Three Valleys Hospital

Updated 18 March 2024

Three Valleys Hospital has been registered with the Care Quality Commission since August 2013 to carry out the following regulated activities:

• Assessment and treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder or injury
• Diagnostic and screening procedures

Three Valleys Hospital is an inpatient locked rehabilitation service. It is a registered location of Elysium Healthcare Ltd. The service provides care for a maximum of 43 male and female patients across five wards.

Long stay or rehabilitation mental health wards for working age adults

• Ingrow is a 12 bedded female rehabilitation ward.
• Winfield is a four bedded ‘step down’ unit

Ingrow and Winfield ward are registered together and had the same manager and staff team.

• Oldfield is a 12 bedded male rehabilitation ward.
• Steeton is a six bedded ‘step down’ unit, designed to provide support for patients from Oldfield ward who are closer to discharge.

Oldfield and Steeton ward are registered together and had the same manager and staff team.

Wards for older people with mental health problems

• Oakworth ward is a nine-bedded service for men with a primary diagnosis of dementia or related neuropsychiatric conditions whose physical illness or frailty contributes to, or complicates, the management of their mental health problem.

The Care Quality Commission previously inspected Three Valleys Hospital in 2018. We rated the service as good across all domains. No breaches of regulation were identified at that inspection.

The hospital had a registered manager at the time of our inspection.

What people who use the service say

We spoke to 10 patients and 7 carers. Patients mostly told us that staff were polite, respectful and caring. Carers were positive about staff; telling us they were friendly, approachable and supportive. We observed warm and caring interactions between staff and patients and staff seemed to know patients well. Patients told us staff were visible on the wards and that there were enough staff to facilitate leave and run activities. Two patients on Oakworth ward said they did not always feel safe on the ward but felt able to raise concerns with staff. Patients said they had access to activities and could choose whether they participated or not but also told us activities were not available 7 days a week. Most patients told us there was a good choice of food on the ward.

Most carers said communication was good and that they felt involved in their loved one’s care. However, 1 carer did not feel fully involved or informed about their loved one’s care. Carers told us they had received an information pack with details about how to give feedback or make a complaint. Several carers told us they wanted to thank the ward team for all they did for their relatives.

Updated 18 March 2024

Our rating of this location went down. We rated it as requires improvement because:

• The hospital was not well equipped, well furnished, or well maintained. Two communal bathrooms were cluttered and not accessible. Decor was tired with peeling paint and there was damage to areas of flooring. Some of the walls were stained and the ensuite bathrooms had staining around the top of the wall and ceiling. Some of the fixtures were in a poor state of repair and some of the furniture needed replacing. The internal doors were heavy and a person using a wheelchair independently could not safely access all areas of the service without support.

• Oakworth ward decor was not dementia friendly to aid orientation of the ward for patients. The design, layout, and furnishings of the ward did not always support patients’ treatment, privacy, and dignity. Physical observations were sometimes taken in communal areas or areas that lacked privacy and there was a lack of observation panels in patients’ bedroom doors.

• Dementia training and training in relation to caring for older people was not mandatory and was not always completed by staff.

• Oakworth ward did not hold regular community meetings, and this had been raised as a concern at our previous inspection.

• There was a large number of care plans which made finding available information difficult for staff. There was no formal system for auditing the quality of care plans.

• Not all risk assessments were up to date.

• Psychological treatments were limited at the time of our inspection, although the provider had recruited a clinical psychologist and was in the process of providing a greater range of psychological treatment options for patients and support sessions for staff.

However:

• 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 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 supervision and appraisals. The ward 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, families, and carers in care decisions.

• The service worked to a recognised model of mental health rehabilitation. It was well led and the governance processes ensured that ward procedures ran smoothly.

Updated 18 March 2024

Our rating of this service stayed the same. We rated it as good because:

• The wards had enough nurses and doctors. They minimised the use of restrictive practices and followed good practice with respect to safeguarding. Medicines were mostly managed safely although we found some errors in medicines documentation.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They mainly provided treatments to the meet the needs of the patients which were in line with national guidance. 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 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.
• The service worked to a recognised model of mental health rehabilitation. It was well led and the governance processes ensured that ward procedures ran smoothly.

However:

• Although the ward environments were clean, they were not well maintained. Decor was tired with peeling paint and there was damage to areas of flooring, some of the walls were stained and the ensuite bathrooms had staining around the top of the wall and ceiling. Some of the fixtures were in a poor state of repair and some of the furniture needed replacing. The internal doors were heavy and a person using a wheelchair independently could not safely access all areas of the service without support.
• There was a large number of care plans which made finding available information difficult for staff. There was no formal system for auditing the quality of care plans.
• There was evidence of discharge planning in patients’ records but this was difficult to find because it was not collated in 1 place. We found 1 record out of 8 that did not contain discharge plans.
• Not all risk assessments were up to date.

• Psychological treatments were limited at the time of our inspection, although the provider had recruited a clinical psychologist and was in the process of providing a greater range of psychological treatment options for patients and support sessions for staff.

Updated 18 March 2024

Our rating of this service ​went down​. We rated it as ​requires improvement​ because:

• The ward was not well equipped, well furnished, or well maintained. The communal bathroom was cluttered and not accessible. Décor throughout the communal areas and bedrooms was worn and not of a good standard.

• The ward decor was not dementia friendly to aid orientation of the ward for patients.

• The design, layout, and furnishings of the ward did not always support patients’ treatment, privacy, and dignity. Physical observations were sometimes taken in communal areas and there was a lack of observation panels in patients’ bedroom doors.

• Dementia training and training in relation to caring for older people was not mandatory and was not always completed by staff.

• The ward did not hold regular community meetings, and this had been raised as a concern at our previous inspection.

However:

• 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 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 supervision and appraisals. The ward 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, families, and carers in care decisions.