8 and 9 September 2022
During a routine inspection
Our rating of this service stayed the same. We rated it as good because:
- Patients told us they felt safe. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
- 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 cared for in a mental health rehabilitation ward and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
- The multidisciplinary team included or had access to a range of specialists required to meet the needs of patients. Managers ensured that these staff received training, supervision and appraisal. The staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
- 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 and families and carers in care decisions.
- Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
- The service worked to a recognised model of mental health rehabilitation.
However,
- NEWS2 charts were not being completed correctly and there were gaps in recording. There was no system in place for auditing the charts.
- Cleaning records for the clinic room did not show when physical health equipment had been cleaned.
- There were a high number of nursing and support vacancies that were covered by bank and agency staff.
- There were some gaps in the provision of the specialist training that all staff needed to work with the current patient group, for example, on topics such as epilepsy and diabetes. Records of emergency scenario simulation training were not available.
- The service did not always escalate concerns to clinical governance meetings and the risk register.