- NHS mental health service
Queen Mary's Hospital
All Inspections
17-21 March 2014
During a routine inspection
Queen Mary’s Hospital is in Roehampton, and South West London and St George's Mental Health NHS Trust provides the three inpatient wards that we visited as part of this inspection.
We found that the services were safe, the wards were clean and staff were aware of risks. There were ways to report and learn from incidents, but improvements were needed in assessing and managing risks to people's safety.
Staff interacted with people who used the service in caring and compassionate . People and their relatives were involved in planning their care, although records did not always reflect this. People were engaged in activities they felt were meaningful and therapeutic. Ward staff listened to people’s feedback and involved them in making positive changes.
Staff often did not have direct access to specialist training. However, they responded to people’s needs by engaging other services and working in collaboration with specialist teams.
The hospital worked well with the general hospital (which is on the same site) regarding people's physical health needs.
We visited the following wards at Queen Mary's Hospital as part of this inspection;
Lavender Ward
Core service provided: Acute admission ward
Male/female/mixed: mixed
Capacity: 23 beds
Rose Ward
Core service provided: Acute admission ward
Male/female/mixed: female
Capacity: 23 beds
Laurels Ward
Core service provided: Acute admission ward
Male/female/mixed: male
Capacity: 23 beds
17 March 2014
During an inspection
13 February 2013
During an inspection looking at part of the service
This unannounced visit to was made to Lavender ward to look at the outcomes for people using the service following these changes. We spoke to nine people using the service, six staff members and one visiting professional during our inspection.
Feedback from people using the service included 'it's ok here, the staff are good', 'I've been looked after really well' and 'everything is ok here'. Seven of the nine people we talked to said that there were generally enough staff around when they needed them with one person reporting ''yes there's more staff around now' compared to their previous experience on the ward. People spoken to said they would still welcome more interaction with staff and said their experience varied according to which staff were on duty.
All of the staff spoken to said that staffing levels on each shift had increased and their feedback included 'things are improving here', 'it's really different now' and 'morale has improved'.
6 August and 6 September 2012
During a routine inspection
6th August 2012 and Lavender ward on the 6th September 2012. We spoke to 23 people using the service and 14 members of staff during our visits.
Listed below is a brief description of the wards we visited:
Laurel Ward - Inpatient ward providing assessment and treatment for males aged 18 to 75 from the Wandsworth area who are experiencing severe mental ill health.
Lavender Ward - Inpatient ward providing assessment and treatment for younger adults of either gender who are experiencing acute mental ill health.
One of our roles as a regulator is to keep the use of the Mental Health Act under review and check that the Act is being used properly. Our Mental Health Act Commissioners perform this work by visiting all places where patients are detained under the Mental Health Act and meet with them in private. A Mental Health Act Commissioner visited Laurel ward on the 15th August 2012 and met with five people who use the service. Their findings are reflected within this report.
Meetings had been held by the host Local Authority in July and October 2012 due to concerns that had been raised about Lavender ward through safeguarding and informal feedback from carers. An action plan had been put in place by the Trust to address these areas of concern that was ongoing.
Feedback was provided to the Care Quality Commission (CQC) from Richmond Local Involvement Network (LINk) in November 2012. They told us that they would be producing their own report for their enter and view visits to Lavender ward in August and September 2012.
Overall comments from people who use the service included 'a great place', 'generally very good', 'this is a good place to be', 'it's been alright here' and 'a good environment'.
The majority of people we spoke to on both wards said that staff treated them with dignity and respect. Comments included 'the staff have talked to me nicely', 'they're ok to you in here', 'the staff treat me well' and 'never unpleasant'.
Individuals spoken to on Laurel ward generally felt that there were enough staff to meet their needs however feedback from people staying on Lavender ward was more varied. People referred to staff on this ward as 'always doing eight things at once', being 'understaffed and overworked' and that 'they are so busy'.
Staff working on Lavender ward told us 'we don't stop ' it's difficult, challenging', 'it's exhausting and frustrating for patients' and 'there are not enough staff'.
Information provided by the Trust to CQC in November 2012 reported that staffing levels had been increased on Lavender ward along with other positive changes made around shift patterns and continued leadership from a Modern Matron. We have reflected the actions taken by the Trust to resolve this important issue in our judgement but we would like to make another unannounced visit to the ward to look at the outcomes for people using the service resulting from these changes.
19 July 2011
During a routine inspection
Specific details of wards and other quotes from people who use the service will appear in the main body of the report.
In general across the wards, people felt that they could express their views and that they would be listened to; this was either via the weekly community meetings or on an individual basis talking to staff. We also received a lot of positive feedback from people we spoke with about the support provided by the Trusts independent advocacy service.
The wards at Queen Mary's Hospital are modern, clean, well equipped and maintained; although some areas are rather stark with no pictures or artwork on the walls.
We received many positive comments about the choice and quality of food on the wards. People with special dietary requirements are catered for including vegetarians and those wishing to eat Halal meat. There is a kitchenette area where people can help themselves to drinks or prepare snacks throughout the day.
Staff at Queen Mary's Hospital are well trained and supported to undertake their work. Some individual staff were singled out by people who use the service as being exceptional in the care that they gave, for their ability to listen and for treating people with dignity and respect.
A common theme that did emerge was people felt disappointed with the amount of quality time they could spend talking with their key-worker or nurse, especially on a one-to-one basis. This was further exacerbated they felt by the number of agency staff on duty who they did not know at all.
People who use the service are not generally involved in developing their own care plans. This has been a trust wide issue which is in the process of being addressed.
How we carried out this review
Two Compliance Inspectors carried out an unannounced site visit of Lavender ward on the 19th of July and one Compliance Inspector visited Rose and Laurel wards on the 20th of July 2011.
During the two day inspection we talked to 14 people who were staying on all three of the Trusts wards at Queen Mary's Hospital, and observed how they were being cared for and treated by staff. We also talked to 14 members of staff, which included: 2 ward managers, 6 mental health nurses and/or care assistants, 2 ward clerks, a modern matron, an occupational therapist, a peer support worker, and a volunteer. Furthermore, we met the relative of someone who was using the service and an independent advocate who was participating in a wards weekly community meeting. We looked around all the wards we visited and scrutinized various information displayed on them and some of the records kept by the Trust and staff on behalf of the people who are using the mental health services at Queen Mary's Hospital.
Listed below is a brief description of all the wards we visited:
Lavender Ward - Inpatient ward providing assessment and treatment for up to twenty-three younger adults of either gender from the Richmond area who are experiencing acute mental ill health.
Rose Ward - Inpatient ward providing assessment and treatment for up to twenty-three females aged 18 to 65 from the Wandsworth area who are experiencing acute mental ill health.
Laurel Ward - Inpatient ward providing assessment and treatment for up to twenty-three males aged 18 to 75 from the Wandsworth area who are experiencing severe mental ill health.
One of the Care Quality Commissions (CQC) roles as a regulator is to keep the use of the Mental Health Act under review and check that the Act is being used properly. Our Mental Health Act Commissioners perform this work by visiting all the places where people who are detained under the Mental Health Act stay and producing visit feedback summary reports and an annual statement regarding their findings.
The Mental Health Act Commissioners last visited Lavender Ward in August 2010, and Rose and Laurel Wards in June 2011. Some of their findings are reflected within the main body of this report.
We would like to thank all the people using the services, managers and staff who contributed to this review and for all their assistance during our visits.