Aspen Centre

The Aspen Centre is a purpose-built unit providing specialist treatment for people aged 16 and over who are living with a severe eating disorder. The unit has 16 inpatient beds (one of which is reserved for emergency admissions) with facilities for psychological therapies at the  Dover Street location. Inpatient treatment usually involves a programme of re-feeding or dietary stabilisation with group and individual therapy. Family work is also offered to some people. The outpatient service is offered Monday to Friday during office hours.

People received an effective service from all of the eating disorder teams to help them understand, as well as manage, their illness to stay healthy. People had personalised programmes of care when they were admitted as an inpatient, and they could choose to have their family work with them to help reach their therapeutic goals.

Staff across the service demonstrated a good understanding of safeguarding issues and there were many examples of good identification of and response to concerns. We found that this was not always recorded clearly in files. A better system was needed to ensure risk assessments were always used, concerns were highlighted and shared across the team, and that someone had responsibility for overseeing practice and outcomes around safeguarding.

All of the specialist eating disorder services we visited provided caring support to service users. People told us that they felt that staff were supportive while recognising that the treatment regime may at times needed to be strict. We found that care plans could be improved by being more personalised, and more consideration given to activities for people on the inpatient unit in addition to the therapy programme.

There was a lack of clarity in the staff guidance and training on use of passive restraint and promoting people’s privacy and dignity when restraint was being used.

Family therapy was not routinely considered for family members although this is recommended in national guidelines. It was not always clear that people, particularly those aged under 18 years old, had given informed consent to treatment.

People with eating disorders got a good, responsive service and benefited from the link between the inpatient and outpatient service at the Aspen Centre. People’s needs were well monitored and followed up, helping ensure that the service could identify and respond to their changing needs quickly. There was a good range of therapeutic support for people and staff ensured people were offered help to meet their emotional and psychological needs even when they were extremely unwell.

The service was well-resourced and staff felt valued and supported with good access to supervision and training, although there was no single overall manager for the Aspen Centre. This hampered the coordination of the service; for example there was no clear lead who could lead improvements across the multi-disciplinary team in the areas for development we identified. Arrangements for quality assurance and monitoring of practice also needed to be strengthened.