Quality Health Mental Health Inpatient Service User Survey 2015 Avon and Wiltshire Mental Health Partnership NHS Final Version Produced 25 January 2016 by Quality Health Ltd
Contents Background 3 Introduction 4 Executive Summary 5 Respondents' Characteristics 7 Survey Results 9 About the Ward 10 Hospital Staff 27 Care and Treatment 38 Service Users' Rights 53 Leaving Hospital 59 Key Scores 71 Differences between Acute and MH Inpatients 74 Results 75 Survey Results Manual 76 Avon and Wiltshire Mental Health Partnership NHS Page 2 of 94
Background The National Service User Survey programme was introduced in 2001 by the Department of Health, and subsequently moved to the Healthcare Commission, and then to the Care Quality Commission in April 2009. The first survey of acute inpatients in all relevant s in England was undertaken in 2002. There is a rolling programme of service user surveys, which includes acute and non-acute s. Some Mental Health s were first surveyed in 2003 (voluntarily); subsequently the survey (of community service users) has been mandatory. The first national survey of mental health inpatients was in 2009; this survey of inpatients in 2015 was undertaken voluntarily by 18 Mental Health s. The content of the 2015 Mental Health Inpatient Survey is identical to the national surveys run in 2009, 2010, 2011, 2012, 2013 and 2014. The question content of the National Service User Surveys is determined by the Care Quality Commission (CQC), as is the content of the covering letters that are sent to service users. A national MREC approval letter covers the ethical issues. Send out is normally undertaken on the s behalf by their approved contractor under an information governance agreement specified nationally and agreed between the parties. These arrangements were replicated for the 2015 voluntary survey of mental health in patients. The comparative data displayed in this report is from all the s with Mental Health functions surveyed by Quality Health this year (18 s decided to run the survey). Avon and Wiltshire Mental Health Partnership NHS Page 3 of 94
Introduction The Mental Health Inpatient Survey was undertaken for Avon and Wiltshire Mental Health Partnership NHS between August and December 2015. Questionnaires were sent to a consecutive sample of a maximum of 1,000 adults aged 16 to 64 (inclusive) who had a stay of at least 48 hours in an acute or psychiatric ward at the between 1st July and 31st December 2014. A census of all eligible service users was used if fewer than 1,000 adults aged 16-64 had an inpatient stay during this period. Response Rate 112 completed surveys were returned from the 's sample of 532. A group of 28 service users were excluded for the following reasons: Moved/not known at this address 28 Ineligible 0 Deceased 0 The response rate was 22% (112 usable responses from a final sample of 504). Report Contents This report contains sections that describe the results from the survey, and sets out the full results in the same format as they appear in the questionnaire. It provides comparisons of the s results against those of other s undertaking the Survey in RAG charts and tables at the end of each section. Due to the nature of this survey, the number of respondents in some s fell below 50. In these cases the response data has to be treated as indicative only. For comparative purposes, the report contains a section comparing the national results from the Mental Health Inpatient Service User Survey to those of the general Inpatient Survey in NHS acute hospitals, where this is possible. This report also pulls together all the report s conclusions and action points into an Executive Summary. The questionnaire provided space for respondents to write their own comments about any aspect of their care. The comments received are set out in a separate supplement to this report. These comments have been anonymised as far as it is possible to do so by the removal of names or other identifying features where these have been included. Avon and Wiltshire Mental Health Partnership NHS Page 4 of 94
Executive Summary This section pulls together the conclusions and action points from each section of the Report to give an overview of the s results and areas for consideration for action planning. About the Ward Actions: Look at how noise of the ward at night can be minimised - scores have declined in this area. Ensure that patients with specific diets get the food they require - scores have declined in this area. Review the cleaning contract in the light of the number of patients saying the ward of 'very clean' declining. Hospital Staff Actions: Patients' confidence and trust in psychiatrists and nurses has improved significantly since 2014, continue to work on this to take the trust above the average level across all trusts Ensure that patients have enough time to discuss their condition and treatment with staff, in particular with psychiatrists. Care and Treatment Actions: The trust scores within the middle of trusts for most questions in this section. There have been some scores improving and others declining. Take action to identify areas where improvements can be made to move the trust beyond the average level. Service Users Rights Actions: Scores have improved in all areas in this section, continue to work on these going forward. Avon and Wiltshire Mental Health Partnership NHS Page 5 of 94
