The Care Quality Commission
  • Mental Health
  • Independent mental health service

The Hamptons

Overall: Requires improvement read more about inspection ratings

Gough Lane, Bamber Bridge, Preston, Lancashire, PR5 6AQ (01772) 646650

Provided and run by:
Active Pathways Limited

All Inspections

During an assessment of Long stay or rehabilitation mental health wards for working age adults

Date of assessment: 04 March 2025 with an additional day on the 12 March 2025.

The Hamptons is a High Dependency Rehabilitation Unit for men with mental health needs between the ages of 18 and 65 years old. It has 14 beds and can admit both informal and detained patients.

We rated the service as Requires Improvement. We found 2 breaches of the regulations in relation to safe care and treatment and governance.

Although the service had governance processes and procedures in place, these did not always operate effectively, and it was not always clear that managers had appropriate oversight and monitoring of these processes. We identified gaps in various documentation that we reviewed, along with inconsistencies with how certain information was recorded and located.

The service did not have a current ligature risk assessment in place at the time of the assessment. The previous ligature assessment had been due for review in November 2024. A review of the risks had taken place in February 2025 but had not been fully written up.

The maintenance system did not clearly document and allow for effective oversight of ongoing maintenance issues within the service.

Patient prescription charts had not been fully signed when all medications had been administered.

Staff supervision compliance rates were low in the months prior to the assessment. Mandatory training compliance was also low for certain courses with 22 courses not meeting the provider’s 80% target.

There were some significant gaps identified in the weekly physical observation checks and it was not clear how managers were assured that these were being monitored. There were also inconsistencies in the recording and locations of certain documentation.

However, there were enough staff to ensure patient safety and meet their needs. Patients were supported to have choice and control and could give feedback on their care. Staff felt supported within their roles and gave positive feedback about working for the service. Managers were passionate about the service and were keen to continue to make improvements.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

88% of staff had received training in the Mental Health Act. Staff were trained in and had an understanding of the Mental Health Act, the Code of Practice and the guiding principles.

Staff had access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

The provider had relevant policies and procedures that reflected the most recent guidance.

Patients had easy access to information about independent mental health advocacy.

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 that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.

The service displayed a notice to tell informal patients that they could leave the ward freely.

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

96% of staff had had training in the Mental Capacity Act.

Staff had a good understanding of the Mental Capacity Act. Staff gave examples of how capacity was considered within the service. Staff knew where to get advice from within the provider regarding the Mental Capacity Act.

Staff took all practical steps to enable patients to make their own decisions

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

During an assessment of the hospital overall

Date of assessment: 04 March 2025 with an additional day on the 12 March 2025.

The Hamptons is a High Dependency Rehabilitation Unit for men with mental health needs between the ages of 18 and 65 years old. It has 14 beds and can admit both informal and detained patients.

We rated the service as Requires Improvement. We found 2 breaches of the regulations in relation to safe care and treatment and governance. 

Although the service had governance processes and procedures in place, these did not always operate effectively, and it was not always clear that managers had appropriate oversight and monitoring of these processes. We identified gaps in various documentation that we reviewed, along with inconsistencies with how certain information was recorded and located.

The service did not have a current ligature risk assessment in place at the time of the assessment. The previous ligature assessment had been due for review in November 2024. A review of the risks had taken place in February 2025 but had not been fully written up.

The maintenance system did not clearly document and allow for effective oversight of ongoing maintenance issues within the service.

Patient prescription charts had not been fully signed when all medications had been administered.

Staff supervision compliance rates were low in the months prior to the assessment. Mandatory training compliance was also low for certain courses with 22 courses not meeting the provider’s 80% target.

There were some significant gaps identified in the weekly physical observation checks and it was not clear how managers were assured that these were being monitored. There were also inconsistencies in the recording and locations of certain documentation.

However, there were enough staff to ensure patient safety and meet their needs. Patients were supported to have choice and control and could give feedback on their care. Staff felt supported within their roles and gave positive feedback about working for the service. Managers were passionate about the service and were keen to continue to make improvements.

