Rushcliffe Independent Hospitals Mill Lodge Hospital Kegworth

We rated Mill Lodge Kegworth as good because :’

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors to keep patients safe. Staff assessed and managed risk well. They minimised the use of physical restraint, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-orientated care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well 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.
• The service managed beds well so that a bed was always available locally to a person who would benefit from admission and patients were discharged promptly once their condition warranted this.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• Patients bedrooms were kept locked and patients had to ask staff to unlock them before they could use them. We raised this with managers as a concern who responded promptly with an action plan, to be completed by 02 December 2019, that would allow patients free access to their bedrooms.
• Staff had introduced set smoking times, this was a blanket restriction. We raised the issue with the managers and by the end of the inspection we saw evidence of, and patients confirmed, the smoking times had been removed and they could go for a vape or cigarette at any time.
• Although the ligature audit was complete, in date and included actions, the actions had not been given a timeframe for completion.
• Multidisciplinary team working needed to be embedded in practice, particularly as managers were moving towards a psychological informed environment (PIE) model approach to patient care.
• Healthcare support workers were not involved in patient care planning or feedback even though they were the people who had most day to day contact with the patients.
• The providers procurement processes were not clear, equipment required by staff for patients’ care was not being supplied in a timely manner.
• Staff in the multidisciplinary team did not have enough computers to enable them to complete their work in a timely manner.