Updated 3 October 2023
We carried out this unannounced focused inspection because we received information giving us concerns about the safety and quality of the service. At our last inspection we rated the provider as requires improvement.
At the previous inspection in July 2021 the provider was found in breach of 5 regulations and issued with requirement notices. We told the provider to make the following improvements:
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The provider must ensure that it maintains a balance between the maintenance of safety and providing a least restrictive environment appropriate to each of its services. The provider must ensure that patients are able to keep their belongings safe, locked away and are able to access them when they need them. The provider must ensure the dignity of patients when using such items as anti-tear clothing. Patients must be treated with dignity and respect. Regulation 10 Safe care and treatment.
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The provider must ensure that the acute wards seclusion rooms comply with the Mental Health Code of Practice. The provider must ensure patients have easy access to fresh air and outside space. All premises and equipment used by the service provider must be (c) suitable for the purpose for which they are being used and (e) properly maintained. Regulation 15(1)(c) and (e) Premises and Equipment
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The provider must ensure it identifies and manages all risk for patients in the acute wards. Care and treatment must be provided in a safe way for service users. Regulation 12 Safe care and treatment.
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The provider must ensure that the range of therapeutic activities is available to meet patients’ needs in the secure wards in accordance with guidance from National Institute of Health and Care Excellence. Regulation 9, Person Centred Care.
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The provider must ensure that it stores keys on the medium and low secure wards safely, so keys can be found easily in the event of an emergency. Regulation 12 Safe care and treatment.
We found at this inspection the provider had made the improvements we told them to make. We found the provider was identifying restrictive practice and acting to remove them when possible. Patients on the acute wards did not have to go through the secure entrance every time they left or returned to the hospital. The provider had supplied secure lockers for patients to keep their belongings safe. The provider had addressed the issues identified with acute ward seclusion rooms and patient access to outdoor space and fresh air. Staff received a risk assessment on all patients referred to the hospital, and patients admitted to the acute wards had a comprehensive risk assessment completed within 24 hours of admission. There was a full range of therapeutic activities available to patients. The provider had organised the storage of keys on the secure wards so that the correct key could be found without delay.
What people who use the service say
The patients we spoke with on the Acute and PICU wards told us staff were supportive and helpful. They also told us they were involved in planning their care and that the doctors and nurses always discussed treatments with them. For example, if they needed to change medication.
Patients on the forensic wards told us they received good care and felt the staff had helped them move on. Some patients said they found the ward routines helpful and enjoyed taking leave from the hospital. Patients said they were seen regularly by the psychiatrist and had access to advocates and Mental Health Act solicitors as needed. Some patients said when at times they felt intimidated by other patients, this had been dealt with appropriately by staff and said they felt safe on the wards. Patients told us they were complying with their care and treatment with a view to discharge.
Patients knew how to complain and raise concerns about their care with hospital staff, advocacy services and the CQC (Care Quality Commission).