We have asked the provider for an action plan in response to the concerns found at this assessment.

 

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

88% of staff had received training in the Mental Health Act. Staff were trained in and had an understanding of the Mental Health Act, the Code of Practice and the guiding principles.

Staff had access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

The provider had relevant policies and procedures that reflected the most recent guidance.

Patients had easy access to information about independent mental health advocacy.

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 that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.

The service displayed a notice to tell informal patients that they could leave the ward freely.

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

96% of staff had had training in the Mental Capacity Act.

Staff had a good understanding of the Mental Capacity Act. Staff gave examples of how capacity was considered within the service. Staff knew where to get advice from within the provider regarding the Mental Capacity Act.

Staff took all practical steps to enable patients to make their own decisions

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

23 & 24 August 2022

During an inspection looking at part of the service

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

  • There was no emergency medicines stored in the service. This did not meet the requirements of the guidance which stated they should have a minimum of adrenaline.
  • Staff were not receiving autism and learning disability training which is now a requirement of the Health and Care Act 2022.
  • Registered staff were not receiving immediate life support training which is a requirement of Resuscitation Council UK.
  • The service had commissioned MAYBO as an accredited provider for Bild Association of Certified Training, which complies with the Restraint Reduction Network Training Standards. However, this should have been introduced in April 2021 and there was only 60% compliance at the inspection, meaning there was not enough trained staff to ensure staff could respond to incidents.
  • Staff records did not meet the requirements of Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We reviewed five staff files and there were gaps in three of the records.
  • There was no oversight of the induction of agency staff. There were five agency induction checklists missing for agency staff that worked in the two weeks prior to the inspection.

However:

  • Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Medicines were managed safely.
  • Records showed regular supervision and appraisals took place. Appraisals included the 360 feedback from patients.
  • Patients spoke positively about the service, including the improvement in the food, following a new chef starting.

13 and 15 November 2017

During a routine inspection

We rated The Hamptons as outstanding because:

  • The service had a person-centred approach to recovery. Patients were involved throughout their care and recovery plans. Individual goals and objectives were identified with each patient to help them achieve their preferred outcome. Staff respected and valued patients as individuals.
  • There was a clear governance structure in place and the registered manager had a strong and thorough oversight of the service. This structure helped to drive improvements to create high-quality person-centred care. There was evidence that actions were taken to resolve issues and there were reporting processes in place. There was a full range of audits completed to monitor performance and to drive improvements.
  • Staff at all levels displayed an understanding of the individual needs of patients and these were highly valued. Staff considered these needs throughout the care and treatment of patients. Patients and relatives were universally positive about the staff and how they would make time to assist patients.
  • The morale of staff was high and they reported strong working relationships with their colleagues. Staff felt supported by management and that they were encouraged to raise concerns with them. Staff spoke highly of the culture. Staff felt that senior management listened to them and included them in the development of the service.
  • The service encouraged feedback from patients and staff in a positive, innovative and inclusive manner. The ‘Champions model’ allowed all patients and staff to develop the service. This gave patients a true voice in how their care and treatment was being delivered. It promoted a culture of innovation and inclusiveness to provide a higher quality of care. The 360 degree patient appraisals also gave patients the opportunity to provide feedback about staff and highlight if there were any issues.

17 and 19 August (2015)

During a routine inspection

We rated The Hamptons as good because:

