Archived: The Willows

Updated 21 December 2018

The Willows is an independent mental health hospital run by Priory Healthcare Group. It is in a rural location approximately nine miles outside the town of Newark. Partnerships in Care used to run the hospital, until they merged with Priory Healthcare Group in December 2016. The Willows is registered to provide assessment or medical treatment for persons detained under the Mental Health Act (1983) and treatment of disease, disorder and injury.

The Willows is a community rehabilitation unit. The patient group expected in this type of service have ongoing complex needs. The role of this type of unit is to facilitate recovery, offer psychosocial interventions and support patients to develop skills for independent living and community activities. The Willows can accommodate up to six female patients with a diagnosis of mental illness, personality disorder, or a combination of both. At the time of our inspection, there were five patients at The Willows. They were all detained under the Mental Health Act. Some patients had a criminal order, which means they receive treatment in hospital instead of going to prison. Ministry of Justice conditions apply to these patients.

The Willows registered with the Care Quality Commission on 29 December 2010. There have been four previous inspections carried out at The Willows, the most recent of which was on 20 April 2016. Following this inspection, we rated the hospital ‘good’ in all five domains and there were no enforcement actions.

The Willows had a registered manager, who had been in post since June 2018. During the time of our inspection the registered manager was giving interim support to another service. The provider had therefore arranged for an interim hospital manager and director of clinical services to support The Willows. Since our previous inspection there have been four different hospital managers at The Willows. The hospital created a new ward manager post which they appointed to in July 2018.

Since our previous inspection there was a Mental Health Act review of the hospital in August 2017. Concerns included mental capacity assessments not always including details of information given to patients and section 17 leave forms not specifying the conditions of leave. During our inspection, we found evidence that the hospital had resolved both these issues. The Mental Health Act review also raised concerns about records not showing carer involvement. During our inspection we found that this was still an issue.

Updated 21 December 2018

We rated The Willows as requires improvement because:

• There were issues with the reliability and safety of clinic room equipment and supplies including portable appliance testing, calibration of equipment and some supplies being out of date. The provider did not detect these issues through their own monitoring processes.
• There was a restrictive practice relating to patients having section 17 leave suspended if they did not request their medication on time.
• Patient records did not show carer involvement. We previously raised this issue during a Mental Health Act review of the hospital in August 2017. It remained an issue during our inspection.
• There were recording errors on patient capacity forms. The provider did not detect this issue through their own monitoring processes. Staff corrected the error when we raised it with them.
• Staff we spoke to were not confident in the rights and management of informal patients. This did not affect patient care since the hospital had never admitted an informal patient. However, the hospital could accept informal patients. The provider had a protocol for the management of informal patients.
• Not all patients had clear discharge plans.

However,

• The hospital provided safe care. The ward environment was safe and clean. The ward had enough staff. Staff assessed and managed risk well and managed medicines safely.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients in a mental health rehabilitation ward and in line with national best practice guidance.
• The ward team included or had access to a range of specialists required to meet the needs of patients on the ward. Managers ensured staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients.  They actively involved patients in care decisions.

Updated 21 December 2018