20 November 2013
During a routine inspection
Most patients spoken with told us they were satisfied with the service they received some comments made were: 'This is the best place that I have ever been in and I've been in institutions all my life the staff are my family and they try to help me out.' One patient did raise some concerns to our attention which have been passed to the relevant authority. Patients also told us there were recurring problems with the wards being short staffed.
We found that the care needs of patients were not always met. For example care records showed that staffing levels had impacted on patients ability to take their section 17 leave (a leave of absence granted to a patient by the responsible clinician under this section of the Mental Health Act 1983) and be involved in therapeutic activities to aid their recovery.
Discussions with the manager and nominated individual indicated that safeguarding referrals had been made to the local authority safeguarding team however we had not been informed. This meant the provider had not been open and transparent in their dealing with us to ensure the safety of patients was monitored effectively.
The environment on Mersey ward did not meet the requirements of the low secure environmental standards. For example parts of the exterior of the building potentially provided patients access to hand a foot grip points that would assist them to abscond from the hospital site.
We checked several staff files. We found that the staff files of four qualified nurses showed their registration with the Nursing and Midwifery Council (NMC) had lapsed. There was no information held in the files to show this had been identified and actioned by the service.
We found that staff did not receive adequate training and support. Staff records showed there was limited information held about the training undertaken and completed by staff. This means that staff may not always have the necessary skills to care for the patients.
There were no effective systems in place to monitor the quality and safety of the service provided. For example serious incident investigations and reports were not robust. They did not effectively review incidents to ensure there was an opportunity to learn from them and change systems and practices to minimise the risk of similar incidents occurring.