Leaving Hospital Actions: Ensure that all service users discharged from inpatient wards are telephoned post discharge by a member of staff to check on their mental health status, irrespective of whether the service user is on CPA or non CPA. Overall scores have improved in this area - take action to ensure this trend continues Key Scores Actions: The trust's overall rating of care score has improved significantly since 2014 and is sure to be as a result of the many other scores which have improved. There are still areas which need attention and some which despite improvement now place the trust at average levels. However, the improvements are clear and should be built upon. Avon and Wiltshire Mental Health Partnership NHS Page 6 of 94
Respondents' Characteristics The characteristics of the service users who responded to the survey for Avon and Wiltshire Mental Health Partnership NHS were as follows: 1. Gender & Age 56% of service users responding were women; 44% were men, 8 service users declined to identify their gender. The age profile of respondents is weighted towards the middle years of life, with 13% of respondents aged between 16 and 34; 86% between 35 and 64; and 1% 65 or over. Age Range of Patients 10 4 3 2 1 16-24 25-34 35-44 45-54 55-64 65+ Level 2. Ethnic Group of the service users were White British; 3% were from an Asian background (Indian, Pakistani, Bangladeshi or other); 1 were from a Black background (Caribbean or African). 3. Work Status 67% of respondents said they were not currently in paid work; 14% said they were in paid work; 8% said they were doing casual or voluntary work; none said they were students; 4% said they were on sick leave; 7% said they were retired. 4. Rating of Health The chart below shows how service users rated their mental health at the time of completing the questionnaire. Rating of Mental Health Right Now 10 4 3 2 1 Excellent Very good Good Fair Poor Very poor Avon and Wiltshire Mental Health Partnership NHS Page 7 of 94
Service users were also asked whether they had any long standing health conditions other than their mental health condition. said they did not have a long standing medical condition; 22% said they had a long standing physical condition; 14% said they had a long standing illness, such as cancer or heart disease. 5. Status of Respondent Respondents were asked whether the main person who had filled in the questionnaire was the service user/client, a friend or relative, the service user/client and friend/relative or the service user/client and a health professional. As the chart shows, 83% of respondents were the service users themselves. 10 Main Person Filling in Questionnaire 4 3 2 1 The service user / client (named on the front of the envelope) A friend or relative of the service user / client Both service user / client and friend / relative together The service user / client with the help of a health professional Avon and Wiltshire Mental Health Partnership NHS Page 8 of 94
Survey Results This section of the report describes the results for each part of the questionnaire in the order in which it was read by service users. The results from each question in the survey are described in the following sections. A bar chart shows the as well as the National score for the current survey, for the purpose of comparison; a line chart shows the as well as the National score over the life of the Mental Health Inpatient Survey. At the end of most sections, a scored dataset has been used to produce benchmark RAG (Red, Amber, Green) charts for key questions within that section. The scoring applied uses the CQC methodology, which scores responses based on how positive they are. To produce a "score" the CQC takes the most positive answer line. Each bar represents the range of results across all s that took part in the survey with Quality Health for one question. The bar is divided into: a red section: scores for the lowest scoring 2 of s; an amber section: scores for the intermediate of s; a green section: scores for the highest scoring 2 of s. The black circle represents the score for this. For example, if the circle is in the green section of the bar, it means that the is among the top 2 of s surveyed by Quality Health for that question. The line on either side of the circle shows the 95% confidence interval (the degree of uncertainty surrounding the s score). Under each RAG chart is a data table. The first column of the table shows the 's score for this year (represented by the black circle on the chart). The second and third columns represent the confidence intervals for this score. The fourth column shows the highest value in the lowest scoring 2 of s (i.e. the threshold or end of the red section on the chart); the fifth column represents the lowest value in the highest scoring 2 of s (i.e. the threshold or start of the green section on the chart). The end column displays a red square alongside any question where the s score falls within the lowest 2 of scores for that question, or a green square if it falls in the highest 2 of scores for that question. Finally, there are a number of management recommendations at the end of each section for consideration when action planning. Avon and Wiltshire Mental Health Partnership NHS Page 9 of 94
About the Ward FEELING WELCOME When you arrived on the ward, did staff make you feel welcome? 85% said staff made them feel welcome when they arrived on the ward; 15% said they did not feel welcome. Made to Feel Welcome on Arrival 10 4 3 2 1 Yes No Can't remember Comparison over time for this question: Staff Made Service User Feel Welcome on Arrival 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 10 of 94
PREVIOUS CARE When you arrived on the ward, did you feel that the staff knew about you and any previous care you had received? 29% said they definitely felt that the staff knew about them and any previous care they had received. Staff Knew About Previous Care 10 4 3 2 1 Yes, definitely Yes, to some extent No Don t know / Can t remember Comparison over time for this question: Definitely Knew About Previous Care Received 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 11 of 94
