Waterloo Manor Independent Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. The service was in breach legal regulation in relation to visiting. However, people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We spoke to 11 patients and 3 carers. Patients that we spoke to said they were treated with kindness and compassion. However, two patient said staff did not always knock before entering their rooms.

Staff described how they gave patients help, emotional support and advice to patients when they needed it. Positive behaviour support plans detailed types of emotional support and help patients wanted when distressed. Staff told us depot injections continued to carry out depot injections in patient’s bedrooms as they felt this promoted privacy and dignity for the patients.

Partners had no specific feedback on this area.

Staff were discreet, respectful, and responsive when caring for patients. Staff were respectful when speaking to other staff in meetings about patients and their care. When we visited the wards, observations we made were that staff were displaying caring and compassion towards patients.

Patients said they were treated as individuals, and this was reflected in their care plans. They said staff answered their questions and helped them in relation to leave, care planning and medication. They told us staff provided food to cater for their needs and described questionnaires which gathered information about what worked and what didn't work well.

Staff explained ways in which they were able to treat patients as individuals. Staff and managers explained that there were a variety of foods available to meet cultural/ religious needs for example halal meals.

Staff appeared to know patients and understand their needs. During our time on the wards, we observed staff treating patients as individuals and in a way that was described in their care plans and risk assessments. Staff showed they understood these. For example, during observation of security checks on Hazel ward, staff told us how to engage with patients. We observed an incident on Larch ward where staff supported a patient effectively to calm down.

Care plans and risk management plans helped staff to understand what patient’s individual needs were. Care plans reflected individualised approaches. There was evidence that patients were involved in the development of their care plans and in MDT meetings where their care was discussed and planned.

Patients told us visits happened in the main hospital building rather than on individual wards. They told us “you can have them, but over on the main unit. No one is allowed on here except patients and staff.” One carer told us there were reasonable adjustments in place, so they were able to visit their relative on the ward. This was an exception rather than regular practice. However, patients told us they could keep in contact with family and friends via telephone, section 17 leave and visitors coming to the hospital. Patients gave examples of ways in which they were given independence and choice. For example, accessing the community, and being given choices about which medicines they might use to manage their conditions.

Staff told us visits did not take place on the wards, except for a patient with physical health needs. However, staff and leaders knew how to promote independence, choice and control. They could explain the different ways they worked with patients to promote these.

Patients accessed the community regular, including to local parks and shopping centres. We saw patients being supported to access the community during the assessment visit.

Patients, carers and staff told us visits happened in the main hospital building apart for one patient. This blanket restriction that was not individually assessed, documented on the blanket restrictions log, or subject to regular review. It was also not in line with the MHA Code of Practice guidance which states at 11.4: “Patients should be able to see all their visitors in private, including in their own bedroom if the patient wishes.” This was a breach of regulation 9 (person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. We reviewed the visitor’s policy which stated: “Where possible, dedicated visiting areas are provided, with facilities for children.” It also referred to “visitors coming onto the unit”. This did was not happening in practice apart from by exception. However, a member of staff was employed as a driver, and there was a minibus used for group trips and outings. Care plans and risk assessments showed that patient’s choice and independence was taken into consideration and recorded within the clinical records.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.