Cheswold Park Hospital

Updated 20 September 2021

Cheswold Park Hospital is a purpose-built hospital in Doncaster. Riverside Healthcare Limited is the provider. The hospital is an independent mental health hospital that provides eight low and medium secure accommodation for male and female patients over 18, with mental disorder, learning disabilities and autism spectrum disorder with an offending background, who require assessment treatment and rehabilitation within a secure environment.

The hospital is registered with the Care Quality Commission to provide the following regulated activities:

· Diagnostic and screening procedures

· Medical treatment of persons detained under the Mental Health Act 1983

· Treatment for disease, disorder or injury.

The hospital has a registered manager. The registered manager, along with the registered provider, is legally responsible and accountable for compliance with the requirements of the Health and Social Care Act 2008 and associated regulations. The hospital had a controlled drugs accountable officer on site. Controlled drugs accountable officers are responsible for all aspects of controlled drugs management within their organisation.

The hospital has two medium secure wards and six low secure wards

· Aire – 12 bed low secure for men with mental illness acute admission, assessment and treatment.

· Esk – 12 beds low secure for men recovery and rehabilitation wards.

· Foss - 12 beds low secure for men pre-discharge rehabilitation and recovery.

· Don – 12 beds low secure for men with personality disorder admission, treatment and rehabilitation

· Calder – 16 beds low secure for men with personality disorder rehabilitation and recovery for people with personality disorder

· Wentbridge – 8 beds low secure service for men with a primary diagnosis of high functioning autism and other associated mental health needs.

· Brook – 16 beds medium secure admission, assessment, treatment and recovery service for men with mental illness, mental disorder and dual diagnosis.

· Bronte – 12 beds medium secure admission, assessment, treatment and recovery service for women with mental illness, mental disorder and dual diagnosis.

In June 2021, there was a fire on Don ward and the ward was uninhabitable due to smoke damage. In order to accommodate the patients from this ward, the provider made changes to the wards which included Haven and Goldthorpe wards becoming a temporary Don ward. Haven ward was a medium secure service for people with learning disabilities and associated diagnosis such as personality disorder, mental illness and autism spectrum conditions. The CQC completed 7 Mental Health Act monitoring visits to the hospital between March 2020 and March 2021. Issues identified included inconsistency in restrictions, poor internet connection, lack of patient involvement in care planning, staffing levels and staff attitudes.

During this inspection we reviewed some of these actions and found the hospital had addressed some of the issues identified such as internet connection, patient involvement in care planning however there were still concerns with staffing levels and this led to some restrictions on patients.

We last inspected the hospital in June 2019. We rated this service as ‘good’ overall with ratings of ‘good’ in the effective, caring, responsive and well led key questions, and requires improvement in safe. The hospital was in breach of the following regulations:

· Regulation 12 Health and Social Care Act 2008 Safe care and treatment

· Regulation 18 Health and social Care Act 2008 Staffing

We also suggested some actions which the provider could take to improve the service; including reviews of patients with long term physical health conditions, improved recording and de-brief following incidents of restraint and reviewing policies.

What people who use the service say

Patients told us there was not always enough staff to meet their needs. Some patients told us that leave from the hospital and activities were cancelled as there was not enough staff to support these.

Patients told us most staff were caring, respectful and helpful. Patients told us they had good relationships with regular members of staff, felt supported and listened to. Patients told us that restrictive interventions were rarely used; they were involved in ward rounds and community meetings and could contribute to these. Some patients were also involved in hospital wide meetings.

Feedback from families and carers we spoke with was generally positive. They told us that staff were kind and polite and their level of engagement with the hospital was good. Five family members felt that communication with them could be improved but all families and carers we spoke with confirmed that they are invited to regular meetings and can attend and speak to the patients via video conferencing. All families and carers we spoke with had the opportunity to give feedback and knew how to raise concerns. None of the family members we spoke with had been provided any information regarding their rights to a carer’s assessment.

Updated 20 September 2021

Our rating of this location went down. We rated it as requires improvement because:

· The wards did not always have enough nurses and support workers in order to provide safe care which had an impact on staff wellbeing and led to cancellation of leave and activities for patients.

· Managers did not ensure that all staff received training, supervision and appraisal.

· The governance processes did not always ensure that ward procedures ran smoothly. Improvements the hospital planned to make were not embedded and therefore the effectiveness of the interventions were not evident.

· Patients self-medicating were not always storing the keys to their medication safely.

· There were some incidents not reported consistently across the wards such as low staffing levels, cancelled leave and racial abuse towards staff, although the staff knew how to report and reported patient safety incidents.

· Carers were not aware of their rights to an assessment of their needs.

However:

· The ward environments were safe and clean. Staff assessed and managed risk well. They minimised the use of restrictive practices, kept clear and comprehensive records and followed good practice with respect to safeguarding.

· The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards, including good physical health care. The ward staff worked well together as a multidisciplinary team.

· Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients in care decisions.

· The service treated concerns and complaints seriously, investigated them and learned lessons from the results.

Updated 20 September 2021