St Ann's Hospital

Patients' needs were assessed and care and treatment was planned and delivered in line with their individual care plan. At the time of inspection there was a patient with a learning disability admitted onto the ward. The ward was not set up to fully meet their specific needs. The staff team were working hard to minimise the impact on this patient and deliver good care. The manager was liaising with other agencies to resolve the situation promptly.

The staff team had received training in safeguarding adults and there was a system in place for yearly updates. They demonstrated knowledge and understanding about how to make a safeguarding referral and how to ensure the safety of patients.

We spoke with two patients on Twynham ward, four patients on Haven ward and two on Dudsbury ward. We spoke with the nurse in charge of each ward and also staff from each ward. The Mental Health Act Commissioner also spoke with the independent mental health advocate for Bournemouth and Poole.

Patients we spoke with were generally positive about the way they were treated and involved in their care. People were positive about the staff, telling us that they were treated respectfully. At this inspection no one raised any issues that compromised their privacy and dignity. They also confirmed that they had been involved in how their care was planned.

Patients we spoke with who were subject to detention told us that when they had been granted permission to have leave from the hospital, no leave had been cancelled because of staffing constraints.

On all three wards we visited we found that people's needs had been assessed and care plans put in place. Generally, we found that care plans were up to date and any interventions planned had been acted upon. On Haven ward, the Mental Health Act Commissioner found that not all discharge plans had updated into care plans and some important information had not been recorded within a risk assessment.

At our inspection in February 2013 we identified that people's physical health care needs we not always assessed and met. At this inspection we found that people's physical care needs had been assessed and addressed, as well as their mental health needs.

At this inspection we found there had been an improvement in activities provided to keep people meaningfully occupied. People we spoke with were satisfied with the levels of activities provided and told us there were groups, outings and games/sports arranged with patients.

People were safeguarded from the risks of abuse as the trust had training, policies and procedures in place to minimise the potential for abuse to occur.

The trust had taken action to address the issues identified at previous inspections concerning the physical environment.

We visited four of the hospital's six wards, two separate treatment wards for male and female patients, a mixed acute admission ward and a male low secure forensic ward.

We observed some of the day to day activities on the treatment wards.

We spoke with nine patients in order to hear what they thought about the service they received and a range of staff in order to obtain their views about the service the hospital provided. They told us staff were polite and treated them with respect. They told us they could make suggestions at ward meetings about how things could be improved.

Information about the hospital's services and facilities was readily available and accessible to patients.

Arrangements were in place that helped to promote patients dignity and privacy but sometimes this had been compromised.

The provider took steps that ensured as far as reasonably possible at all times there were sufficient numbers of suitably qualified, skilled and experienced persons on duty to meet patients' needs.

There were systems in place to monitor the quality of the service provided at the hospital and identify and manage risk to patients, visitors and staff.

Records we looked at were accurate and up to date which ensured patients were protected from unsafe care and treatment.

Our MHA Commissioners looked at the rights of detained patients to ensure they were upheld. A separate report was produced about this.

We visited five of the hospital's six wards and spoke with sixteen people who had received treatment. One person had been kept in seclusion. We also spoke with a visiting relative and a range of staff members, including the hospital manager, complaints and ward managers, doctors, trained and student nurses, support workers and the Mental Health Act manager.

Where people's wishes were not upheld in relation to the care they received this was because it could prevent them engaging properly in their treatment programmes.

The physical health needs of people were not always included in plans for their care and treatment. Limited leisure activities meant that people's individual needs were not always met.

Safeguarding procedures were robust but the monitoring of the use restraint was not sufficiently robust.

Medication was managed appropriately and safely.

Seclusion facilities were not totally suitable and their use could compromise people's dignity.

There were comprehensive arrangements for managing people's complaints.