The Care Quality Commission checks whether hospitals, care homes and care services are meeting government standards. Visit our website at www.cqc.org.uk.
- Whorlton Village, Barnard Castle, County Durham, DL12 8XQ
- (01833) 627278
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Type of service
Mental health, learning disability or substance misuse hospital service
Diagnostic and/or screening services, Learning disabilities, Mental health conditions, Caring for adults under 65 yrs, Caring for people whose rights are restricted under the Mental Health Act
Local Authority Area
People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)
Our latest report on this standard published on 11 October 2012
We inspected on 18 and 20 September 2012 during a routine inspection
We checked that people who use this service:
- Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.
How this check was done
We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 September 2012 and 20 September 2012, observed how people were being cared for and talked with people who use the service. We talked with staff.
People experienced care, treatment and support that met their needs and protected their rights.
Reasons for our judgement
People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.
We looked at three people’s care records during our visit. We saw a wide range of risk assessments relating to behaviour and “coping and tolerance plans”. The coping and tolerance plans contained information about what a person did when they were agitated and the action to be taken by staff depending upon the extent of the agitation. We saw these had been regularly reviewed.
The interim service review manager, who was present during the inspection and carrying out a review of the service, told us they were in the process of introducing a new person centred care plan document. (Person centred means they were written in a way to describe the person’s abilities and how they preferred their care needs to be met). This was to also include person centred behaviour care plans instead of the coping and tolerance plans as well as all aspects of a person’s life. We looked at one person’s person centred care plan document which had been completed. This contained information written in easy to understand language, with pictures to help people to understand the information. It included the person’s own goals and aspirations and an action plan about how their individual goals were to be achieved and when. We saw a detailed behaviour care plan had been written to describe, not only what a person did when they became agitated, but what might cause this to happen, for example a noisy environment, so staff could support this person to avoid such situations.
We saw those people who were detained under the Mental Health Act were treated within the requirements of the law with access to Independent Mental Health Advocates.
People told us staff supported them to go to the dentist, optician and attend hospital appointments. One person said “The staff look after us here.”
We looked at people's daily information records which were completed by the staff. These were generally well completed and included reference to visits made by relatives, people's safety, welfare and daily activity.
Following the risk assessment about their ability to manage their behaviours, some people had close observation throughout the day. This meant that one or two members of staff would be at ‘arms-length’ from the person at all times. The interim service review manager explained to us how they were reviewing this in line with current good practise and the “least restrictive principle.” The “least restrictive principle” in services for people who have a learning disability means changing an environment to allow people to take part as much as possible with the least restrictions. This is so people could take part in the same activities as everyone else. It could also describe the least restrictive intervention, where, there is a choice of more than one intervention within a personalised support programme for a person. The interim service review manager told us the provider was reviewing their “observation” policy as they acknowledged a high level of observation was not always the least restrictive way of supporting some people following an incident.
We talked to staff about the people living in the hospital. They clearly had a good understanding of the health and social care needs of the people in their care. All of these measures demonstrated how the provider met people’s health and welfare needs.
We saw there was a full time activities co-ordinator. We talked with them during our visit. They explained how they involved people in developing an activities programme. We saw each person had an individualised activities programme, based upon their likes and aspirations. The range of activities available to people included bike riding, Zumba keep fit, shopping, going to the cinema and going to the pub for a meal or long walks in the countryside.
People described to us the activities they were involved with. One person said “We are involved in activities like going to the pub”. Another person told us they had been out riding their bike that day. We saw people involved in knitting and computer sessions. The range of activities available to people helped to meet their social needs.