WARD ROUTINE When you arrived on the ward, or soon afterwards, did a member of staff tell you about the daily routine of the ward, such as times of meals and visitors' times? 34% said they were told completely about the daily routine of the ward such as meal times and visitors times. Told About Ward Routine 10 4 3 2 1 Yes, completely Yes, to some extent No Comparison over time for this question: Told Completely About Ward Routine 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 12 of 94
MIXED GENDER SLEEPING AREAS During your most recent stay, did you ever share a sleeping area, for example a room or bay, with patients of the opposite sex? Patients were asked if they ever had to share a sleeping area with patients of the opposite sex. 91% said they did not have to share; 9% did have to share. Shared Sleeping Area with Opposite Sex 10 4 3 2 1 Yes No Comparison over time for this question: Never Shared Sleeping Area With Opposite Sex 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 13 of 94
NOISE AT NIGHT During your most recent stay, were you ever bothered by noise at night from hospital staff? 33% of service users said they were bothered by noise at night from hospital staff; 67% said they were not bothered by noise. Bothered at Night by Noise From Staff 10 4 3 2 1 Yes No Comparison over time for this question: Never Bothered by Noise at Night From Staff 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 14 of 94
FEELING SAFE During your most recent stay, did you feel safe? As the chart shows, 41% of service users said they always felt safe during their stay in hospital; 19% said they did not feel safe; 41% said they felt safe only some of the time. Felt Safe in Hospital 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: 10 4 3 2 1 Always Felt Safe During Stay 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 15 of 94
FOOD How would you rate the hospital food? Of those service users saying they had hospital food, 27% of service users said it was very good; 38% rated the food as only fair or poor. Rating of Hospital Food 10 4 3 2 1 Very good Good Fair Poor I did not have any hospital Food Comparison over time for this question: 10 4 3 2 1 Hospital Food Good / Very Good 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 16 of 94
DIETARY NEEDS Do you have a specific diet, for example because of your cultural or religious beliefs, because you have a particular health condition, or through personal choice? Service users were asked if they had a specific diet because of cultural or religious beliefs, or for health reasons or personal choice; 19% of service users said that they did have such a diet. Service Users With Specific Diet 10 4 3 2 1 Yes No Comparison over time for this question: 10 4 3 2 1 Had a Specific Diet 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 17 of 94
DIETARY NEEDS CATERED FOR Were you able to get the specific diet that you needed from the hospital? Of those service users that did have a specific diet, 32% said they always were able to get the diet they needed from the hospital; 55% said they were able to get it sometimes and 14% said they were not able to get it. Able to Get Specific Diet 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Able to Get Specific Dietary Needs 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 18 of 94
CLEANLINESS OF WARD In your opinion, how clean was the hospital room or ward that you were in? 55% of service users said the hospital room or ward they were in was very clean; 6% said it was either not very clean or not at all clean. Cleanliness of the Room / Ward 10 4 3 2 1 Very clean Fairly clean Not very clean Not at all clean Comparison over time for this question: 10 4 3 2 1 Room / Ward Very Clean 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 19 of 94
CLEANLINESS OF TOILETS How clean were the toilets and bathrooms that you used in hospital? 57% of service users said the toilets or bathrooms they used in hospital were very clean; 8% said they were either not very clean or not at all clean. Cleanliness of Toilets / Bathrooms 10 4 3 2 1 Very clean Fairly clean Not very clean Not at all clean I did not use a toilet or bathroom Comparison over time for this question: Toilets and Bathrooms Very Clean 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 20 of 94
KEEPING IN TOUCH Do you feel the hospital helped you to keep in touch with family or friends? 34% of service users who needed it felt that the hospital definitely helped them to keep in touch with family or friends; 18% said they would have liked help but did not get it. Hospital Helped Keep in Touch With Family / Friends 10 4 3 2 1 Yes, definitely Yes, to some extent No, but I would have liked help No, and I did not need help Comparison over time for this question: Hospital Definitely Helped Service User Keep in Touch with Family / Friends 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 21 of 94
ORGANISING HOME LIFE During your most recent stay, did you need any help from hospital staff with organising your home situation (e.g. payment of bills, looking after pets, taking care of relatives, keeping in touch with work)? 27% of service users said they needed help from hospital staff with organising their home situation. Needed Help With Home Situation 10 4 3 2 1 Yes No Comparison over time for this question: Help Needed with Home Situation 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 22 of 94
