Archived: Cambian - The Willows

Updated 28 June 2016

Cambian - The Willows is a 14 bedded mixed gender inpatient service for patients aged between 12 and 18. It provides care and treatment to patients in crisis who are experiencing mental health issues. At the time of the inspection, two patients were detained under the Mental Health Act (MHA) 1983. In total the service had 12 patients admitted, two of whom were on leave. Patients were either admitted to the unit informally or detained under the MHA.

Cambian Group provides the service from a stand-alone unit located in the rural village of Gorefield, which is approximately four miles from the nearest town of Wisbech. The service provides a teacher to work with those patients who are not well enough to attend the nearby education facility.

The Willows has a registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations.

The service is registered to carry out the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983
• treatment of disease, disorder and injury

The CQC previously inspected Cambian – The Willows on 04 July 2013. Concerns identified during this visit have since been addressed and the service was compliant. A Mental Health Act reviewer inspected the service in November 2015 and found the service needed to look at improving its practice regarding the locked door policy for informal patients. This is the first inspection of Cambian – The Willows using the CQC’s current methodology.

Updated 28 June 2016

We rated Cambian – The Willows as good because:

• Risk assessment and risk management plans were of good quality, consistent and reviewed regularly.

• Staff had a good understanding of the different levels of observation necessary to keep patients safe. They followed the hospital’s policy and documented observations appropriately.

• The service complied with local safeguarding children board procedures and appropriate national guidance. Staff were knowledgeable about safeguarding patients from abuse and had access to safeguarding leads for further guidance.

• Staff completed a comprehensive assessment of the patients’ needs in a timely manner. They held formulation meetings with families and other agencies to develop up to date, personalised recovery focused care plans.

• The service used best practice guidance to improve patients’ self-esteem and confidence and promoted the use of diversionary activities.

• The service manager and clinical lead supported staff, who received regular clinical and managerial supervision. Staff had an annual appraisal of their work performance and were able to contribute with suggestions.

• The multi-disciplinary team (MDT) introduced a ward round book. This encouraged patients to write down what they wanted to discuss but did not feel confident to say in person.

• Staff treated patients with kindness, respect and compassion. They participated in activities and interacted at an appropriate level.
• The service had a clear admissions policy, taking into account the current mix of patients before accepting new admissions, to prevent the recovery of existing patients from being compromised. Staff devised a weekly activity plan offering a range of therapeutic pursuits, with activities provided by external organisations. These included local animal centres and specialised art therapy centres.
• The service provided meals that met patients’ specific dietary requirements. The catering team took into account culture, individual preferences and allergies when producing menus and provided clear information about the ingredients used in each dish.
• The service had a clear organisational governance structure and used key performance indicators to monitor service performance.

However:

• The provider’s Mental Health Act (MHA) policy was not up to date following changes made to the code of practice in April 2015.
• Staff compliance with mandatory MHA and Mental Capacity Act (MCA) training was 55%. We were not assured this training included the MHA revised code of practice.
• The service was not always able to accommodate external activities on a one to one basis.
• Action plans developed from feedback obtained from patients’ contained actions carried over from one plan to another with no end date.

Updated 28 June 2016