Archived: Bestwood

Updated 23 February 2017

Bestwood is an independent hospital for people who are detained under the Mental Health Act. The location provides a locked rehabilitation service and people live in their own self-contained apartments with their own garden. The hospital aims to provide slow stream rehabilitation into a community setting for individuals who may have come from settings of increased security. On the day of our visit, there were two residents. Four apartments were empty. Specialist nursing care is available and provided at the service. This includes learning disabilities.

The hospital has a secure gate to the site and visitors cannot enter freely.

At the time of our inspection, Bestwood had been under new ownership for a month by the new owners St Andrews Healthcare. There was no registered manager. The proposed registered manager was present on the day of our inspection and we were aware the proposed manager had made an application to the Care Quality Commission (CQC) and the application was under consideration.

The CQC had inspected the hospital on 20 May 2013 and 27 February 2015. At the February inspection we found the provider had not met Regulation 9 HSCA (RA) Regulations 2014 Person-centred care, Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment and Regulation 17 HSCA (RA) Regulations 2014 Good governance.

A warning notice was issued in relation to Regulation 17. A follow-up inspection took place on 21 July 2015. At that inspection, all requirements had been met.

Updated 23 February 2017

We rated this service as requires improvement because:

• Staff did not update care plans regularly enough and although care plans did show some patient involvement they did not show the plans had been developed in a collaborative way. This meant changes in care may not be carried out correctly and patients may not have discussed choices about how their care is given. Staff were in the process of reviewing care plans in accordance with the new owner, St Andrews policies and procedures.
• Patients did not have enough meaningful activities, which meant the patients were not being prepared sufficiently for a move into the community.
• Staff had not received regular supervision.
• Not all staff had completed mandatory training and the uptake of specialist training was low.
• Staff had not received training in the Mental Health Act, although staff showed a good understanding of their responsibilities.
• Not all staff had undertaken Mental Capacity Act training.
• Staff did not review capacity and consent assessments for day to day decision making.
• The provider did not involve patients and staff with the running of the service.
• There were no patient or staff surveys, or community meetings to gain feedback on patient care provided by the previous provider.
• There had been no community meetings or surveys to assess any patient feedback around their care provided by the previous provider.
• There were no easy read information leaflets about patients’ rights, or information on how to complain on display.

• The use of stable doors on the flat entrances created confusion over whether the patient was secluded, segregated or being observed.

However:

• At the time of the inspection a new provider, St Andrews, had been managing the service for a month. Although there was more still to do, it was evident the provider had introduced many positive changes. The changes introduced had only recently been implemented and did not affect the ratings in this report.
• Carers said they were involved and felt staff kept them informed.
• Patients said nurses treated them in a caring way, with respect and dignity.
• St Andrews senior management staff had visited the hospital and staff had visited other locations within the organisation.
• There were enough staff to meet patient needs and services kept patients ‘safe from avoidable harm’.
• Staff felt positive about the new provider St Andrews and reported an increase in morale.

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Updated 23 February 2017