GETTING HELP ORGANISING HOME LIFE Did you receive the help you needed from hospital staff with organising your home situation? Of those who needed it, 55% of service users said they received all the they needed; 16% said they did not receive any help. Received Help Needed With Home Situation 10 4 3 2 1 I received all the help I needed I received some of the help I needed I did not receive any help Comparison over time for this question: Got Help Needed with Home Situation 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 23 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this About the Ward Q1: Made to feel welcome on arrival by staff Q2: Staff definitely knew about previous care received Q3: Told completely about the ward routine on arrival Q4: Did not share a sleeping area with opposite sex Q5: Never bothered by noise at night from staff Q6: Always felt safe in hospital 1 2 3 4 10 < worse Percentage score better > RVN Question Q1 Made to feel welcome on arrival by staff 85% 83% 87% 79% 10 93 Q2 Staff definitely knew about previous care received 29% 26% 32% 21% 34% 4 94 Q3 Told completely about the ward routine on arrival 34% 31% 37% 28% 43% 48% 109 Q4 Did not share a sleeping area with opposite sex 91% 91% 91% 86% 97% 10 111 Q5 Never bothered by noise at night from staff 67% 67% 67% 71% 84% 108 Q6 Always felt safe in hospital 41% 37% 44% 35% 46% 53% 111 Avon and Wiltshire Mental Health Partnership NHS Page 24 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Q7: Hospital food very good / good Q9: Always able to get specific dietary needs Q10: Hospital ward or room very clean Q11: Toilets and bathrooms very clean Q12: Hospital definitely helped keep in touch with family Q14: Received all the help needed from staff with home situation 1 2 3 4 10 < worse Percentage score better > RVN Question Q7 Hospital food very good / good 62% 59% 65% 57% 68% 84% 110 Q9 Always able to get specific dietary needs 32% 29% 35% 27% 48% 71% 22 Q10 Hospital ward or room very clean 55% 52% 58% 53% 73% 108 Q11 Toilets and bathrooms very clean 57% 55% 59% 36% 55% 67% 109 Q12 Hospital definitely helped keep in touch with family 34% 31% 37% 34% 53% 74% 102 Q14 Received all the help needed from staff with home situation 55% 52% 58% 36% 64% 88% 31 Avon and Wiltshire Mental Health Partnership NHS Page 25 of 94
Actions: Look at how noise of the ward at night can be minimised - scores have declined in this area. Ensure that patients with specific diets get the food they require - scores have declined in this area. Review the cleaning contract in the light of the number of patients saying the ward of 'very clean' declining. Avon and Wiltshire Mental Health Partnership NHS Page 26 of 94
Hospital Staff PSYCHIATRISTS LISTENING Did the psychiatrist(s) listen carefully to you? Some of the service users who saw a psychiatrist felt that the psychiatrist only listened carefully to them sometimes, or not at all, as the chart shows. Psychiatrist Listened Carefully 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: 10 4 3 2 1 Psychiatrist Listened Carefully 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 27 of 94
TIME WITH THE PSYCHIATRIST Were you given enough time to discuss your condition and treatment with the psychiatrist(s)? Service users were asked if they felt that they were given enough time to discuss their condition and treatment with the psychiatrist. 39% said they always were; 24% said they were not given enough time; 37% said they only sometimes were. Given Enough Time to Discuss Condition / Treatment With Psychiatrist 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Given Enough Time to Talk to Psychiatrist 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 28 of 94
CONFIDENCE AND TRUST IN PSYCHIATRISTS Did you have confidence and trust in the psychiatrist? 42% said they always had confidence and trust in the psychiatrist they saw; 23% said they did not have confidence and trust. Had Confidence and in Psychiatrist 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Had Confidence and in Psychiatrist 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 29 of 94
TREATED WITH RESPECT AND DIGNITY BY THE PSYCHIATRIST Did the psychiatrist(s) treat you with respect and dignity? 62% of service users said that they were always treated with respect and dignity by the psychiatrist they saw; 8% said they were not. Psychiatrist Treated Patient With Respect and Dignity 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Treated with Respect and Dignity by Psychiatrist 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 30 of 94
NURSES LISTENING Did the nurses listen carefully to you? Service users were also asked if the nurses listened carefully to them. 48% of service users said they always did; 13% of service users said they did not. Nurses Listened Carefully 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: 10 4 3 2 1 Nurses Always Listened Carefully 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 31 of 94
TIME WITH THE NURSES Were you given enough time to discuss your condition and treatment with the nurses? Service users were asked if they felt that they were given enough time to discuss their condition and treatment with the nurses. 35% of service users said they always were; 19% said they were not given enough time; 46% said they only sometimes were. Given Enough Time to Discuss Condition / Treatment With Nurses 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Given Enough Time to Talk to Nurses 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 32 of 94
CONFIDENCE AND TRUST IN NURSES Did you have confidence and trust in the nurses? of service users said they always had confidence and trust in the nurses; 34% said they had confidence and trust in nurses only sometimes ; 16% said they did not have confidence and trust. Had Confidence and in Nurses 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Had Confidence and in Nurses 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 33 of 94
