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

Archived: Regency Hospital Heswall

Broad Lane, Heswall, Wirral, Merseyside, CH60 9LE (0151) 342 0270

Provided and run by:
Regency Hospitals Limited

All Inspections

20 November 2013

During a routine inspection

At the time of the inspection visit the registered manager had not been in day to day control of the hospital since September 2013.

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.

22 July 2013

During a routine inspection

This scheduled inspection was brought forward due to concerns raised about the care and support offered to patients. We spoke with three patients. All said they felt respected and valued by the staff team, patients also told us they felt the staff team supported them to work towards their discharge in a positive manner. Care records showed that patients were involved in the care planning process and were supported to set achievable goals.

During the inspection visit issues were identified about how the service identified safeguarding concerns, reported and managed them. Records held about the use and management of restraint were limited and did not provide information about the length of time the restraint was used and how patients were monitored following the restraint.

Regency Hospital Heswall had a non-seclusion policy in place. Records viewed showed seclusion had been used to maintain a safe environment however the required safeguards were not in place to ensure patients' rights were protected. The training record showed the staff team had not received specialised training to enable them to maintain patients' safety and their own.

Staff records showed 12 members of staff had ceased employment at the service since January 2013. Limited work had been undertaken to ascertain the reasons why people had left and to use this information to improve the recruitment and retention processes within the service. The internal monitoring processes were not robust.

8 December 2012

During a routine inspection

We spoke with six of the people who were living at the hospital and we also checked their records. People told us they were involved in making decisions about their care, treatment and future plans. One person spoke about the rehabilitation programme they are on learning new skills and working towards independent living.

Another person told us how they are supported to work, prepare meals for themselves and go out into the local community.

During a check to make sure that the improvements required had been made

Anita Carlton has been registered as manager of the service. The manager sent us the information we requested which showed that Criminal Records Bureau disclosures were applied for with respect to all members of staff employed to work at the hospital.

20 September 2011

During a routine inspection

The Mental Health Act Commissioner spoke to each of the people who was living at the hospital and they were invited to have a private interview with her if they wished to. Four people had an interview with the Commissioner and she also checked their records. The four patients spoke positively about their care and treatment and said that they feel positive about their care pathways.

We spoke with a Community Psychiatric Nurse who supports one of the patients living at Regency Lodge. He told us 'I think Regency Lodge are doing very well. I have worked with this person for five years in three different services and Regency Lodge is doing best. I have no concerns, they are spot on. They listen to any advice I give and are constantly reassessing. They don't give up on people.'

The Mental Health Act Commissioner found that since her last visit there have been a number of significant developments, in particular the introduction of the 'ISIS' rehabilitation and recovery programme. She found that:

This has been welcomed by patients, staff and carers. It is a specialised individualised therapeutic programme which incorporates a person-centred approach. This is designed to develop and enhance personal recovery in a systematic way. The result has been the rehabilitation of three patients and several now moving towards this. The programme is to be commended for the clarity of care planning and care pathways. The Commissioner also noted that there was now an well organised documentation system in place.

Patients expressed confidence in the new Responsible Clinician and their treatment plans.

During our visit we saw that patients were offered a choice of what they would like to eat and had facilities to make their own drinks.

One patient told the Mental Health Act Commissioner that he recently had to be restrained by staff. In discussion it was apparent that the hospital had followed the Code of Practice requirements as outlined in the Code of Practice 15 (Safe and Therapeutic Responses to Disturbed Behaviour). The patient said that his behaviour was managed by appropriate restraining techniques and he indicated that he had been de-briefed and understood the reasons why restraint had been necessary and how to prevent similar situations occurring.

We spoke with the pharmacist who is currently working with the hospital to improve their medicines procedures. She told us that they have very recently changed to a system whereby all medicines are supplied for individual patients rather than being from a stock supply. She has provided two full days training which has included both nursing staff and support staff. She carried out a detailed audit and found that improvements were needed to the way that medicines were managed and considered that the senior staff were 'keen to improve'. She is continuing to support the service in implementing the new policies and procedures and ways of working and considered that there would now be a much clearer audit trail of all medicines entering the hospital.

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.