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

Grove Park

Overall: Good read more about inspection ratings

2 The Linkway, Brighton, BN1 7EJ (01273) 543570

Provided and run by:
Grove Park Healthcare Group Limited

All Inspections

During an assessment under our new approach

Date of Assessment: 24 April 2025. Grove Park provides accommodation with nursing care for older people with nursing needs and some who were living with dementia. Our assessment was prompted by concerns around care delivery and the previous rating of the service. The provider was previously in breach of legal regulations. Improvements were found at this assessment and the provider was no longer in breach of the regulations. We identified some areas of improvement needed in respect to person centred care planning and systems of governance and audit. However, overall, people received good care that met their needs and protected their rights. The provider had a good learning culture and people could raise concerns. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met people’s needs, were clean and well-maintained. There were enough staff with the right skills and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

People were involved in assessments of their needs. Staff worked with all agencies involved in people’s care for the best outcomes. They monitored people’s health to support healthy living. Staff involved those important to people in people’s best interests where they did not have capacity.

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The provider supported staff wellbeing. Leaders and staff had a shared vision and culture based on listening, learning and trust. Staff felt supported to give feedback and were treated equally. Managers worked with the local community and there was a culture of continuous improvement.

During an assessment of Acute wards for adults of working age and psychiatric intensive care units

Date of assessment: 6 and 7 August 2024

Grove Park is an independent mental health hospital that provides acute services for adults of working age. The hospital has two wards; Sanderson ward is a 9-bedded ward for men and Westbourne ward is a 9-bedded ward for women. At the time of our inspection, there were four patients on Sanderson ward and no patients on Westbourne ward, with the ward being temporarily closed. This was a decision made by the senior leaders at the service due to lower-than-expected patient referral and admissions. Grove Park also has a nursing unit, which is inspected separately.

We assessed all 33 quality statements across the safe, effective, caring, responsive and well-led key questions. The service had previously been inspected in April 2024, with Safe and Well-led looked at, and they received an overall rating of Good, with previous inspection ratings also adding to this from an inspection in February 2023. We conducted this assessment so that we could look at all of the quality statements and give an up-to-date rating. The overall rating has not changed, and the service is rated as Good.

The service provided safe care. The hospital was clean and fit for purpose. Environmental risks such as ligature risks were assessed, monitored and mitigated. Staff protected people from abuse and improper treatment. Staff completed risk assessments for patients and updated these regularly. Care plans guided safe practice. People were supported to have choice and control and were involved in planning their care. The wards had enough staff to keep patients safe and meet peoples’ individual needs. People were supported to have choice and control and could give feedback on their care.

However:

The checklist used by staff to carry out and record their findings from the daily environmental checks they completed was not effective in guiding staff what they should specifically look for to ensure the environment and equipment was well maintained.

The hospital had a shared communal dining room that was accessed by male and female patients at the same time. However, the provider did not have a policy in place to ensure that patients’ sexual safety was maintained.

Incident forms were not always reviewed and signed off by two managers, as per the provider’s own policy and process.

Patient care notes from each staff discipline were not all in one contemporaneous record. Psychology, occupational therapy and the doctors recorded their patient notes separate from nurses. Staff told us they were aware of the risks with this, and plans were in place to introduce a new electronic patient recording system which would resolve this.

Governance systems and audits were not always effective in identifying or addressing areas for improvement.

 

Mental Health Act and Mental Capacity Act Compliance/Mental Health Act

Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice. Managers made sure that staff could explain patients’ rights to them.

Staff received and kept up to date with training on the Mental Health Act and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.

Staff knew who their Mental Health Act administrator was and were positive about the support and guidance given by them on both Mental Health Act, and the Mental Capacity Act.

Staff told us that they would always ensure they explained to each patient their rights under the Mental Health Act in a way that they could understand, repeated as necessary and recorded it clearly in the patient’s notes each time.

We saw evidence of information documents on patients’ rights available in communal areas for both informal and detained patients. However, on the day of the inspection, we saw that the service had not displayed a notice to tell informal patients that they could leave the ward freely and how to do so. We raised this with staff and immediate action was taken to rectify this.

Patients had easy access to information about independent mental health advocacy and the advocate regularly visited the ward to meet with people.