TREATED WITH RESPECT AND DIGNITY BY THE NURSES Did the nurses treat you with respect and dignity? 57% of service users said that they were always treated with respect and dignity by the nurses; 8% said they were not. Nurses Treated Service User With Respect and Dignity 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Treated with Respect and Dignity by Nurses 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 34 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Hospital Staff Q15: Psychiatrist always listened carefully Q16: Always given enough time to discuss condition and treatment with psychiatrist Q17: Always had confidence and trust in the psychiatrist Q18: Always treated with respect and dignity by psychiatrist 1 2 3 4 10 < worse Percentage score better > RVN Question Q15 Psychiatrist always listened carefully 52% 49% 55% 44% 58% 105 Q16 Always given enough time to discuss condition and treatment with 39% 36% 42% 38% 58% 67% 103 Q17 psychiatrist Always had confidence and trust in the psychiatrist 42% 39% 45% 35% 51% 104 Q18 Always treated with respect and dignity by psychiatrist 62% 59% 65% 61% 73% 106 Avon and Wiltshire Mental Health Partnership NHS Page 35 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Q19: Nurses always listened carefully Q20: Always given enough time to discuss condition and treatment with nurses Q21: Always had confidence and trust in the nurses Q22: Always treated with respect and dignity by the nurses 1 2 3 4 10 < worse Percentage score better > RVN Question Q19 Nurses always listened carefully 48% 45% 51% 42% 57% 64% 109 Q20 Always given enough time to discuss condition and treatment with nurses 35% 31% 38% 32% 45% 55% 110 Q21 Always had confidence and trust in the nurses 47% 54% 4 53% 109 Q22 Always treated with respect and dignity by the nurses 57% 54% 61% 46% 68% 86% 108 Avon and Wiltshire Mental Health Partnership NHS Page 36 of 94
Actions: Patients' confidence and trust in psychiatrists and nurses has improved significantly since 2014, continue to work on this to take the trust above the average level across all trusts Ensure that patients have enough time to discuss their condition and treatment with staff, in particular with psychiatrists. Avon and Wiltshire Mental Health Partnership NHS Page 37 of 94
Care and Treatment MEDICATION GIVEN IN HOSPITAL During your most recent stay, were you given any medication (including tablets, medicines and injections) as part of the treatment for your mental health? 97% said they were given medication as part of their treatment during their stay in hospital. Given Medication During Stay 10 4 3 2 1 Yes No Comparison over time for this question: 10 4 3 2 1 Given Medication During Stay 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 38 of 94
PURPOSE OF MEDICATION EXPLAINED Did the hospital staff explain the purpose of this medication in a way you could understand? Of service users who were given medication, 43% said that staff explained the purpose of the medication completely. Purpose of Medication Explained 10 4 3 2 1 Yes, completely Yes, to some extent No I did not need an explanation Comparison over time for this question: Purpose of Medication Completely Explained 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 39 of 94
SIDE EFFECTS OF MEDICATION Did the hospital staff explain the possible side effects of this medication in a way you could understand? Service user opinion on whether they had been told about possible side effects of medication varied. 24% of those service users who needed an explanation said they had been told completely about potential side effects; 41% said they had not been told. Possible Side Effects of Medication Explained 10 4 3 2 1 Yes, completely Yes, to some extent No I did not need an explanation Comparison over time for this question: Possible Side Effects of Medication Completely Explained 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 40 of 94
PRIVACY Were you given enough privacy when discussing your condition or treatment with the hospital staff? 55% said they were always given enough privacy when discussing their condition or treatment with hospital staff; 1 said they were not given enough privacy. Given Enough Privacy When Discussing Condition / Treatment With Staff 10 4 3 2 1 Yes, always Yes, sometimes No Comparison over time for this question: Always Given Enough Privacy When Discussing Condition / Treatment 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 41 of 94
DECISIONS ABOUT CARE Were you involved as much as you wanted to be in decisions about your care and treatment? 3 of service users said they definitely were involved as much as they wanted to be in decisions about their care and treatment; 49% of service users said they were involved to some extent; 21% of service users said they were not involved in decisions. Involved as Much as They Wanted in Decisions on Care / Treatment 10 4 3 2 1 Yes, definitely Yes, to some extent No Comparison over time for this question: Definitely Involved Enough in Decisions About Care and Treatment 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 42 of 94
WANTING TALKING THERAPY During your stay in hospital, did you ever want talking therapy? Service users were asked if they ever wanted talking therapy during their stay in hospital; 52% of service users said they did. Wanted Talking Therapy 10 4 3 2 1 Yes No Comparison over time for this question: Service User Wanted Talking Therapy During Stay 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 43 of 94
