Where people are able to they can consent to the care, support and treatment they receive. If a parent asks for information about their child, staff ask the child first if they can share this information.

Staff told us that if a person refuses their medication they talk to them about the reasons for taking it and if it is in the person’s best interests to take they encourage them to do so.

People told us: "Every few months we discuss what's happening. They made it clear that I was involved."

"I can bring forward the appointment if it is needed. I’m happy with the way we have been treated. We seem to get out of the visit what we want and we never feel rushed."

Staff told us that appointment times in the community services are usually about one hour. Staff said “I take as long as I need, but not less than 20 minutes, we are flexible over times”.

Staff told us that they do not just consider people’s mental health needs but also their physical health, social and relationship needs, their housing and finances, including what benefits they are entitled to.

We saw that the arrangements for storing and transporting medication when visiting people’s homes were safe and reduced the risk of medication going missing or being misused.

Staff said that all people who use the service are offered a copy of their care plan.

Records sampled included good, clear information that showed what support the person had received.

When assessing a person staff gather information about the person, look at what services they have been offered and what services they would benefit from.

Staff we spoke with were concerned about the future of the service as staff have left and not been replaced. This is due to reorganisation of community health services. Staff said this may mean that people do not always have a choice about whether male or female staff support them, which could impact on their privacy and dignity.

We saw that staff had the skills and knowledge to know how to safeguard adults and children from abuse and harm.

Staff felt supported by their team and their manager and had the training they need to be able to support people who use the service.

Complaints are seen as a positive process from which any improvements needed are made.

Regular audits are completed and action is taken to improve the service, so benefiting the people who use it.

The headquarters of Dudley and Walsall Mental Health Partnership NHS Trust is in Dudley. This is where all of the trust’s community activities are registered to, but the services are in various locations across Dudley and Walsall.

The community services we visited were :

• Children and adolescent mental health service
• Community services for older people
• Adult community-based services
• Community-based crisis services
• Specialist eating disorder services
• Other specialist services (Military veterans, Substance Misuse and the Recovery Intervention service)

We found that safeguarding and systems for reporting incidents were robust and ensured people were safe.

There was a consistent assessment approach across community teams, and information could easily be understood and transferred between the types of services.

There was a single assessment tool which ensured continuity and consistency of care.

Across the community services, we found good risk assessment in place, as well as systems for flagging where more than one member of staff needed to attend.

There was no formal induction programme in place for agency staff and they were not always aware of the trust’s lone working policy.

There was a lack of out-of-hours and crisis intervention services for children and young people. Waiting times from initial assessment were lengthy.

There was good evidence of multi-agency and cross-sector working.

We saw good examples of learning from audits and incidents being shared across the trust, and practice being changed as a result.

There were inconsistencies in how the teams we visited obtained people’s views.

We saw good examples of the executive team visiting local delivery teams, as well as positive involvement of non-executive directors.