Staff made sure patients could take section 17 leave (permission to leave the hospital) when this was agreed with the Responsible Clinician.

We saw evidence in care plans of staff requesting an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to. Staff stored copies of patients’ detention papers and associated records correctly and staff could access them when needed.

 

Mental Capacity Act

Staff supported patients to make decisions on their care for themselves. They understood the service policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity. Staff received and kept up to date with training in the Mental Capacity Act. Staff told us they regularly discussed capacity and consent during meetings about the patients care and treatment. They also said they would speak to the ward manager or another clinician if they had concerns around capacity.

We saw evidence of capacity and consent recorded in care plans, with capacity to consent to treatment obtained at admission and evidence of this being regularly reviewed. We also saw evidence in care plans of staff attempting to support and engage patients in decision processes before deciding that a patient did not have the capacity to do so. When staff assessed patients as not having capacity, they made decisions in the best interest of patients and considered the patient’s wishes, feelings, culture and history. Staff told us that they held a best interest meeting which would involve the patient, the nursing team, the consultant(s) and the patient’s next of kin, where appropriate.

 

During an assessment of the hospital overall

Date of assessment: 6 and 7 August 2024 Grove Park is an independent mental health hospital that provides acute services for adults of working age. The hospital has two wards; Sanderson ward is a 9-bedded ward for men and Westbourne ward is a 9-bedded ward for women. At the time of our inspection, there were four patients on Sanderson ward and no patients on Westbourne ward, with the ward being temporarily closed. This was a decision made by the senior leaders at the service due to lower-than-expected patient referral and admissions. Grove Park also has a nursing unit, which is inspected separately. We assessed all 33 quality statements across the safe, effective, caring, responsive and well-led key questions. The service had previously been inspected in April 2024, with Safe and Well-led looked at, and they received an overall rating of Good, with previous inspection ratings also adding to this from an inspection in February 2023. We conducted this assessment so that we could look at all of the quality statements and give an up-to-date rating. The overall rating has not changed, and the service is rated as Good. The service provided safe care. The hospital was clean and fit for purpose. Environmental risks such as ligature risks were assessed, monitored and mitigated. Staff protected people from abuse and improper treatment. Staff completed risk assessments for patients and updated these regularly. Care plans guided safe practice. People were supported to have choice and control and were involved in planning their care. The wards had enough staff to keep patients safe and meet peoples’ individual needs. People were supported to have choice and control and could give feedback on their care. However: The checklist used by staff to carry out and record their findings from the daily environmental checks they completed was not effective in guiding staff what they should specifically look for to ensure the environment and equipment was well maintained. The hospital had a shared communal dining room that was accessed by male and female patients at the same time. However, the provider did not have a policy in place to ensure that patients’ sexual safety was maintained. Incident forms were not always reviewed and signed off by two managers, as per the provider’s own policy and process. Patient care notes from each staff discipline were not all in one contemporaneous record. Psychology, occupational therapy and the doctors recorded their patient notes separate from nurses. Staff told us they were aware of the risks with this, and plans were in place to introduce a new electronic patient recording system which would resolve this. Governance systems and audits were not always effective in identifying or addressing areas for improvement.



Mental Health Act and Mental Capacity Act Compliance



Mental Health Act



Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice. Managers made sure that staff could explain patients’ rights to them. Staff received and kept up to date with training on the Mental Health Act and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. Staff knew who their Mental Health Act administrator was and were positive about the support and guidance given by them on both Mental Health Act, and the Mental Capacity Act. Staff told us that they would always ensure they explained to each patient their rights under the Mental Health Act in a way that they could understand, repeated as necessary and recorded it clearly in the patient’s notes each time. We saw evidence of information documents on patients’ rights available in communal areas for both informal and detained patients. However, on the day of the inspection, we saw that the service had not displayed a notice to tell informal patients that they could leave the ward freely and how to do so. We raised this with staff and immediate action was taken to rectify this. Patients had easy access to information about independent mental health advocacy and the advocate regularly visited the ward to meet with people. Staff made sure patients could take section 17 leave (permission to leave the hospital) when this was agreed with the Responsible Clinician. We saw evidence in care plans of staff requesting an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to. Staff stored copies of patients’ detention papers and associated records correctly and staff could access them when needed.Mental Capacity Act Staff supported patients to make decisions on their care for themselves. They understood the service policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity. Staff received and kept up to date with training in the Mental Capacity Act. Staff told us they regularly discussed capacity and consent during meetings about the patients care and treatment. They also said they would speak to the ward manager or another clinician if they had concerns around capacity. We saw evidence of capacity and consent recorded in care plans, with capacity to consent to treatment obtained at admission and evidence of this being regularly reviewed. We also saw evidence in care plans of staff attempting to support and engage patients in decision processes before deciding that a patient did not have the capacity to do so. When staff assessed patients as not having capacity, they made decisions in the best interest of patients and considered the patient’s wishes, feelings, culture and history. Staff told us that they held a best interest meeting which would involve the patient, the nursing team, the consultant(s) and the patient’s next of kin, where appropriate.

