse Children and Young People (delivered by Mermaids), others had attended specialist training such as Dialectical Behaviour Therapy (DBT) and how trauma affected young people. Staff encouraged patients to develop and maintain relationships both in the service and the wider community. There was information available for young people to get involved in and access in the wider community.

Partners gave feedback on care provision in real time when attending MDT meetings. Other partners also investigated incidents and were satisfied the provider acted appropriately.

Managers had regular meetings with staff outside the weekly multidisciplinary meeting. Daily briefings allowed managers to put into action changes to the care plans after incidents. We saw managers hold regular meetings with those with parental responsibility to discuss how they were responding to the needs of individual young people.

All the young people told us they had access to their care plans and felt that staff had listened and developed that plan regarding those needs. They also confirmed that they had all the information they needed which included what medication they were taking and why they were taking it. We spoke with external agencies, and they confirmed that the provider always responded positively to requests for information.

Managers ensured that staff had easy access to information about the the young people as well as the provider policy and procedures. These were all available on the intranet and all staff had access to these.

The provider had policies and training for GDPR (General Data Protection Regulation) and had translation and interpretation services available as and when needed.

Young people knew how to complaint and they told us that they did so mostly informally, and staff did respond to those complaints. We saw local authority care co-ordinators had raised complaints on behalf of the young people, and they had all expressed satisfaction they had been responded to appropriately. There was regular community meetings taking place, and complaints were also addressed in this forum.

Staff knew how to support young people to make complaints. Staff told us there were posters and cards providing young people with information on how to complain. Some staff spoke about encouraging young people to complain if they had concerns. Staff fed back to young people about the results of their concerns and complaints.

We observed staff speaking with the young people. Staff talked about the ward and what was happening and how that affected the plans for that day. All the young people knew what was happening and when they had therapy sessions and when they had leave.

There was a complaints policy which was in date and provided relevant guidance to staff to manage complaints. We reviewed a range of complaints and responses over the past three months. One complaint was about a staff member speaking inappropriately to a young person, we saw this was fully investigated and partially upheld with the staff member receiving extra supervision. Managers had introduced record keeping to ensure young people were properly debriefed after incidents. This allowed young people to talk about how they felt after the incidents and come to a resolution regarding the circumstances. This was used as a learning experience for young people and staff.

Young people could easily access the care and treatment they needed. Support for patients who spoke a different language was available. Young people told us they were supported and did not feel their needs were not being supported.

All staff had received an induction and the appropriate training. They could identify where they could access support if a young person had difficulty with translating speech or had communication problems. Staff could access services when they needed to, including out of normal hours and in an emergency. Physical premises and equipment were accessible. They felt supported to overcome barriers to ensure equal access.

The young people came from different backgrounds and partners expressed no concerns that any of their young people faced discrimination.

Managers and staff were alert to discrimination and inequality that could disadvantage the young person’s experience and access to treatment and support. Providers use people’s feedback and other evidence to actively seek to improve access for people more likely to experience barriers or delays in accessing their care.

All the young people we spoke with felt they were treated fairly and equally, and they were actively involved with planning care. 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.

The young people did not raise any concerns about their experiences on the ward in respect of equality or discrimination. The wards held community meetings that the young people attended to give their views and feedback on the services. Young people described that they knew how to raise any concerns that they may have and that they would feel confident in being able to do this. Young people gave examples of when they had accessed advocacy services. Staff were 100% compliant in mandatory equality and diversity training which was refreshed annually. The service had links with local support and social groups to support patients such as religious groups and LGBT+ organisations.

Managers gave examples of where adjustments had been made or were already in place to support young people who may have accessibility or mobility needs. Staff and managers described how young people would be supported with any spiritual or cultural needs that they may have, which included visits from religious leaders, having access to spiritual materials or being supported to attend places of worship. Staff also described how any dietary needs would be supported for any young people that had specific requirements for cultural or religious reasons. Managers described how young people who had specific communication needs would be supported, using interpreter or translation services. Managers felt assured that young people would be treated equally whilst on the wards and that, if they had any concerns about this, that they would raise this with them. There was one young person who had experienced a delayed discharge. This was because the community service had not been able to provide an appropriate placement. All incidents were recorded and investigated, and the service recorded the outcomes of these incidents. These were used to examine trends, and we saw they were discussed in senior management meetings. There was also a staff survey that recorded staff opinions on the equity of the service.

Through meetings with their named nurse young people told us they discussed the options for their care and were provided with all information they needed and in way they could understand. They felt in control of planning their care and support. They were supported to plan ahead and all the young people could explain how they were progressing and the plans for their future care.

Managers were in constant communication with care co-ordinators about the future discharge of the young people. Where there had been a delayed discharge managers had continued top help identify a suitable placement for the young person.

Every young person had a discharge plan and we could see from those records that they represented the wishes of the young people and they were involved in developing those plans.