18 October 2023
During a routine inspection
Our rating of this location improved. We rated it as good because:
- The hospital was clean and well maintained. Cleaning records were up to date and the wards were bright, airy, well-furnished, and fit for purpose. The hospital had a dedicated maintenance team, we saw all staff had access to an electronic log, where issues were prioritised, actioned in a timely manner and signed off on completion.
- Staff completed risk assessments for each patient on admission, using a recognised tool, and reviewed this regularly, including after any incident. Staff documented the individual risks for each patient and acted to prevent or reduce them. Staff we spoke were aware of what strategies to use to minimise and manage risks and how to support individuals when they posed a risk to themselves, others, or their environment. Accurate risk information was handed over and recorded in the morning management meeting.
- Staff followed National Institute for Health and Care Excellence (NICE) guidance when using rapid tranquilisation. They ensured it was recorded in the care record and an incident form completed. The hospital incident reporting system would not allow the incident to be closed unless all physical health checks had been completed and recorded appropriately.
- Staff completed a comprehensive assessment of each patient either on admission or soon after. We looked at six care records, all of which reflected patients’ assessed needs and were holistic and recovery oriented.
- Managers supported staff with appraisals, supervision, and opportunities to update and further develop their skills. Staff supervision and appraisal rates were 100%. They identified any training needs and gave staff the time and opportunity to develop their skills and knowledge. Staff received specialist training for their role, for example Oliver Mc Gowan training, diabetes, oral health and learning disability. Staff told us managers were supporting them to undertake a master’s degree.
- We saw “you said - we did” boards on all wards. Patients had provided feedback and suggestions which they recorded on the boards. Managers had acted upon feedback for example; we saw white boards had been installed in bedrooms where patients could write down the name of their nurse, and more evening activities had been planned and a new washer/dryer had been purchased.
- We saw staff involved patients in decisions about the service, when appropriate for example suggestions on the décor, menu choice and therapeutic activities. Staff and patients attended weekly community meetings where topics discussed included the environment, meals, patient involvement opportunities, achievements and celebrations and staying connected with family and friends.
- Leaders were visible and approachable, not only to them but for patients too. Staff told us leaders often visited the wards and would work shifts to support the team and were always available whenever for whatever they needed. They confirmed development opportunities for career progression were available and were encouraged to take these up.
However:
- Staff used a range of rooms and equipment to support treatment and care, however there was no dedicated spaces for therapeutic activities which were undertaken in dining and lounge areas.
- We found left over medicines from a patient who had been discharged in cupboards on two wards. We brought this to the attention of the nurse in charge who disposed of the medicines immediately.
- We were concerned that governance systems and processes were not sufficiently embedded so that when the patient numbers and acuity increase, they remain effective to support the operational performance of the service.