During an assessment under our new approach

Date of Assessment: 01 February 2024 to 19 April 2024. Grove Park is operated by Grove Park Healthcare Group Limited. Grove Park is a hospital that has two acute mental health wards for adults of working age, and 2 nursing units for older adults with complex needs. Each of the acute mental health wards has 9 beds and the nursing unit has 58 beds.

We assessed a limited number of quality statements from the safe and well-led key questions and found areas of good practice. The scores for these areas have been combined with scores based on the key question ratings from the last inspection and the overall rating has improved and is now rated good.

We conducted this assessment because we had received information of concern relating to the hospital. We assessed 11 quality statements over safe and well-led. At this inspection we saw that staff were recording incidents and that incident form were reviewed regularly to identify themes and trends. Staff could access reflective practice sessions to review how they felt about incidents and to look at ways they could improve the service. Staff had received training in safeguarding people and could explain what action they would take to keep people safe from abuse. Staff involved people in planning and managing their own risk. Staff reviewed restriction and removed them if they were unnecessary. The hospital employed enough staff to keep the people using the service safe. Staff checked the hospital environment daily to ensure it was safe for the people admitted to the service. The senior leader employed at the hospital had the skills and experience to needed for their roles. Staff felt able to speak up if they had concerns about the quality of care being provided at the hospital. We saw that the multidisciplinary team employed at the hospital worked well together.

However, the hospital director was in the process of embedding new ways of working around governance and learning from incidents.

During an assessment under our new approach

Date of assessment: 13 Aug 04 Sept 2024. Our onsite visit took place 13 Aug 2024.

We assessed the nursing unit and there were 33 people living there. Some elements of the service had improved following our previous assessment, however, the service remained in breach of regulations. There were continued concerns around safe care and treatment, safeguarding, person centred care and governance. We looked at quality statements within the key questions of Safe, Effective, Caring and Well led.

This assessment was undertaken, in part, due to an incident, following which a person using the service died. This assessment did not examine the circumstances of the incident as it is subject to further investigation. Details of the incident indicated potential concerns about the management of falls, so this assessment examined those risks for other people.

Risks to people were not always fully assessed or managed. Staff and managers did not always understand their responsibilities related to safeguarding and had not always submitted statutory notifications to CQC regarding allegations of abuse. Staff did not always respond to peoples calls for assistance in a timely manner. Since the previous assessment improvements had been made in relation to incident reporting and medicines management to ensure safe practice.

Some leadership and governance measures remained ineffective in identifying shortfalls and failed to assess, monitor and mitigate some risks relating to people’s health, safety and welfare. Several changes had been made to the leadership team and a recently appointed manager was working to make further improvements. Although the leadership team were working to improve the culture and listen to staff concerns, some staff indicated that they continued to not always feel safe to speak up.

You can find more details of our concerns in the Safe, Effective, Caring and Well led findings below.

During an assessment under our new approach

Grove Park is a hospital that consists of two nursing units which provides nursing and personal care for up to 62 older people with complex needs, and an acute inpatient mental health service for adults of working age. At this assessment, we only assessed the nursing units and there were 62 people living there. We carried out our on-site assessment on 18 and 25 January 2024, assessment activity started on 13 January 2024 and ended 28 February 2024 We looked at 21 quality statements within the key questions of Safe, Effective, Caring and Well led.

