3 August 2023
During an inspection looking at part of the service
Our rating of this service went down. We rated it as requires improvement because:
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Wards were not always safe, clean or well maintained. Repairs did not happen quickly and the environment was not therapeutic.
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Staff did not assess and manage risks well. Risk assessments and management plans did not address the needs of all patients. Some opportunities to prevent or minimise harm were missed.
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Information relating to patient care and treatment was not kept up to date or easy for staff to find.
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Staff had not always completed training to meet the specific needs of patients.
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Incidents, including the use of restrictive interventions were not well recorded. Lessons learnt were not always identified and shared with the whole team. Managers could not be assured physical restraint was being carried out in line with guidance.
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Managers had not ensured staff had received training necessary for their roles.
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The service was not well-led at all levels. Governance processes did not ensure that ward procedures ran smoothly. Some audits to evaluate the quality of care provided were not completed.
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The approach to service delivery and improvement had sometimes been reactive. This meant risks and improvements were not always managed appropriately or rectified quickly enough.
However:
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Staff were respectful to patients and were caring in their approach.
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Staff we spoke to were enthusiastic about the service and most felt supported in their role.
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Some improvements had been made following our previous inspection. Leaders had an action plan for future improvements and needed time for changes to be embedded.