Archived: Bushey Fields Hospital

Updated 14 May 2014

Bushey Fields hospital is located in Dudley and offers specialist assessment, care and treatment to adults and older adults who are experiencing mental health difficulties. Bushey Fields hospital has three acute wards. One male ward (Clent), one female adult ward (Kinver), an admission ward (Wrekin) and two older adult wards (Holyrood and Malvern).

Clent ward has 22 beds and Kinver ward has 20 beds. Wrekin ward has 16 beds and a two bed extra care area. Wrekin is mixed gender.

The older adult’s wards are both mixed gender although they do have separate male and female sleeping areas, toilets and bathroom facilities. Malvern ward has 22 beds whilst Holyrood ward has capacity for 17 beds.

Updated 14 May 2014

Clent

Core service provided: Acute admission ward

Male/female/mixed: male

Capacity: 22

Kinver

Core service provided: Acute admission ward

Male/female/mixed: female

Capacity: 20

Wrekin

Core service provided: Acute admission ward

Male/female/mixed: mixed

Capacity: 16 + 2 bed extra care area

Core service provided: Psychiatric Intensive Care Units and health based places of safety

Male/female/mixed: mixed

Capacity:

Holyrood

Core service provided: Older People

Male/female/mixed: mixed

Capacity: 17

Malvern

Core service provided: Older

Male/female/mixed: mixed

Capacity: 22

Bushey Fields Hospital is in Dudley and offers specialist assessment, care and treatment to adults and who are experiencing mental health difficulties. Bushey Fields Hospital has three acute wards – one male ward (Clent), one female ward (Kinver), and an admission ward (Wrekin). It also has two older people’s wards (Holyrood and Malvern).

We found a number of inconsistencies across the different services.

We found that on some wards, staff were not trained to meet the specific needs of the people who use services and this increased the risks to both people using the service and staff.

In the majority of wards there was continuity of care and most staff understood the needs of the people they were caring for. Staff worked with other providers to ensure that transfers and discharges were effective.

There was evidence of good risk assessment taking place and every person’s record we saw had a completed assessment. However, there was not always an associated risk management plan in place to manage the identified risks.

There was a system for staff to report incidents.

Incident reporting was not completed in a consistent manner and we could not see evidence that the results of local audits were analysed and shared quickly enough within the older people’s wards.

On some adult acute wards, we saw examples of learning from audits and incidents being embedded and changes to practice being made as a result.

Some wards were better managed than others and we had concerns about the care environment and treatment on Holyrood ward.

We saw that people were treated with dignity and respect and saw staff and people who use services interacting positively with each other in most wards.

The Mental Health Act responsibilities were discharged appropriately, although actions from previous Mental Health Act monitoring visits were not fully resolved.

Staff were unaware of the future plans for the older people’s service.

We saw evidence that people were nursed in isolation in the extra care areas, were prevented from leaving the extra care area and refused contact with other people.

The staff had not recognised that the practices used in the extra care areas may meet the threshold of seclusion, as defined by the Mental Health Act Code of Practice.

The medicine management team had recently introduced a ‘drop-in’ session to discuss any medicine issues with patients.

There was good collaborative working regarding physical health needs with the general hospital, which is on the same site.

We saw that the health-based place of safety did not meet the recognised environmental standards.

We saw that the older peoples wards were mixed gender and placed people at risk of receiving care that compromised their dignity.

Updated 14 May 2014

The trust does not have a psychiatric intensive care unit (PICU) at any of its locations.  Patients were taken to neighbouring trusts when they required PICU care. There is a hospital-based places of safety (HBPOS) managed by the trust at Bushey Fields. Hospital-based places of safety are also sometimes called section 136 suites. Section 136 of the Mental Health Act is the police power to remove someone experiencing mental distress from a public place to a place of safety. National guidance encourages the use of hospital-based places of safety rather than police stations so that people experiencing mental health distress or crises receive appropriate treatment. We carried out a ‘Mental Health Act admission and assessment focused visit’ to the Dudley and Walsall area in June 2012. As part of this, we considered the use of the hospital-based place of safety at Bushey Fields hospital. We saw positive practice, but also raised issues about compliance with the Mental Health Act Code of Practice and national guidance (see the ‘well-led section for more information).