The Care Quality Commission checks whether hospitals, care homes and care services are meeting government standards. Visit our website at www.cqc.org.uk.
Mary Seacole House
- Lodge Road, Winson Green, Birmingham, West Midlands, B18 5SD
- (0121) 301 1111
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Type of service
Mental health, learning disability or substance misuse hospital service
Assessment or medical treatment for persons detained under the Mental Health Act 1983, Diagnostic and/or screening services, Mental health conditions, Treatment of disease, disorder or injury, 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 20 August 2012
We inspected on 18 July 2012 during a check to make sure that the improvements required had been made
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 reviewed all the information we hold about this provider, carried out a visit on 18/07/2012 and observed how people were being cared for.
The provider was meeting this standard. People experienced care, treatment and support that met their needs and protected their rights.
What people who use the service experienced and told us
With the exception of one person who banged doors and windows at intervals during our visit, patients were generally calm. The person who was banging was agitated because they felt they should not be on the unit. They were further aggravated because they had not got the responses they had wished for at a meeting to discuss their progress. Staff spoke with this person at intervals in a calming manner.
One person who had been admitted the previous night was keen to discuss why they should not be there and their perception of the problems with the NHS. The manager spent time listening to him. This person did not get angry, but appeared content to have someone listen to his views. He did not show any concerns about how he was admitted, merely that he felt strongly that he should not be there at all.
One person we spoke with said that they did not feel safe on the unit. They said they and were attacked and not protected by staff. Discussions with staff and another patient indicated that this person had previously instigated assaults.
One patient we spoke with said that, while there were a number of incidents, staff were “pretty sharp”. By this he meant that staff were quick to respond, frequently defused situations, and were prompt in intervening if anyone was attacked.
During our visit there was a member of staff in the courtyard/garden area, except when it was raining heavily. This meant that patients were able to use this area freely. The area had sturdy seating and lighting, with flowers in sturdy planters, and a well maintained area for football and basketball. We noted one person using the football and goals by themselves during our visit. Most patients were using the courtyard for smoking or just to be outside. The fence, though high, is green and unobtrusive, allowing it to blend with the hedges and trees beyond it. The manager advised that patients cannot be out in the courtyard unescorted, as it would be possible for those athletic enough to scale the fence. The manager advised that a higher fence was a possibility, but they were aware of the concern not to have something too obviously ‘prison like’.
We saw activities taking place during our visit. We saw one-to-one activities taking place in communal areas and in restricted areas. We spoke with the activity workers who showed us the activities schedule, the facilities, and discussed activities and risk assessments for individual patients.
One patient spoke of cooking, pottery, ball games and of using the internet.
Discussions with staff and patients indicated that, where special leave outside the unit was granted, it was enabled and supported by staff.
One member of staff while acknowledging that the clear priority was to stabilise each patients’ mental health, told us that there was scope to re-establish old interests or develop new ones, as part of a therapeutic approach. They gave gardening, cooking and chess as examples.
Each patient had a named nurse. Patients we spoke with were aware of this person. There were ongoing plans for discharge. A community nurse was the care co-ordinator for this. One patient we spoke with said they had seen this person just briefly, once. The manager acknowledged that there is more work to be done in ensuring that the role of care co-ordinator works effectively for everyone.
We looked at two care plans as part of looking in depth at the experience of two current patients. Care records were clear and comprehensive. These included details of physical health checks, triggers for behaviours, medication details and allergies. Diet, food and fluid intake were documented where required.
We saw details of consents and explanations having been given. There were individual plans for managing any aggression and violence with the emphasis on de-escalation. There were recordings of the patient’s views, as well as details of any special needs and how to meet them. There were clear records of observations.
Activity workers also completed detailed notes and had a clear picture of each patient’s needs and progress. Up to date risk assessments helped facilitate and guide activities.
We saw up to date information had been obtained in respect of a recently admitted patient. This had assisted in the formulation of an ongoing care plan.
We were advised that no current patient had physical health needs. Each patient has a health assessment upon admission. A medical member of staff explained this procedure to us.
Patients we spoke with about food did not voice particular concerns or praise for it. “It’s OK”, was one comment. “Not brilliant” was another. One patient noted that people’s different dietary and cultural needs were catered for, but that some people had requests that were not easy to meet. They gave us the example of someone wanting ‘more beef’ as a general request.
More general concern about the food came from a staff member. They noted that while the caterers complied with dietary requests quite promptly, they felt that the overall food quality was sometimes not good. They noted that unless specific foods were requested patients sometimes received poor quality, poorly thought out combinations. They gave macaroni cheese with rice as a recent example of a meal. They felt that a little extra money, time and thought could result in big improvements in food for patients. This staff concern for patient food was typical of the overall concern shown by staff for patient well-being.
One member of staff noted that the food “caters for needs, not necessarily choices”.
The provider might like to note that suitable, good quality food should be an important part of a therapeutic approach.