10 and 11 November 2015
During a routine inspection
We rated Rosebank House as requires improvement because:
- There were blind spots that undermined staff’s ability to undertake effective observations.
- Staff were not undertaking or recording the minimum level of observation of patients.
- There were numerous ligature points, no ligature cutters nor a ligature risk assessment.
- The hospital did not fully comply with same sex accommodation guidance.
- Temporary staff had not received an adequate induction.
- There was no system in place to check the competence of staff to administer medicines safely.
- Staff did not always follow medicines management policies.
- Clinical nursing staff were not involved in clinical audits.
- There were no clear recovery pathways in patients care plans.
- The service did not use outcome measures when supporting people.
- Care plans did not reflect patients’ specialist needs.
- There were no audits or plans to review the hospitals effectiveness in meeting the needs of patients who may have autism or a learning disability.
- There was an absence of internal monitoring to improve services.
- When an audit did identify gaps, no robust action plan was put in place.
- The provider was not adequately monitoring the risks around staff skill mix to meet considerable variances in patients’ needs and risks.
- The provider had not taken steps to assure itself about patients’ safety.
However:
- There were sufficient numbers of staff on duty to meet people’s needs.
- The hospital was clean and well maintained.
- There was emergency equipment available in the event of a health crisis and this was checked daily.
- Medication was prescribed within National Institute for Health and Care Excellence (NICE) guidelines.
- There was good monitoring of patients physical health needs, and treatment was sought promptly, when required.
- Staff received regular supervision.
- We observed consistent supportive and caring interactions between staff and patient.s
- Patients were treated with dignity and respect.
- A recent patient satisfaction survey was positive about the service, 100% of patients felt listened to.
- The hospital had suitable furniture and equipment to meet people’s needs.
- There was an interpreting service available if required.
- There was good access for people who may be wheelchair dependent.
- Patients had access to an art therapy room, computer room and meeting space.
- Locally staff reported feeling well supported and enjoyed working in the service.