HAVING TALKING THERAPY During your stay in hospital, did you have talking therapy? Service users were then asked if they had had talking therapy in hospital. 27% of service users said they did have talking therapy; there is a gap of 25% between those who wanted talking therapy in hospital and those who said they had talking therapy. Had Talking Therapy 10 4 3 2 1 Yes No Comparison over time for this question: Service User Had Talking Therapy During Stay 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 44 of 94
HELPFULNESS OF TALKING THERAPY If you had talking therapy during your stay in hospital, did you find it helpful? Service users who did have talking therapy in hospital were asked if they found it helpful; 55% of service users said they definitely did; 14% of service users said they did not. Found Talking Therapy Received Helpful 10 4 3 2 1 Yes, definitely Yes, to some extent No Comparison over time for this question: 10 4 3 2 1 Found Talking Therapy Helpful 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 45 of 94
ACTIVITIES DURING WEEKDAYS During your most recent stay, were there enough activities available for you to do during the day on weekdays (Monday to Friday)? 26% of service users said that there were enough activities to do during the day on a weekday all of the time; 28% of service users said that there were not enough activities. Enough Activities During Weekdays 10 4 3 2 1 Yes, all of the time Yes, some of the time No Comparison over time for this question: Always Enough Activities on Weekdays 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 46 of 94
ACTIVITIES DURING EVENINGS AND WEEKENDS During your most recent stay, were there enough activities available for you to do during evenings and/or weekends? 52% of service users said that there were not enough activities to do during evenings and weekends. In every surveyed, more service users said there were too few activities in the evenings and at weekends than said that in respect of weekdays. Enough Activities Evenings / Weekends 10 4 3 2 1 Yes, all of the time Yes, some of the time No Comparison over time for this question: Always Enough Activities in Evenings and on Weekends 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 47 of 94
PHYSICAL HEALTH TESTS During your most recent stay, did you have any medical tests about your physical health (e.g. having your blood pressure measured or having a blood or urine test)? 95% of service users said they had medical tests about their physical health (e.g. blood pressure, urine tests etc.) while they were in hospital. Had Tests on Physical Health During Stay 10 4 3 2 1 Yes No Don't know Comparison over time for this question: Had Tests on Physical Health During Stay 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 48 of 94
CARE TAKEN OF PHYSICAL HEALTH During your most recent stay, do you feel that enough care was taken of any physical health problems you had (e.g. diabetes, asthma, heart disease)? Service users were also asked if they felt that enough care was taken of any physical health problems they had. Of those with health problems, 45% of service users said definitely that enough care had been taken. Enough Care Taken of Physical Health Needs During Stay 10 4 3 2 1 Yes, definitely Yes, to some extent No I did not have any physical health problems Comparison over time for this question: Definitely Felt Enough Care Taken of Physical Health Needs During Stay 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 49 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Care and Treatment Q24: Purposes of medications explained completely Q25: Told completely about the side effects of the medication Q26: Always given enough privacy when discussing condition or treatment Q27: Definitely involved as much as wanted in decisions about care and treatment 1 2 3 4 10 < worse Percentage score better > RVN Question Q24 Purposes of medications explained completely 43% 4 46% 37% 49% 62% 98 Q25 Told completely about the side effects of the medication 24% 22% 27% 21% 29% 36% 98 Q26 Always given enough privacy when discussing condition or treatment 55% 52% 58% 52% 66% 79% 107 Q27 Definitely involved as much as wanted in decisions about care and treatment 3 27% 33% 26% 39% 55% 109 Avon and Wiltshire Mental Health Partnership NHS Page 50 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Q29: Had talking therapy if wanted Q30: Definitely found talking therapy helpful Q31: Enough activities available all of the time on weekdays Q32: Enough activities available all of the time in evenings and on weekends Q34: Definitely felt enough care taken of physical health 1 2 3 4 10 < worse Percentage score better > RVN Question Q29 Had talking therapy if wanted 27% 27% 27% 24% 38% 108 Q30 Definitely found talking therapy helpful 55% 52% 58% 43% 29 Q31 Enough activities available all of the time on weekdays 26% 23% 29% 22% 33% 4 107 Q32 Enough activities available all of the time in evenings and on weekends 16% 13% 18% 12% 19% 26% 108 Q34 Definitely felt enough care taken of physical health 45% 42% 48% 38% 53% 63% 80 Avon and Wiltshire Mental Health Partnership NHS Page 51 of 94
Actions: The trust scores within the middle of trusts for most questions in this section. There have been some scores improving and others declining. Take action to identify areas where improvements can be made to move the trust beyond the average level. Avon and Wiltshire Mental Health Partnership NHS Page 52 of 94
Service User s Rights DETENTION UNDER THE MENTAL HEALTH ACT At any time during your most recent admission were you detained (sectioned) under the Mental Health Act? 72% said they had been detained under the Mental Health Act during their most recent admission to hospital. Sectioned During Admission 10 4 3 2 1 Yes No Don't know Comparison over time for this question: 10 4 3 2 1 Sectioned During Stay 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 53 of 94