  • The ward environment was clean and in good repair, appropriate environmental assessments were in place, and staff checked emergency equipment regularly. The ward had sufficiently qualified staff to meet the needs of the patients.
  • Staff treated patients with kindness, dignity and respect. Staff discussed patients with us in a respectful manner. All staff had a good understanding of their individual needs. There were good opportunities for patients to be involved in the planning of their care and involvement in the development of the service. There was a good range of activities available to patients.
  • There were no serious untoward incidents or adverse events recorded in the 12 months before the inspection. There was one notable incident related to a registered nurses conduct which was dealt with appropriately. The provider reviewed incident data as part of ongoing governance arrangements.
  • The Hamptons had a timetable of mandatory training for which attendance was good. There was a timetable of attendance for new starters. There was a clinical supervision policy in place and an ongoing timetable of clinical supervision.
  • There was evidence in the care records of comprehensive assessment on referral/admission and ongoing care planning with reference to national guidance. There was evidence of ongoing patient involvement in care. Regular multi-disciplinary treatment MDT meetings were held with the patient’s involvement.
  • There was positive leadership at the hospital, and staff described shared visions and values. The culture was recovery focused, inclusive and person centred. The leadership of the Hamptons was committed to quality improvement. Governance systems and a clear structure were in place to ensure monitoring and management of the hospital.

11 October 2013

During a routine inspection

At the time of our inspection there were 12 people living at 'The Hamptons'. People using the service were all detained under the Mental Health Act 1983. This placed some restrictions on their freedom of choice and lifestyle. We spoke to a number of patients, one visiting professional who visited on the day as well as staff working at the service. Patients told us that they were consulted on a daily basis in terms of what they wanted to do, one person told us, "We have morning meetings every day and we get asked what we want to do".

People's needs were assessed and care and support was planned and delivered in line with their individual care needs. From speaking to staff it was clear that they were able to act appropriately in the event of an emergency such as a fire or a medical issue.

The design and layout of the building was fit for purpose. The premises had recently been refurbished and the number of rooms increased from ten to fourteen.

The provider had an effective system in place to identify, assess and manage risks to the health and safety of people using the service and others.

6 March 2013

During a routine inspection

Patients were all detained under the Mental Health Act. This placed some restrictions on freedom of choice and lifestyle. Patients told us they were able to express their views and were involved in decisions about their support. One person said, “I have lived here for a year. I go to MDT (multi-disciplinary meetings) to say what I want and they always listen to me.”

We found patients’ needs were assessed prior to moving into the service, and that support was planned and delivered in line with individual needs. We found that up to date care plans were in place and staff members knew about the support needs of the patients. We found that risk assessments were carried out in relation to patient’s health, safety and well-being and that plans were in place to manage any risks that were identified.

There was a small amount of equipment in place to promote people’s independence and comfort. Additional equipment was obtained on an individual basis.

We found there was sufficient staff with the right skills to meet the needs of the current patients. One patient said, “The staff are good and the service meets my needs.”

We found that sometimes patient’s outings were cancelled at short notice. The manager was investigating the reasons for this to determine what action needed to be taken

There was an effective complaints procedure in place. A patient said, "The unit manager is very approachable and diplomatic. I would go to him or the other staff if I had a problem.”

12 October 2012

During an inspection looking at part of the service

People told us they were satisfied with the quality of care and support they received. We were told the staffing levels were sufficient to meet the needs of people and that the staff were professional, caring and friendly.

Two of the people we spoke with made various positive comments about the staff team which included,

"The staff have helped me settle in here and assisted me in every way they could.They have gone out of their way to make my life better than it was"

People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to.

28 August 2011

During an inspection in response to concerns

People told us that staff were kind and respected their privacy. We observed staff supporting people in a friendly and professional way and saw that people were being offered choice with regard to menus and activities.

We asked people who use the service what they thought about the care and treatment they received. They responded positively and said they felt supported by the staff team and that they were included in decisions about their care as far as possible. One person commented, 'Nice staff'.

The North West Specialised Commissioning Team(NWSCT) that have responsibility for monitoring the secure provision in the Hospital have visited and expressed a number of concerns which, when taken together, indicate a unit which is failing to deliver a safe and secure service for men who require a low secure environment. The Provider is in discussion with the NWSCT with a view to providing alternative care at the Hospital that will not require a Low Secure provision.

NWSCT recognises that the Hamptons has provided good quality care for many patients, providing rehabilitation services for a number of patients with longer term needs and long histories in care services.

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.