28-29 July 2021
During a routine inspection
Mill Garth is a 21-bed locked rehabilitation and recovery service for men aged 18 years and over who have complex mental health issues.
Our rating of this location stayed the same. We rated it as good because:
The service provided safe care. The ward environments were safe and clean. The 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 knew about any risks to each patient, and there was an ethos of positive risk taking.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of interventions to help patients acquire independent living skills, such as psychological therapies, training and work opportunities, that were suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national guidance about best practice.
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 staff received training, supervision and appraisal. Staff worked well as a multidisciplinary team and with external partners, such as care co-ordinators and other service providers.
Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and their families and carers in care decisions. Care plans were mainly written from the patient’s point of view. Patients were involved in decisions about the service.
Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason. There were links with local businesses and college. Staff helped patients to stay in contact with their families and carers.
The service was well led, and the governance processes mainly ensured that ward procedures ran smoothly. Recent reviews of culture and engagement at the service had positive outcomes. Leaders were focused on continuous learning and improvement.
However:
Patients were unable to progress through the stages of self-medication as they did not have a lockable cabinet in their bedrooms.
Governance systems did not always identify when practice was not in keeping with the provider’s policy.