What people told us about the estate

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In autumn 2018, the trust’s estates team, supported by the communications department, launched a listening exercise to elicit views from staff, service users and their carers on what estate issues were important to them and what aspirations they had for future development of estate as part of high-quality mental health service provision. There was also a workshop for senior clinical leaders and presentations and discussion items on the agendas of local user and carer forums through the autumn. Despite the differences between these constituencies, some remarkably similar themes emerged in the
feedback, summarised here and set out in more detail in Annex A. Some of the commentary related to the buildings per se, some to the way buildings are managed

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There was a very significant bloc of positive feedback from all sources, complimentary about how well the trust uses and manages its estate. It is likely that many of these perspectives came from people who work in those parts of the trust where buildings are either recently acquired/upgraded or are of high quality (the survey was anonymous). Just over half of the trust inpatient units and just under half of its community units would fall into this description.

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Where comments were constructively critical, there was a clear focus on the view that buildings needed to be fit for purpose and that the safety and security of both patients and staff were primary in this respect. So building access control systems and minimum, or ligature-free, environments featured prominently in the feedback, for example. There are ambitious proposals within the trust’s technology strategies to fully integrate building access control systems - network connected, centrally managed and monitored. Panic alarm systems, control of visitors to sites and equipment that was safe, maintained and fit for purpose were all cited frequently.

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It was interesting how many people pointed out the need to balance security systems of one kind or another, however sensitively deployed, with the need for a therapeutic environment, one which fostered wellbeing for both service users and staff, allowing the clinical interventions provided by the trust to achieve their effect without hindrance from the environment. As an example of how this concern is being addressed the trust is piloting a trial system at the seclusion suite in Dartford, which unobtrusively monitors patients’ vital signs and alerts staff if needed.

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Although much of the feedback focussed on providing clinical services, it was recognised there was a need to try and minimise the “clinical feel” of buildings. Notably, reception and waiting areas were picked out by many people as needing to be more welcoming and comfortable, as well as modern and functional.

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There were a range of other concerns from staff and leaders, in particular picking up the importance of facilities for staff training, welfare and “rest” areas at work. Use of videoconferencing to aid non-physical attendance at training featured regularly in the feedback discussions. Control of temperature in various settings and for differing reasons, perhaps remotely through building management systems (BMS) also featured prominently, as did the workforce’s clear interest (and ideas) for ensuring the trust acts as a provider of choice in its approach to issues such as sustainability, carbon reduction and parking facilities.

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Although there was some contradictory feedback, particularly around issues such as whether there should be more individual offices or open plan work areas (about which people hold differing views) and whether buildings should be very secure or openly welcoming, what is clear is that the estate from which the trust offers services is important to all and forms a valuable part of the trust’s service offer to the community and workplace wellbeing of its staff. This strategy recognises and welcomes that interest in its buildings and in the need to ensure they are continually improved and well-used.

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The document sets out how the trust intends to try and meet the various demands placed on its estate with our building users’ needs at the forefront of our thinking, alongside the demands and expectations of regulators and others. The strategy identifies the key performance management tools used; the key clinical, strategic and operational drivers for change, the chief considerations when planning capital expenditure, and the trust’s approach to the optimisation of its assets in support of clinical service delivery. Annex A includes indication of where the Trust is responding to specific issues highlighted by the stakeholder survey, using a colour-code layout