24 April 2018
During a routine inspection
We rated Meadow Park as good because:
- Concave mirrors situated in the ceiling allowed full view of the corridors, thereby allowing staff to observe all parts of the ward. Ligature points were noted during the inspection, and the environmental risk and assessment plan showed that these points were considered and action was in place to address issues. The hospital furniture was well maintained, the hospital itself was very clean. Staffing levels were good, and followed policy. Care plans showed evidence of positive risk taking on the part of the staff at Meadow Park.
- Patient care plans were comprehensive, personalised, holistic, and recovery orientated. Each patient had signed that they agreed with their care plans. Positive behavioural support plans were in place. There was evidence of patient involvement in all aspects of their care. There was evidence that staff participated actively in clinical audit. Staff were regularly supervised and appraised. Discharge planning was evident in care records and case files. There was active physical health monitoring at Meadow Park, with a registered general nurse employed to take the physical health lead. Mental Health Act documentation was in order and audited. There was training in the Mental Capacity Act.
- We saw staff interacting with patients at Meadow Park, and it was clear that there were good relationships. Patients stated that staff were respectful, approachable, and interested in patient well-being. Staff were clearly knowledgeable about their patients, and this was reflected in their interaction and notes on case files. Patients commented favourably on the available activities, their named nurses and their plans for the future.
- Patients who were on leave did not have their beds filled in their absence, ensuring the bed was available on return. Patients had access to their bedrooms, and could securely lock the room. There was access to a telephone with a privacy hood, as well as patients having their own mobile telephones. On admission to Meadow Park, patients completed a questionnaire relating to dietary requirements. Likes and dislikes, allergies, and religion were considered.
- Staff knew senior managers; both qualified staff and support workers said that senior managers visited the hospital. Staff used key performance indicators to gauge and improve performance. Clinical audit was being carried out with full staff involvement. Staff felt they could raise concerns without fear of victimisation, and morale was reported as being high among staff. We saw evidence of good team working, and there was a high level of support from the hospital manager and senior staff.
- However
- Although patients had signed to agree with their care plans, there was no evidence to show that patients had received a copy of the care plan. Some patients told us they did not have copies, but that they were involved in the production, so they knew what the care plan entailed.
- Psychologist input was initiated through a service level agreement, but we could not fully determine the levels of input by the psychologist; guidance suggests 0.4 whole time equivalent for a psychologist in a 14-bedded unit, and Meadow Park is a 20-bedded unit.
- There was one full-time Occupational therapist at Meadow Park, a 20-bedded unit. This is the accepted guidance for a 14-bedded unit, and it was felt that an occupational therapy assistant could be utilised to ensure therapies were fully utilised.