EXPLANATIONS OF RIGHTS UNDER THE MENTAL HEALTH ACT When you were detained (sectioned), or soon after, were your rights explained to you in a way that you could understand? Of this group of service users who said they had been detained under the MHA, said that staff explained their rights under the Act to them. Rights Explained if Sectioned 10 4 3 2 1 Yes, completely Yes, to some extent No Don t know / Can t remember Comparison over time for this question: Rights Were Completely Explained When Sectioned 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 54 of 94
MAKING A COMPLAINT During your most recent stay, were you made aware of how you could make a complaint if you had one? 51% said they had been made aware during their stay in hospital of how they could make a complaint if they had one; 49% said they had not been made aware. Made Aware of How to Make a Complaint 10 4 3 2 1 Yes No Don t know / Can t remember Comparison over time for this question: Made Aware of How to Make a Complaint if Needed 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 55 of 94
FAIR TREATMENT During your most recent stay, do you feel that you were treated unfairly for any of the reasons below? Service users were asked if they felt that they had been treated unfairly for any reason during their stay in hospital. 54% said they were not treated unfairly for any of the reasons given; the chart shows the percentage of service users who did feel they were treated unfairly for each reason. Reasons for Service Users Feeling Unfairly Treated 10 4 3 2 1 Your age Your sex Your race / ethnic background Your religion Your sexual orientation A disability that you have Another reason None of these Comparison over time for this question: Not Treated Unfairly for Any Reason Stated During Stay 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 56 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Service Users Rights Q36: When sectioned, rights were explained completely Q37: Made aware of how to make a complaint if had one Q38: Did not feel unfairly treated for any of the reasons given 1 2 3 4 10 < worse Percentage score better > RVN Question Q36 When sectioned, rights were explained completely 47% 53% 34% 49% 62% 62 Q37 Made aware of how to make a complaint if had one 51% 48% 54% 49% 61% 76% 84 Q38 Did not feel unfairly treated for any of the reasons given 54% 52% 56% 48% 67% 71% 112 Avon and Wiltshire Mental Health Partnership NHS Page 57 of 94
Actions: Scores have improved in all areas in this section, continue to work on these going forward. Avon and Wiltshire Mental Health Partnership NHS Page 58 of 94
Leaving Hospital NOTICE OF DISCHARGE Do you think you were given enough notice of your discharge from hospital? 73% said they were given enough notice of discharge from hospital. Given Enough Notice of Discharge 10 4 3 2 1 Yes No Don t know Comparison over time for this question: Given Enough Notice of Discharge 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 59 of 94
DELAYS IN DISCHARGE Once you were due to leave hospital, was your discharge delayed for any reason? 18% said their discharge was delayed. Discharge Delayed for Any Reason 10 4 3 2 1 Yes No Comparison over time for this question: 10 4 3 2 1 Discharge Not Delayed 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 60 of 94
REASONS FOR DISCHARGE DELAYS What was the MAIN reason for the delay? The chart below shows the main reasons given for any delays to discharge. Reason Service User Waited for Discharge 10 4 3 2 1 To see a doctor or nurse in charge of the ward To wait for suitable accommodation To wait for financial help To wait for community services to become available Something else * It is known from the National Acute Inpatient Survey in mainstream acute hospitals that the most significant reason given by service users for delay on discharge is that of waiting for discharge medication. This option is not available in the Mental Health Inpatient Survey, which may account for the significant number of service users saying something else as the reason for the delay. Avon and Wiltshire Mental Health Partnership NHS Page 61 of 94
PLANNING DISCHARGE As far as you know, did hospital staff take your family or home situation into account when planning your discharge from hospital? Service users were asked if they thought hospital staff had taken their family or home situation into account when planning their discharge. 58% said they had completely; 16% said they had not taken these considerations into account. Home Situation Taken into Account When Planning Discharge 10 4 3 2 1 Yes, completely Yes, to some extent No Don t know / Can t remember Comparison over time for this question: Home Situation Completely Taken into Account in Planning Discharge 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 62 of 94
OUT OF HOURS NUMBER Do you have the number of someone from your local NHS Mental Health Service that you can phone out of office hours? 77% of service users said they had the number of someone from their local NHS Mental Health Service that they could call out of office hours; 23% of service users said they did not have such a number. Have Out of Hours Phone Number 10 4 3 2 1 Yes No Don t know / Can t remember Comparison over time for this question: 10 4 3 2 1 Given Out of Hours Number 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 63 of 94
