- Independent mental health service
Nightingale Hospital
Assessment report published 6 August 2025
Contents
Ratings - Acute wards for adults of working age and psychiatric intensive care units
Our view of the service
We carried out a comprehensive assessment of all mental health wards for adults of working age delivered by Nightingale Hospital. We undertook a site visit on 28 and 29 April 2024 and carried out further offsite activities. Our last interview was on 20 May 2025. We carried out this assessment to check on compliance with requirements from the previous inspection in June 2022.
Nightingale Hospital is an independent hospital that provides mental health care and treatment for people who may or may not be detained under the Mental Health Act 1983. The hospital offers treatment for general psychiatry, eating disorders, obsessive compulsive disorder and addiction for adults as both inpatients and outpatients. The service provides 3 acute wards for adults of working age, an obsessive-compulsive disorder ward, a substance misuse and detoxification ward, and a specialist eating disorder service for adults.
At the previous inspection in June 2022 the acute wards were rated requires improvement in all key questions except caring which was rated good, leading to an overall rating of requires improvement. We required the provider to make improvements to ligature risk management, care planning and risk management, medicines management, physical health observations, discharge planning and governance arrangements.
At this assessment we found improvements in all of these areas. Our rating of this service improved. We rated the service as good. The service is no longer in breach of regulations.
Patients told us they felt safe. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
The multidisciplinary team included or had access to a range of specialists required to meet the needs of patients. Managers ensured that these staff received training, supervision and appraisal. The staff worked well together as a multidisciplinary team and with those outside the service who would have a role in providing aftercare.
Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
Staff said they felt respected, supported and valued. They said they could raise any concerns without fear and reported that their concerns were taken seriously. Staff reported they were positive and proud to work for the provider, they described the leadership team as having a focus on staff well-being and ensured a culture promoting good practice, good quality, and safe care and treatment.
Governance processes operated effectively, and performance and risk were managed well.
People's experience of this service
During this inspection, we spoke with 12 patients and 6 carers. Overall feedback from patients and carers was very positive. All patients told us they felt safe at the service and were well looked after. Patients said that staff were kind, helpful and responsive to their needs. They told us that staff were well trained. Comments we received included `I find the staff very helpful, they are all well trained, `The staff are great, no issues', `there are always staff around and I can get help when I need it' and `this is my safe space'. However, two patients told us that night staff could be more caring.
Patients told us the service offered a comprehensive therapeutic and activities program which aided their recovery. They had regular one-to-one sessions with their key nurse and were involved in all aspects of their care and treatment.
The hospital carried out regular patient satisfaction surveys. The overall summary report for 2024 showed that patients were happy with their stay, care and treatment and involvement in their care and discharge planning. The provider used the survey results to identify areas of improvement, to inform service changes and enhance patient care and experience. For example, feedback from the patients on the quality of the environment had contributed to the service carrying out renovations on each ward.
We spoke with 7 carers. All carers spoke positively about the service. Comments we received included `what was nice about the Nightingale, the reception staff were friendly, and visitors always felt welcomed', `staff have been very very good', `staff were very caring and kind' and `I have only positive things to share'.
Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
The service rarely admitted patients under the Mental Health Act 1983. At the time of the inspection, there was one detained patient on the acute wards.
Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. Training on the Mental Health Act was mandatory for staff, and the compliance rate was 98%.
Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. The service had a Mental Health Act administrator that staff could speak with.
Consent to treatment and capacity requirements were adhered to. Medical and nursing staff ensured that initial patient assessments included consent to treatment. Patients were supported to make their own decisions wherever possible.
Staff had access to policies, procedures and administrative support and legal advice on the implementation of the Mental Health Act and its Code of Practice.
Patients had easy access to information about independent mental health advocacy and staff supported patients to contact advocacy services.
Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.
Staff ensured patients could take section 17 leave (permission to leave the hospital) when this was agreed with the responsible clinician. The use of leave from the ward was agreed by the multidisciplinary team.
Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly and so that they were available to all staff that needed access to them.
Informal patients were aware of their right to come and go from the wards as they wished. Staff displayed information on the rights of informal patients on the wards.
Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits.
Mental Capacity Act
87% of staff had had training in the Mental Capacity Act.
Staff had a good understanding of the Mental Capacity Act, including the five statutory principles.
Our observations of staff and patient interactions indicated that consent was sought from patients prior to any care intervention or treatment.
There was a clear policy on Mental Capacity Act and Deprivation of Liberty Safeguards, which staff knew how to access.
Staff took all practical steps to enable patients to make their own decisions.
Staff assessed and recorded capacity to consent clearly each time a patient needed to make an important decision, for example a patient had been assessed as having capacity to refuse physical health care monitoring. Staff gave patients all possible support to make specific decisions for themselves before deciding a patient did not have the capacity to do so.
When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person's wishes, feelings, culture and history.
Staff completed an assessment on admission of each patient's capacity to consent to admission and treatment. Further assessments took place during reviews by the multidisciplinary team.
The service had arrangements to monitor adherence to the Mental Capacity Act. Staff audited the application of the Mental Capacity Act and took action on any learning that resulted from it.