Risks to people were not adequately identified and managed. Incidents affecting people’s health and welfare were not managed safely. Staff failed to understand their responsibilities under safeguarding with respect to identifying potential abuse, escalation and reporting concerns. Blanket measures designed to keep people safe were restrictive to some people. Medicines were not always managed safely or in line with current guidance. As required medicine (PRN) protocols and care plans failed to provide guidance to staff on when it was appropriate to administer a particular medicine or associated risks.

Staff did not always receive effective training or support to monitor and improve learning and practice. For example, staff had completed safeguarding training, however, they had not implemented it in practice. Staff did not always respond to peoples calls in a timely manner. Some staff felt supported by managers, however, others disagreed.

Existing leadership and governance measures were not effective in identifying service shortfalls and failed to assess, monitor and mitigate risks relating to health, safety and welfare for people. There were indications of a closed culture at Grove Park. A closed culture is a poor culture in health and social care that increases the risk of harm.

1 February 2023

During a routine inspection

Grove Park is a hospital that has two acute mental health wards for adults of working age and 2 nursing units for older adults with complex needs. We inspected both the hospital and nursing home parts of the service. This report details the findings from the hospital inspection and a separate report details the findings from the nursing home inspection.

This was the first time we rated this service. We rated it as ​requires improvement​ because:

  • Staff had not carried out a full ligature risk assessment of the mental health unit. This meant that there were potential ligature risks which did not have clear mitigation in place and therefore posed a risk to patient safety.
  • There were blanket restrictions in place on the wards. Patients were unable to make hot drinks or snacks without staff support.
  • Staff were unaware of the provider’s physical health and wellbeing policy which led to inconsistencies in how often physical health monitoring was being carried out on each of the wards.
  • The service had a 37% vacancy rate for nurses and a 45% vacancy rate for healthcare assistants. The service used bank and agency staff to fill any gaps.
  • We found gaps in physical health monitoring charts which had not been picked up through the provider’s quality assurance processes.
  • The provider did not ensure that their risk register was kept up to date.
  • The service did not have an Occupational Therapist and we found instances where patient’s needs had not been assessed.
  • Patients told us they had not been involved in their care planning.
  • The area where emergency drugs and equipment were stored on Westborne ward was very cluttered and we were concerned this could cause a delay in staff accessing these items in an emergency.
  • The provider did not have a clear process in place around the completion of Venous thromboembolism (VTE) assessments.
  • Staff did not always ensure capacity assessments were carried out when patients had important decisions to make.
  • Staff had not documented whether discussions around consent to informal admission had taken place with patients.
  • The provider had improved their mandatory training compliance since their last inspection, however, compliance with some courses was still low.

However:

  • The ward environments were pleasant and clean. The wards had enough nurses and doctors. They managed medicines safely and followed good practice with respect to safeguarding.
  • Managers ensured that staff received supervision. The ward staff worked closely with those outside the ward who would have a role in providing aftercare.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983.
  • Staff treated patients with compassion and kindness and understood the individual needs of patients.

1 February 2023

During a routine inspection

About the service

Grove Park is a hospital that consists of two nursing units which provides nursing and personal care for up to 58 older people with complex needs, and an acute inpatient mental health service for adults of working age in two wards (nine beds on each). At this inspection, we only inspected the nursing units and there were 43 people living there.

People’s experience of using this service and what we found

The required improvements had been made since the last inspection in respect to the recording of food and fluids, relevant training for staff and having robust systems in place to monitor and improve the quality of the service.

The provider had systems of quality assurance to measure and monitor the standard of the service and drive improvement. These systems also supported people to stay safe by assessing and mitigating risks, ensuring people were cared for in a person-centred way and the provider learned from any mistakes. Our own observations and the feedback we received supported this. Staff had received appropriate training and people received good care that met their needs and improved their wellbeing. The staff team were dedicated and enthusiastic.

People were happy with the care they received, felt relaxed with staff and told us they were treated with kindness. They said they felt safe, were well supported and there were enough staff to care for them. Our own observations supported this, and we saw friendly relationships had developed between people and staff.

People received medicines safely. The service was clean, hygienic and a pleasant environment to spend time in. People’s care plans were up to date and accurately reflected their needs. People were able to receive visits from their relatives and there was a programme of activities to support their well-being.

