All inspections: The Lanes - Care Quality Commission

The Lanes provided personalised care to patients at the hospital. Patients were involved in their care planning and took part in a range of individual activities. Monitoring of patients physical health was good.

Staff understood patients needs very well. The arrangements for staffing ensured all staff knew patients well and that care was consistent. Risk assessments were reviewed and updated. A number of audits took place regularly and the multidisciplinary staff team worked well together.

However, information was displayed for patients but this was not in an 'easy read' or pictorial format. Two patients did not have consent or authorisation certificates for medicines. Ratings scales or outcome measures were not used to assess patients progress. The frequency of staff supervision was inconsistent.

The Lanes

Core service provided: Long stay/rehabilitation mental health wards for working age adults

Male/female/mixed: male

Capacity: 18 beds

Mental Health Act responsibilities

Seven patients were detained under the Mental Health Act 1983 (MHA). Most MHA documentation was available and completed appropriately. However, two patients had previously had authorisation (T3) certificates. Both patients were subsequently assessed as having the capacity to consent. Consent (T2) certificates were then completed. Later, both patients were assessed again as not to have capacity regarding medicines. We were unable to locate current T3 certificates for both patients authorising treatment. There was no evidence that a Second Opinion Appointed Doctor (SOAD) had been requested or had examined either patient.

Most patients were informed of their rights under the Mental Health Act (MHA) on a regular basis. However, for one patient we were unable to find evidence that they had their rights explained to them for over one year.

Mental Capacity Act and Deprivation of Liberty Safeguards

We did not specifically look at this area during this inspection. However, we noted that a patient was currently subject to a Deprivation of Liberty Safeguards authorisation. We also noted that there had been a best interests decision for one patient. This had concerned the patients’ physical health.

We spoke with four people using the service. One person told us, 'It's alright, the staff are okay.' Another person told us, 'It's better than some places. I get on with my life.' One person told us, 'They don't push us around, they ask us to do things.'

At our previous inspection on 22 March 2013, we issued a number of compliance actions in relation to various aspects of the service. We have revisited these areas and found considerable improvements had taken place. Since November 2013, the provider had been working with an external company, Careport, which had been appointed by the Receiver. The provider and Careport were working to improve overall standards with a view to selling the service as a going concern.

We found that the service dealt appropriately with consent issues. Care plans and risk assessments had been updated and were person centred. People using the service were involved in care planning and plans were reviewed regularly or in response to changing needs. People were protected from abuse.

We reviewed the support for staff to provide safe and appropriate care and treatment to people using the service. We found that training had been provided for staff and an ongoing cycle of training had been planned. Staff attended regular supervision meetings. There were processes in place to assess and monitor the quality of service provided and there was an appropriate system for complaints that was brought to the attention of people using the service. We checked records and found they were up to date, relevant and readily accessible.

At the time of our inspection there were twelve people using the service. During our visit we spoke with four people who use the service and four staff. We also used information from a recent visit by a Mental Health Act (MHA) Commissioner.

People who use the service told us they were involved in the decision to move to the service and they liked the activities provided. We saw staff being respectful and talking to people in a friendly and caring way.

We found that staff were not provided with training and support in their work, to ensure that they were competent and skilled to meet people's needs.

People were not informed about how to make a complaint and there was a lack of records to show that the service was being run in the interest of the people who use the service, or that staff received any training and support for their role.

We spoke to a number of people who use the service, they told us that they like to be called residents. They told us that they feel their human rights, their dignity and privacy are respected and that they are given choices about the care and treatment that they receive at the Lanes. They told us that they have choices about the social activities that they do and the food that they eat.

We spoke to five residents about their care plans, they told us they knew they had one, which most believed they could see if they wanted to by asking either their key worker or the Manager. One person said, 'I have a care plan'its kept in the office', 'I've been to meetings about my care plan', another said 'I have not read my care plan recently but I can see it if I want to'.

Most of the residents we spoke to told us that they enjoyed the food provided by the project. Some told us that they participate in cooking sessions with the occupational therapist and got to cook and eat meals they enjoyed. All said that they were able to have tea and coffee and snacks when they wished.

We spoke to a number of residents about whether they felt safe living at the Lanes Project. The feedback we received was positive and included such comments as ' 'staff look after us' I tell my key worker if I have a problem'. Another resident said, 'I trust the staff here...I think they make sure we are safe and well cared for'.

Residents told us that they receive their medication as required and from what staff told us about how they handle medicines, they are handled safely and appropriately. Staff follow published guidance about the safe handling of medicines.

Residents told us that they were very happy with the overall d'cor, comfort and appearance of the project. Three residents showed us their rooms and they all told us that they were very happy with them. One resident said, 'I like my room, I have a good view and I have all my electronic gear in there that I want. My bed is comfy'. Another resident said, 'Yes my room's ok, I like it anyway', whilst another resident told us, 'It's alright here, it's not bad my room'. We found that The Lanes Project was meeting this essential standard.

Staff members, the Manager and the Operations Director all told us about the Unit's recruitment process. From what we were told by these people and from the information that we saw at the site visit on staff files that we reviewed we found that the provider is meeting the essential standard regarding requirements relating to workers. This is because the provider has sufficiently robust recruitment checks in place to ensure it employs the right calibre of staff to meet the health and welfare needs of the residents, as well as keep them safe.

All the residents we met told us they felt confident staff would always take their concerns seriously and look into them. They all knew what to do and who to speak to if they had a complaint.

The Manager told us the service had received a number of formal complaints about its operation in the past twelve months, which had all been taken seriously however the complaints record needs to be improved so that it reflects whether the complaints have been dealt with to the satisfaction of the people who raised them

Archived: The Lanes

All Inspections

20 May 2015

During an inspection looking at part of the service

The Lanes

21 January 2014

During a routine inspection

22 March 2013

During a routine inspection

26 January 2011

During a routine inspection