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We are carrying out checks at The Hamptons using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Good

Updated 24 February 2016

We rated The Hamptons as good because:

  • The ward environment was clean and in good repair, appropriate environmental assessments were in place, and staff checked emergency equipment regularly. The ward had sufficiently qualified staff to meet the needs of the patients.

  • Staff treated patients with kindness, dignity and respect. Staff discussed patients with us in a respectful manner. All staff had a good understanding of their individual needs. There were good opportunities for patients to be involved in the planning of their care and involvement in the development of the service. There was a good range of activities available to patients.

  • There were no serious untoward incidents or adverse events recorded in the 12 months before the inspection. There was one notable incident related to a registered nurses conduct which was dealt with appropriately. The provider reviewed incident data as part of ongoing governance arrangements.

  • The Hamptons had a timetable of mandatory training for which attendance was good. There was a timetable of attendance for new starters. There was a clinical supervision policy in place and an ongoing timetable of clinical supervision.

  • There was evidence in the care records of comprehensive assessment on referral/admission and ongoing care planning with reference to national guidance. There was evidence of ongoing patient involvement in care. Regular multi-disciplinary treatment MDT meetings were held with the patient’s involvement.

  • There was positive leadership at the hospital, and staff described shared visions and values. The culture was recovery focused, inclusive and person centred. The leadership of the Hamptons was committed to quality improvement. Governance systems and a clear structure were in place to ensure monitoring and management of the hospital.
Inspection areas

Safe

Good

Updated 24 February 2016

We rated safe as good because:

  • The hospital was located over two floors. The building was clean and well maintained. The layout of the building included some narrow staircases, which meant staff could not always see what was happening in all areas of the building. However, staff demonstrated a good knowledge of these risks and individual risk assessments were in place

  • Emergency equipment was in place and accessible in an emergency. Staff checked it regularly and all equipment and drugs were in date.

  • The ward had sufficient numbers of qualified staff on duty to meet the needs of patients. Staff training and safe staffing were regularly monitored and shortfalls addressed and actioned.

  • Incident data was reviewed as part of ongoing governance arrangements. From February to July 2015, there were nine incidents of the use of restraint. None of these incidents involved restraint in the prone position (face down restraint) and none resulted in rapid tranquilisation.

  • A safeguarding adult’s policy was in place (. Safeguarding training formed part of mandatory training for staff. Attendance was 88% for mandatory training and 77% for online follow-up training.

    However:

  • Some rooms were locked to all patients. Patients were unable to access the kitchen without staff supervision. All facilities for making drinks had been removed from the open areas to manage the risks associated with one patient. This meant the level of restriction was not based on the clinical risks of the majority of patients. This was not in line with the MHA code of practice. There were however plans in place to enable patients to access the kitchen areas.

Effective

Good

Updated 24 February 2016

We rated effective as good because:

  • There was a range of staff specialities and the team consisted of a psychiatrist, psychologist, mental health nurses and occupational therapist. The staff were skilled and experienced in working with this patient group.

  • Policies were in place on the Mental Health Act (MHA) and Mental Health Act Administration was good. Patients had regular discussion and information informing them of their rights under the MHA and the staff we spoke with had a good understanding of the MHA. Mental Health Act training took place annually and attendance was 88%.

  • Paper care records were stored securely and available to all staff when needed. There was evidence in the care records that patients received a comprehensive assessment on referral/admission and ongoing care planning.

  • There was evidence in the patients’ records of a holistic approach to all aspects of care with a good balance between physical healthcare and mental healthcare, and associated issues such as substance misuse. There was also evidence of ongoing patient involvement in care. All the care plans reviewed referred to the National Institute for Health and Care Excellence (NICE) guidance.

  • Regular multidisciplinary team meetings (MDT) were held with the patient’s involvement. Outcome measures such as Health of the Nation Outcome Scales (HONOS) and MDT discussion determined transition through the care pathway. A care pathway is an outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes.

  • An audit programme was in place to check quality issues and assure the following of best guidance principles.

Caring

Good

Updated 24 February 2016

We rated caring as good because:

  • Staff we spoke with and observed spoke in a respectful manner and responded with kindness, dignity and respect to the patients. All staff had a good understanding of patients’ individual needs.

  • There were many opportunities for patients to be involved in the planning of their care and involvement in the development of the service.

Responsive

Good

Updated 24 February 2016

We rated responsive as good because:

  • Bed occupancy had been consistent with 90% occupancy from February to July 2015. The average length of stay at the Hamptons was two years. Staff described the adjoining building Brookhaven as part of the pathway towards community residence and discharge, to aid a quick transition through the anticipated care pathway. We found evidence of comprehensive admission procedures for all newly admitted patients.

  • The care programme approach (CPA) was used as a framework for planning and co-ordinating support and treatment for patients.

  • There was a range of activities available to patients and an opportunity to join in with a recent initiative for therapeutic earnings, where patients received earnings for participation in real work opportunities. Regular community assessments took place with occupational therapy support, and patients took part in a range of community activities such as the library and volunteer work. Patients had spiritual support within the community and one patient told us of attending local churches.

  • Facilities and accommodation were available for patients requiring disabled access.

  • All the patients felt the quality of the food was good and all had the opportunity to make their own food.

  • All complaints were investigated and feedback given to the person making the complaint in the timeframe detailed within the complaints policy. We were informed the service received 18 formal complaints from August 2014 to July 2015. One of these was upheld.

  • Discharge planning was carried out in liaison with the care co-ordinator. Two patients had active discharge plans in place with transition to Brookhaven imminent, at the time of inspection.

Well-led

Good

Updated 24 February 2016

We rated well led as good because:

  • There was positive leadership at the hospital, and staff described shared visions and values. The culture was recovery focused, inclusive and person centred.

  • Governance systems and a clear structure were in place to ensure monitoring and management of the care and treatment provided.

  • Staff told us that managers were supportive and there was good team working at The Hamptons. Staff were given opportunities to give feedback on services and had been encouraged to be involved in service developments.

  • The leadership of the Hamptons was committed to quality improvement. Although the provider did not take part in national quality initiative programmes, senior managers had examples of local initiatives of quality improvement.

Checks on specific services

Long stay/rehabilitation mental health wards for working age adults

Good

Updated 24 February 2016