Staff worked collaboratively with outside agencies such as the local authority and healthcare professionals. People were protected from harm and abuse, as staff knew how to safeguard people and what procedures they should follow. Complaints were responded to appropriately and people’s wishes at the end of their life were respected. People were able to express their views and had their dignity, independence and privacy promoted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service had Insufficient evidence to rate (published 23 September 2022) and there were breaches of regulation. We did not rate this service at that inspection because we did not look at the key questions in full. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from insufficient evidence to rate to good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

10 August 2022

During an inspection looking at part of the service

About the service

Grove Park is a hospital that consists of one nursing unit which provides nursing and personal care for up to 31 older people with complex needs, and an acute inpatient mental health service for adults of working age in two wards (nine beds on each). At this inspection, we only inspected the nursing unit and there were 24 people living there.

People's experience of using this service and what we found

People’s hydration intake was not being effectively monitored to reduce the risk of dehydration. Incidents were not recorded fully and did not show actions taken to minimise the risk of further incidents. They were also not monitored to identify trends. People had individual risk assessments in place to help manage and minimise risks. There were high levels of agency staff which meant there was a risk of staff not knowing people’s needs and risks well.

Staff had not all completed the provider’s mandatory training. This meant that staff did not always have the required skills to carry out their roles effectively and safely. Staff had not been receiving supervision or regular team meetings to adequately support them. People’s eating preferences and needs were being catered for. Staff told us that this had recently improved and prior to this people who required a special diet was not consistently receiving what they needed. People’s physical healthcare was assessed and supported, and people had access to GP’s and other healthcare professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However; the provider did not consistently record that consent was sought by the person, a next of kin or Power of Attorney.

Quality assurance systems were not robust which meant areas of improvement were not identified or acted upon. There was not adequate management oversight of the service. There were not effective or detailed policies and procedures in place for staff to follow. Managers did not ensure that staff were adequately trained or supported.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We received concerns in relation to the safe care of people on the unit. As a result, we undertook a focused inspection to review part of the key questions of safe, effective and well-led only.

Grove Park was registered with the CQC in February 2022. We inspected the mental health wards in June 2022, but this was the first time we inspected the nursing unit. We did not rate this service at this inspection because we did not look at the key questions in full.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment of people, staff training and support and the management processes of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

29 June 2022

During an inspection looking at part of the service

Grove Park is a hospital that provides acute inpatients mental health services for adults of working age in two wards (nine beds on each) and one nursing unit which provides care for 31 older people with complex needs.

We inspected the acute inpatient mental health wards at Grove Park on 29 June 2022. This was an unannounced, focused inspection following information of concern we received about the safe running of the service. These concerns were about poor staffing levels and staff competence, the management of patient’s risk and the way physical health monitoring of patients was being carried out The service had suspended admissions following concerns raised by the local NHS trust commissioning the acute inpatient mental health beds and therefore there were only four patients on the wards at the time of the inspection.

As this was a focussed inspection, we did not inspect any of the key questions in full so did not award ratings.

  • The service did not consistently provide safe care. The service had in the week prior to inspection, following concerns being raised by a number of sources, reviewed all risk assessments for the current patients. These had improved but prior to this, risks were not being managed effectively.
  • At the time of the inspection there were no emergency medicines on the wards. Managers told us that these had been ordered but we found that no one had followed up on these and they had not been received. This meant that the service would not be able to respond appropriately in the event of an emergency placing patients at significant risk. We raised our concerns with the service; managers confirmed that emergency medicines had been received 15 days after the inspection.
  • There were not enough staff trained in immediate life support (ILS) to respond in a timely manner to emergency medical situations. This training had been booked but staff had not yet completed it. This meant there were not always staff on site with ILS training to respond to medical emergencies or who could administer the emergency medicines. Staff had not all received mandatory training to ensure they were competent and confident to carry out their roles and keep patients and staff safely.
  • Staff did not develop detailed care plans in a timely manner for patients on admission. Managers did not ensure that staff received training, supervision and appraisal in line with their policy and best practice. Patients did not receive all physical health assessments in line with best practice on admission.
  • Staff did not carry out venous thromboembolism (VTE) assessment in line with National Institute for Health and Care Excellence (NICE) guidelines.
  • The service was not well led. The provider did not have a robust governance system to assess, monitor and make improvements to the service. Leaders did not have clear oversight of the safety and quality of the services.

However:

  • Prescribed medicines for the four current patients were managed safely.