Baldock Manor

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

Staff did not always interact with patients while they were on observation. Some patients felt that they were not involved with or did not understand their care plan. Patients told us that they were read their rights regularly, however some patients told us that their rights were not explained. Patients and carers we spoke with were generally positive about the service and felt they were treated with kindness, dignity and respect. We observed that patient care plans reflected their needs and most patients felt they had choice and control over their care. Staff felt that managers were supportive and told us they felt they could raise concerns. There was a freedom to speak up guardian available.

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.

Feedback we received from patients and carers was mixed. One patient told us that staff had not got to know them and another told us that Baldock Manor could be a lonely place. One patient told us that most staff were positive and respectful but there were some staff that were less experienced and less so. Some patients told us that staff made them feel very safe on admission and that their overall experience was positive. Some relatives told us that staff were caring. One relative told us their loved one did not want to leave Baldock Manor. Some relatives were invited to ward rounds if consent was given, however others told us that they had to request to be invited.

Staff we spoke with understood the needs of patients and were able to discuss treating patients with dignity and compassion. Staff told us that they tried to respect patients’ dignity by reading them their rights, using privacy screens and using least restrictive methods.

Feedback from partners included a bed manager at an NHS trust, a safeguarding lead and an advocate, who were all positive about the service. Partners told us that the treatment, care and support patients had received at Baldock Manor prepared them for successful discharge into the community.

Patients on Radley Ward felt they were being watched by their allocated staff member and the staff showed little interest in communicating and engaging with them. We also saw no interactions between staff allocated to patients on level 3 and 4 observations. However, we did observe patients being supported by staff with kindness, compassion and dignity on Burberry Ward during the on-site visit. Staff showed positive interactions with patients of an inclusive, facilitative and warm nature. We observed some positive interactions on Radley Ward where staff were observed providing safety, security, comfort and warmth. The service had an expert by experience in post to help support the monitoring of staff engagement and patient feedback. Since the last inspection the service had implemented additional training and reflective sessions on compassion, dignity and respect. Each ward had a mission statement on dignity and respect.

One patient told us they had been given a copy of their care plan but it was too much information to read. Others felt that views were not listened to. Some patients told us they worked together with staff to develop care plans. Patients felt the advocacy service was very useful. One carer told us that they did not believe their loved one’s individual needs were taken into account, however most carers told us they felt staff at Baldock manor understood and respected their relatives’ individual needs.

Staff and leaders told us that they responded to patients’ individual needs by having easy read leaflets available. Staff could book an interpreter to help with communication needs if required. Staff told us that they supported patients with different dietary needs by gathering information at assessment. Staff told us that care plans were updated to reflect individual needs.

During our onsite inspection we observed that there was easy to read and accessible information available to patients on their mental health condition, treatments available, physical health conditions, how to access primary health care, smoking cessation, how to make a complaint and advocacy services. Some ensuite bathrooms had rails to support patients with mobility problems and were large enough to accommodate patients in wheelchairs.

We reviewed patient concerns, compliments and feedback during our assessment. The complaints tracker clearly documented the nature of the complaint, the outcome of the complaint, lessons learned and how this would be shared with the wider team. We also reviewed patient forum minutes, where clear actions were identified. Community meeting minutes did not always have actions set following the meeting.

One patient we spoke to told us that staff showed little interest. Some patients told us that staff knew and understood their needs, preferences, and wishes. Two patients told us they were not included in their care planning process, however others told us they felt included in their care planning and treatment. Most patients were aware that they could have a copy of their care plans, although few wanted to have a copy. Patients generally said that staff treated them as individuals, with consideration to any relevant protected characteristics. All patients we spoke to said that their cultural, social, and religious needs were understood and met by the service. One relative felt the staff did not support their relative to make their own decisions. Most relatives felt staff supported patients to make informed decisions.

Staff we spoke with were knowledgeable about individual patients’ needs and gave examples of how they supported different patients according to their needs and preferences. For example, one patient has specific dietary and nutritional needs and was provided alternate meals and access to cooking facilities to support their preferences, and one patient was able to access the multifaith room to pray.

We observed positive interactions on Burberry Ward to support patients’ preferences and wishes. For example, a patient was being escorted on section 17 leave, and the staff member asked where the patient would like to go, gave options and held space for the patient to talk and respond. We also observed staff supporting patients with their individual needs and preferences as reflected in their care plans. On Radley Ward, we observed interactions to support a patient’s independence for example, supporting a patient to do their laundry and patients having access to the courtyard and outdoor space whenever the patient wished. We also saw evidence of positive risk taking in care records further supporting patient’s independence, choice and control. At multidisciplinary meetings, staff discussed patients’ individual needs in sufficient detail to ensure that they provided holistic care and support. The service did not place restrictions on smoking but did offer smoking cessation sessions to all new admissions. This was reflected in patient care records and support plans.

Patients were able to raise concerns or suggest improvements through community meetings. There was also an Expert by Experience in post and regular advocate support available. The service had a robust visitor’s policy and guidance for children visiting the service. These visits were planned in advance, staff completed a risk assessments and visits took place in a designated family visiting room that was not accessed via the ward. Patients’ electronic records noted whether patients had chosen to have a copy of their care plan.

Patients mostly felt that staff at Baldock Manor were responsive to their immediate needs. However one patient told us that they felt doctors and managers were not on the ward often enough. Most patients felt that access to community leave was good but one patient told us that it could take a long time to get access to leave. Carers mostly felt that staff were responsive to the needs of their loved one.

Managers overbooked for shifts to ensure that there were enough staff available to meet patient’s needs. There were more female staff members allocated to female wards than at our last inspection. Staff we spoke with also told us that they tried to be as responsive to patients requests as they could be. Staff were able to give examples of when they had been responsive in situations that had needed de- escalation. Staff told us how they worked to meet patients’ needs through engagement during interactions, activities, observations, and knowledge of patients’ different needs and priorities. Staff we spoke with told us that there were usually enough staff on shift to meet patients’ immediate needs, including in the event of a serious incident. Managers ensured that policies and procedures prioritised individual people’s needs, preferences and choices. Staff we spoke with understood their duties to anticipate and respond to patients’ needs to support their recovery, treatment pathway and prevent discomfort or distress. Patients’ care plans detailed their needs and patient’s views were recorded. The care plans are reviewed regularly and updated to accommodate varying needs and any emerging care and support needs.

We saw staff allocated to enhanced observations outside of the patient’s bedroom with the door and viewing panel closed. Although staff did not always interact with patients, we did see staff supporting patients and being responsive to their needs.

Managers ensured that policies and procedures prioritised individual needs. The hospitals complaints log detailed the nature of the complaint, the outcome of the complaint and lessons learned.

Staff told us that support was available to them and that the senior leadership team were approachable. Staff enjoyed working at Baldock Manor and found it a supportive environment. Staff also told us that Managers had introduced ‘you said we did’ board, which made them feel listened to. Since our last inspection Managers had introduced more breaks for staff allocated to enhanced observations.

Leaders completed a staff survey in March 2024 and the results of this were shared with staff. The staff satisfaction survey showed that 73% of staff felt motivated and enjoyed coming to work every day, 20% felt motivated most days and 7% felt motivated some days. All staff said they felt they had received the training they needed to complete their job. There were also regular reflective practice sessions available to staff at the hospital.