Grove Park

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed all 6 quality statements in the effective key question. This means we looked for evidence that patients’ care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence. At our last inspection in February 2023, we rated this key question as Requires Improvement. At this assessment the rating has changes and is now Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Qualified nurses or doctors completed a comprehensive mental health assessment of each patient either on admission or soon after. Assessment documentation was comprehensive and covered all relevant areas. This included an assessment of the patient’s capacity to consent to admission and treatment. Staff we spoke with were able to describe the assessment process. They were able to describe how they were informed of the outcomes of patient assessments and how care and risk management plans were then created and shared with them. Staff we spoke with described how updated information on each patient was shared at handovers between shifts. Staff described how patient observation levels were assessed and reviewed daily.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. Physical health screening was completed within 24 hours of admission, either by the hospital physical health team or the nurse on duty. Physical health assessments included baseline bloods and an electrocardiogram. Staff developed a care plan for each patient, with their input, which met their mental health and physical health needs, including food and drink and for any specialist nutrition and hydration needs.

Care plans were recovery orientated. Plans for treatment set out the patient’s goals, the support they needed as well as arrangements for occupational therapy, psychology and risk management.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). In addition to providing medicines and psychology and occupational therapy, the service provided therapeutic activities and support with daily life skills.

Provider policies were written in line with national guidance. There were governance structures at hospital and provider level to review and disseminate new guidance. Staff completed clinical audits to ensure compliance with relevant standards and guidance.

Staff held regular multidisciplinary meetings to discuss patients and improve their care and outcomes. Each patient was reviewed by the full multidisciplinary team every week. The responsible clinician, ward doctor, nurse, psychologist and occupational therapist all attended the meetings. At these meetings, staff reviewed the patients’ progress and made changes to their care and treatment, where needed.

Staff made sure they shared clear information about patients and any changes in their care and treatment or risk indicators. Nurses and healthcare assistants held a handover meeting at the start of each shift. The multidisciplinary team and leaders met each day to review risks and incidents. At this meeting, staff shared information about incidents, safeguarding, staffing, maintenance, patients enhanced observation levels, patients’ physical health, discharges, admissions and referrals and plans for the day. We observed the meeting and found conversations between colleagues to be friendly, supportive and engaging with appropriate challenge.

Staff we spoke with described a supportive multi-disciplinary team within the ward and told us that they worked well together.Staff were able to describe the processes for sharing information within the multidisciplinary team and with external professionals and services.

There were clear processes and systems in place to support admissions, discharges and transfers of care. There were clear pathways and referral procedures into the service. The service had an exclusions policy to ensure they only accepted referrals that they could safely support. For example, the service did not have a seclusion room and did not accept referrals where people’s risk indicated a possible need for this type of care and treatment. Staff had access to policies and procedures to support transitions and pathways into and out of the service.

Staff assessed patients’ physical health needs and recorded them in their care plans. Staff completed checks of each patient’s pulse, temperature, weight, height and blood pressure on admission and regularly each week, or sooner if needed. Staff documented progress notes for each shift covering patients’ compliance with medication, food and fluid intake, personal hygiene and sleep. However, the 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. At the time of the inspection, plans and training for the new systems were underway.

Staff made sure patients had access to physical health care, including specialists as required. Patients were seen promptly by a doctor when they felt unwell or taken to an Urgent Treatment Centre or AE, if required.

Patients we spoke with told us that their care and treatment was well coordinated and that felt well supported by staff and their needs and wishes were listened to. They told us that the care and support they received was helping them to improve their mental and physical health and their well-being.

Staff used effective approaches to monitor people’s care and treatment and their outcomes. Staff told us they discussed with people outcomes of their care plan in their multidisciplinary team meetings and with other staff at handovers between shifts. Staff monitored outcomes through reduction of people’s risk and their use of unescorted and escorted leave from the hospital. Psychologists and occupational therapists told us they used recognised tools to measure people’s outcomes following therapeutic interventions and involved the person and their relatives, where appropriate, in these.

Staff reviewed and analysed data on patient outcomes at the hospital’s monthly clinical governance meetings.

Staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions such as treatment and personal finances. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. Family members were involved, where appropriate.

Staff completed mandatory training around the Mental Health Act and Mental Capacity Act. Staff we spoke with were able to describe the five principles of mental capacity and give examples of when capacity had been assessed and considered as part of care and treatment.The service regularly audited Mental Capacity Act compliance on the ward.

We observed staff checking people’s understanding and gaining verbal consent before undertaking any activities or therapies.

Consent to treatment records for patients receiving their medicines was well documented.