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Inspection carried out on 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.

Inspection carried out on 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.

Inspection carried out on 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.

Inspection carried out on 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.”

Inspection carried out on 12 October 2012

During an inspection to make sure that the improvements required had been made

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.

Inspection carried out on 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.

Reports under our old system of regulation (including those from before CQC was created)

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.