The Care Quality Commission
  • Mental Health
  • Independent mental health service

The Spinney

Overall: Good read more about inspection ratings

Everest Road, Atherton, Manchester, Lancashire, M46 9NT (01943) 871779

Provided and run by:
Elysium Healthcare Limited

Important: The provider of this service changed. See old profile

All Inspections

28, 29, 30 June, 6, 7 July 2022

During a routine inspection

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

  • The service provided safe care. The ward environments were safe and clean, and there was an extensive refurbishment programme under way. The wards had enough nurses and doctors. Staff assessed and managed risk well. They managed medicines safely and followed good practice with respect to safeguarding. There was a clear emphasis on honesty and learning when things went wrong.
  • The environment was peaceful and calm. There were extensive grounds that were well maintained, with areas that patients had been involved in building, such as the hope garden.
  • The provider worked with patients to understand their perspective of security and their feelings about it. Patients and carers were actively involved in the provider’s restrictive interventions reduction programme.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They had a clear view of how physical wellbeing and a healthy lifestyle was essential to recovery. They involved patients in developing their care plans and encouraged them to take responsibility as much as they could. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice.
  • There were strong relationships with other organisations, so that patients had options and choices away from the hospital, including education and work experience. Patients had a wide-ranging choice of activities on site. The hospital had outstanding provision that included a gym and sports hall, plus music, art and photographic studios.
  • Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The service understood how physical wellbeing and healthy living supported mental and physical health and was integral to recovery. There was a comprehensive healthy living programme that educated patients about fitness, healthy eating and nutrition. In addition, two physical healthcare nurses supported patients with their physical health needs.
  • 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, and encouraged them to develop their skills and share best practice. 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.
  • There was a clear culture of empowering patients by ensuring they were central in their care. Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They recognised the needs of diverse groups. They actively involved patients and families and carers in care decisions. There was strong support for carers, so they could engage with plans for the service and share their views and experiences.
  • Staff acquired the skills they needed to develop an enhanced programme of specialist care to meet the specific needs of a patient whose presentation was outside their usual expertise.
  • We saw dedicated and motivated teams who worked hard for patients, carers and staff, to enhance their experience and optimise recovery.
  • Staff planned and managed discharge well and liaised with services that would provide aftercare. Staff supported patients to use local services, demonstrating the recovery ethos and emphasis on living in the community. There was good participation with other services and the community that was central to care planning and recovery. As a result, discharge was rarely delayed for other than a clinical reason.
  • The service was well-led, and the governance processes mainly ensured that ward procedures ran smoothly. There was an ethos of joint decision-making. Patients were actively involved in developing the service. This meant that patients were involved in all aspects of service planning and delivery, via a range of meetings from ward community meetings, the patients’ council and governance.

However:

• Some governance processes were not effective. For example, managers did not ensure fire evacuation procedures were carried out according to policy. Some restrictive practices, such as opening mail in front of staff and the practice of selecting patients to be searched in the rehabilitation service, were not individually risk assessed. Some governance documents were not dated.

• There were no risk assessments on Hindsford ward for patient steps without handrails, and no means for patients to call for assistance in one of the communal bathrooms on Lever ward.

• Some medicines on Hulton ward were out of date, and fridge temperatures were not always taken and logged as required.

• On Hulton ward, required checks were not always completed and documented in line with national guidance following the use of rapid tranquilisation.

• Pharmacy visits did not take place consistently and in accordance with contractual arrangements.

• Furnishings on some of the wards were damaged and in poor condition. The communal shower on Hulton ward was in a poor state of repair and did not ensure patients' privacy and dignity.

• Some patients’ advanced statements were not reflective of their current wishes and preferences.

• Patients did not always have access to snacks between meals. Some patients were not happy with the food choices and portion sizes available at mealtimes.

11/04/2018

During an inspection looking at part of the service

We rated The Spinney good for safe because:

  • Staffing levels were appropriate with low staff sickness and limited use of agency staff.
  • Patients all had valid and up to date risk assessments.
  • The environment was routinely reviewed to ensure it was safe and well maintained.
  • All safety equipment was safely and securely held in areas where it was accessible by all those that may need it.
  • The rehabilitation ward allowed patients who were well enough sufficient independence whilst ensuring they remained safe.
  • Safety was an active consideration across the service and was routinely reviewed by ward staff and the senior management team.

