- Independent mental health service
Nightingale Hospital
Report from 7 November 2024 assessment
Contents
Ratings - Specialist eating disorder services
Our view of the service
Nightingale Hospital is an independent hospital that provides mental health care and treatment for people who may or may not be detained under the Mental Health Act 1983. The hospital offers general psychiatry, eating disorders, obsessive compulsive disorder and addiction treatment for adults as both inpatients and outpatients. The service provides 3 acute wards for adults of working age, an obsessive compulsive disorder ward, a substance misuse and detoxification ward, and a specialist eating disorder service for adults. The eating disorder ward is located in a separate 9-bedded 3-storey building. Bendall Mews eating disorder unit provides eating disorder services for individuals aged 18 and above. Treatment can be accessed as part of an outpatient, day patient or inpatient programme. We carried out our on-site assessment of the service on 17 April and 13 June 2024 to check on compliance with requirements from the previous inspection in June 2022 and in response to feedback about the service received by CQC. At the previous inspection the eating disorder service was rated Requires Improvement in all key questions except Responsive which was rated Good, leading to an overall rating of Requires Improvement. Overall, we found significant improvements at the service. Patients felt safe in the service, and most relatives of people using the service were positive about staff care and treatment. The environment was clean, and well maintained. Patients said that staff were readily available and generally supported them with kindness. However, they raised concerns about the number and skills of bank or agency staff that worked with them. The ward manager was working to address these concerns. Patients were involved in producing their care plans and completed their own daily risk assessments alongside staff members. There had been an improvement in the governance systems and processes within the hospital following an unsettled period on the ward.
People's experience of this service
We spoke with 8 patients, 4 relatives/carers of patients and an independent advocate who attended the service regularly. Feedback was generally very positive about the service. Patients we spoke with felt safe there. Most relatives of people using the service were positive about staff care and treatment. However, some raised concerns about incidents that had occurred on or off the hospital premises particularly in the winter of 2023. They had been in contact with the hospital management to discuss ways in which systems could be improved. Patients and carers said that the environment was clean, well maintained, with any repairs undertaken swiftly. Patients said staff were readily available and generally supported them with kindness, and knew how to meet their needs. However, patients raised concerns about the number of bank or agency staff that worked with them, who did not always support them sensitively. Patients were aware of actions being taken by the ward manager to address their concerns. Patients said that they were involved in producing their care plans and completed their own daily risk assessments. They said that they were supported with medicines appropriately and provided with relevant information about their treatment. Patients told us that staff helped them to prepare for stepping down to being day patients with appropriate advice and consideration of risks that they would face. Patients reported that there had been an improvement in staff respecting their privacy as far as possible, including knocking and waiting for a response before entering their bedrooms. A family and friend support group was held regularly. Prior to the inspection, a small number of patients and carers were unhappy with how responsive the service was to their concerns, but told us that this had improved by time of the inspection. Patients spoke very highly of the skills, knowledge and experience of the ward manager.