Avesbury House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

The ward felt welcoming, and staff–patient interactions were consistently warm and respectful. This included domestic staff, who were seen engaging naturally with patients. This helped create a calm and settled atmosphere. Patients rarely approached the nursing station directly, suggesting staff were visible and available in communal areas.

We saw staff engaging positively with patients during the inspection. Most patients told us that staff were caring and helpful. They described being able to take their agreed leave, and activities that they enjoyed. Staff demonstrated a good knowledge and understanding of patients’ individual needs. Patients had direct access to hot drinks and snacks.

Carer feedback was positive indicating good involvement in patients’ care when possible, and welcoming, approachable, flexible and professional staff. They described reasonable restrictions, approachable staff, good communication with the doctor, but slow progress to make changes.

Overall, the hospital environment was in a good state of repair and furnished comfortably. Patients were positive about the environment within the unit. They were also very positive about the food provided.

Carers described staff as warm and welcoming, adjusting to support family members travelling from far away. We found evidence of good patient involvement in their ward rounds. During a ward round we attended, staff engaged with patients in a warm and respectful way. The MDT showed a solid understanding of each patient’s needs and progress. Discussions were structured, patient‑centred, and clearly collaborative. Patients had information provided on how to access advocacy services.

Care plans stated that patients were involved in planning their care, but their voice was not always clearly reflected in 2 of the 5 care plans we reviewed. There was room to make these more personalised.

Patients completed surveys on discharge. A patient representative attended patient council meetings, and the provider organisation was working to recruit lived experience partners to provide advocacy throughout the hospital. We saw evidence that patients views and requests as raised in community meetings and patient council meetings, led to changes within the hospital such as activities provided, and new equipment for the hospital.

Most staff we spoke with felt well supported by their immediate team and line managers and this was reflected in the most recent staff survey.

Patients appeared to enjoy and actively take part in occupational therapy activities. Several commented positively on the sessions, and overall engagement seemed good, showing that the programme was meaningful to them. However, some patients thought there should be more activities available at weekends.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The ward felt welcoming, and staff-patient interactions were consistently warm and respectful. This included domestic staff, who were seen engaging naturally with patients. This helped create a calm and settled atmosphere.

We observed many positive interactions between staff and patients. During our inspection we carried out a short observational framework for inspection (SOFI). This is a tool developed and used by inspection teams to capture experiences of people who use services. Staff treated patients with respect and encouraged patients to take part in activities.

Most patients spoke highly of the staff that supported them and described the hospital atmosphere as therapeutic, safe and calm. They told us that staff were kind and caring, helpful, treated them with dignity, and helpful if they needed anything. One patient said that staff could sometime be rude, if they (staff) were having a bad day.

Patients described being able to take their agreed leave and being involved in activities that they enjoyed. Several patients commented positively on OT and therapy sessions, indicating that the programme was meaningful to them.

Staff demonstrated a good knowledge and understanding of patients’ individual needs. Patients and staff felt that they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients.

Patients said that they were treated as individuals and supported according to their needs. For example, one patient said staff had taken them to introduce them to the job centre.

Carers were generally positive about patients’ work towards their discharge plans. They described staff as warm and welcoming, making adjustments to support family members travelling from far away.

Overall patients and carers reported that the hospital was kept clean and tidy, with lots of choices of activities to meet their preferences. Patients were very positive about the food provided and confirmed that they had access to cultural meals of their choice.

Patients and carers said that staff involved them in their care and treatment During ward round, staff engaged with patients in a meaningful and respectful way. The MDT showed a solid understanding of each patient’s needs and progress. Discussions were structured, patient‑centred, and clearly collaborative.

However, although care plans stated that patients were involved in their creation, patients’ voice was not clearly reflected in 2 of the 5 care plans we reviewed. There was room to make care plans more personalised.

We found evidence of effective patient involvement in their ward rounds. People’s personal, cultural, social and religious and individual needs were reflected in their care plans. For example, staff supported or escorted patients to attend a local church/mosque in person or online in accordance with their preferences. Some patients told us, that they sang cultural songs together in the communal lounge over the weekend. Patients we spoke with, were aware and able to access the multi-faith/computer room as required. Patients also told us they were able to do online shopping or order a takeaway. However, several patients said that they would like more opportunities for activities at weekends.

The layout of the hospital in the form of flats, was conducive to encouraging patients to develop their independence. Some but not all rooms had ensuite toilet facilities.

Staff supported patients where English was not their first language and booked interpreters for ward rounds. The provider organisation was working to recruit lived experience partners to provide advocacy throughout the hospital. Patients had information provided on how to access advocacy services.

Patients completed surveys on discharge. Patient council meetings were held fortnightly. Recent topics discussed included maintenance issues, organised trips in the community, gym equipment and access to the dietitian.

Patients had access to call bells in their bedrooms and in communal areas. Patients gave largely positive feedback about staff support, indicating that staff would come quickly for an urgent issue.

During the inspection we observed staff responding to patients’ needs promptly and appropriately.

Patients had direct access to hot drinks and snacks.

Staff we spoke with described how they identified and responded to changing risks to, or posed by, patients. Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. For example, following an incident, a patient reported that staff were calm in their approach which resolved the situation without physical restraint.

Patients rarely approached the nursing station directly during the inspection, suggesting staff were visible and available in communal areas.

Most staff we spoke with felt well supported by their immediate team and line managers. The most recent staff survey results from April 2025 (with a response of 84% staff) indicated improved scores for communication, appreciation, leadership, empowerment and teamwork. Lower scores were returned for line manager support, contact with senior managers, discrimination and purpose.

Prior to the inspection we received anonymous whistleblowing concerns relating to racial bias and favouritism towards staff, and retaliatory treatment to those raising concerns. At the time of the inspection some of these issues remained under investigation.

Staff and managers told us, well-being was discussed in supervision sessions and staff felt supported by the team and their managers. However, some staff said that they did not always feel that their concerns were heard by management. The provider gave monthly awards to staff who were nominated as going the extra mile.