CRISIS SUPPORT Before you left hospital, were you given information about how to get help in a crisis, or when urgent help is needed? 81% of service users said they were given information about how to get help in a crisis or when urgent help was needed before they left hospital; 19% said they were not given this information. Given Information on How to Get Help in a Crisis 10 4 3 2 1 Yes No Don t know / Can t remember Comparison over time for this question: Given Information on How to Get Help in a Crisis 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 64 of 94
CONTACTED AFTER DISCHARGE Have you been contacted by a member of the mental health team since you left hospital? Service users were asked if they had been contacted by a member of the Mental Health Team since leaving hospital; 89% of service users said they had. Have Been Contacted by Member of Mental Health Team Since Discharge 10 4 3 2 1 Yes No Don t know / Can t remember Comparison over time for this question: Contacted by Mental Health Team Since Discharge 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 65 of 94
TIME BEFORE CONTACT About how long after you left hospital were you contacted? The chart shows how long it was after discharge that service users said they waited before being contacted. Wait for Contact After Discharge 10 4 3 2 1 One week or less Two weeks Three weeks Four weeks or longer Don t know / Can t remember Comparison over time for this question: Contacted by Mental Health Team Within a Week 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 66 of 94
RATING OF OVERALL CARE Overall, how would you rate the care you received during your recent stay in hospital? As the chart shows, 54% rated the care they received in hospital as either excellent or very good; 27% rated it as only fair or poor. Overall Rating of Care 10 4 3 2 1 Excellent Very good Good Fair Poor Comparison over time for this question: Care Rated as Excellent / Very Good 10 4 3 2 1 2009 2010 2011 2012 2013 2014 2015 Avon and Wiltshire Mental Health Partnership NHS Page 67 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Leaving Hospital Q39: Given enough notice of discharge from hospital Q40: Discharge not delayed for any reason Q42: Staff took home situation into account completely Q43: Have out of hours phone number 1 2 3 4 10 < worse Percentage score better > RVN Question Q39 Given enough notice of discharge from hospital 73% 76% 69% 81% 88% 100 Q40 Discharge not delayed for any reason 82% 82% 82% 73% 84% 91% 104 Q42 Staff took home situation into account completely 58% 55% 61% 45% 59% 68% 95 Q43 Have out of hours phone number 77% 74% 64% 86% 93% 99 Avon and Wiltshire Mental Health Partnership NHS Page 68 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Q44: Given information about getting help in crisis Q45: Have been contacted by MH team since discharge Q46: Contacted by MH team within one week of discharge Q47: Overall care during stay excellent / very good 1 2 3 4 10 < worse Percentage score better > RVN Question Q44 Given information about getting help in crisis 81% 78% 84% 74% 82% 100 Q45 Have been contacted by MH team since discharge 89% 87% 91% 78% 95% 108 Q46 Contacted by MH team within one week of discharge 72% 71% 73% 85% 95% 88 Q47 Overall care during stay excellent / very good 54% 52% 57% 45% 56% 63% 105 Avon and Wiltshire Mental Health Partnership NHS Page 69 of 94
Actions: Ensure that all service users discharged from inpatient wards are telephoned post discharge by a member of staff to check on their mental health status, irrespective of whether the service user is on CPA or non CPA. Overall scores have improved in this area - take action to ensure this trend continues Avon and Wiltshire Mental Health Partnership NHS Page 70 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Key Scores Q6: Always felt safe in hospital Q7: Hospital food very good / good Q17: Always had confidence and trust in the psychiatrist Q18: Always treated with respect and dignity by psychiatrist Q25: Told completely about the side effects of the medication 1 2 3 4 10 < worse Percentage score better > RVN Question Q6 Always felt safe in hospital 41% 37% 44% 35% 46% 53% 111 Q7 Hospital food very good / good 62% 59% 65% 57% 68% 84% 110 Q17 Always had confidence and trust in the psychiatrist 42% 39% 45% 35% 51% 104 Q18 Always treated with respect and dignity by psychiatrist 62% 59% 65% 61% 73% 106 Q25 Told completely about the side effects of the medication 24% 22% 27% 21% 29% 36% 98 Avon and Wiltshire Mental Health Partnership NHS Page 71 of 94
Scored % in highest/lowest 2 of s 2015 Number of responders for this Highest 's percentage score Threshold for highest scoring 2 of all s Threshold for lowest scoring 2 of all s Upper 95% confidence interval Lower 95% confidence interval 2015 Percentage for this Q39: Given enough notice of discharge from hospital Q43: Have out of hours phone number Q45: Have been contacted by MH team since discharge Q47: Overall care during stay excellent / very good 1 2 3 4 10 < worse Percentage score better > RVN Question Q39 Given enough notice of discharge from hospital 73% 76% 69% 81% 88% 100 Q43 Have out of hours phone number 77% 74% 64% 86% 93% 99 Q45 Have been contacted by MH team since discharge 89% 87% 91% 78% 95% 108 Q47 Overall care during stay excellent / very good 54% 52% 57% 45% 56% 63% 105 Avon and Wiltshire Mental Health Partnership NHS Page 72 of 94
Actions: The trust's overall rating of care score has improved significantly since 2014 and is sure to be as a result of the many other scores which have improved. There are still areas which need attention and some which despite improvement now place the trust at average levels. However, the improvements are clear and should be built upon. Avon and Wiltshire Mental Health Partnership NHS Page 73 of 94