However we also found some areas for improvement:

  • Compliance training targets for some mandatory training courses was below the service target.
  • Overall staff appraisal rates for one quarter were below the service target, with nursing and psychology staff in particular showing lowest percentage compliance with appraisals

Following an inspection we follow a set of principles when aggregating ratings using discretion and professional judgement in reviewing all the available evidence.

As the management team at The Spinney had made the improvements within six months from the date of publication of our last inspection report. We re-rated the safe key question from requires improvement to good. Using our aggregation principles, this also led to an overall rating of outstanding for The Spinney because the caring, responsive and well led key questions were previously rated as outstanding and the effective key question was rated as good.

We rated The Spinney as outstanding because:

  • The service tried to minimise the difficulties friends and families could experience when a loved one is admitted into a secure service.
  • The service had established a well-supported network for carers to exchange views and share their experiences.
  • The service had forged excellent partnerships with other organisations to enable it to facilitate opportunities for patients outside the service.
  • The service had good links with other healthcare which meant these providers would visit and offer services to patients on site without the need for them to leave the hospital grounds.
  • Patients were actively involved in how the service was run, participating in community meetings, the patient council, panels and project committees.
  • The service recognised the importance of physical health and wellbeing, with a range of initiatives encouraging a healthier lifestyle, including a 12 week fitness programme.
  • Patients had access to a vast array of varied activities, utilising the various facilities including a gymnasium, swimming pool, sports hall, art rooms, social room, photography suite and music studio.
  • Patient centred care focused on patient recovery and the individual’s potential after hospital.
  • Staff and patients felt valued and that their opinions would be respected.
  • Patients were not subject to restrictive practices which limited or infringed on their rights.
  • The environment across the site was well maintained and situated within large peaceful grounds.

11-13 September 2017

During a routine inspection

We rated The Spinney as good because:

  • The service recognised the difficulties friends and families could have when a loved one is admitted into a secure service. The service had established and maintained a well-supported network for carers to exchange views and share their experiences, the carers’ forum, which held regular meetings and events.
  • The service had forged excellent links and partnerships with other organisations to enable it to facilitate opportunities for patients outside the service.
  • The service had good links with other healthcare providers including opticians, dentists and podiatrists, which meant these providers would visit and offer services to patients on site without the need for them to leave the hospital grounds.
  • Patients were actively involved in how the service was run, from community meetings in each ward to an active patient council, which was also represented on the governance committee. Furthermore, patients participated in staff recruitment panels and project committees focusing on specific service improvement and development initiatives such as developing the new ward.
  • Managers and staff had appropriate systems and measures in place to ensure the safety of patients and staff.
  • The service recognised the importance of physical health and wellbeing, with a range of initiatives encouraging a healthier lifestyle, including a 12 week fitness programme.
  • Patients had access to a vast array of activities and therapies including a sports hall, gym and swimming pool on-site.
  • Staffing levels were safe and staff knew their patients well, even when covering other shifts.
  • Patient centred care focused on patient recovery and the individual’s potential after hospital.
  • Staff and patients felt valued and that their opinions would be listened to and respected.
  • Staff ensured that patients’ risk assessments were regularly reviewed and documented.
  • Patients were not subject to restrictive practices which limited or infringed on their rights.
  • Staff ensured that physical health checks and monitoring were done routinely and reflected patient co-morbidities and the use of medication, which required additional monitoring.
  • The environment across the site was well maintained and situated within large peaceful grounds.
  • Individual wards were kept clean.
  • The complaints procedure was understood by the patients and carers, with posters displayed in each ward outlining the process.
  • Patients were allowed opportunities to take part in their own care.
  • Staff ensured that the emergency equipment and drugs were routinely checked.

However:

  • Some ligature risks had not been captured on the ligature risk assessment audit.
  • On one ward, we saw ligature scissors were attached to the office noticeboard in an office, which was often unlocked when staff were present. This was rectified when this was raised.
  • Not all references of new employees were fully verified.
  • Information about section 61 reviews was not always documented on individual care records though reviews were taking place as evidenced in other documents.
  • Paper case notes and records were not always dated, though in most instances we were told the information was also captured electronically.


The complaints policy and complaint outcome letter did not explain the role of the CQC regarding complaints relating to the Mental Health Act.