Avesbury House

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff completed a detailed mental health and physical health assessment of patients’ needs at, or soon after, admission. They used the national early warning score (NEWS) tool to monitor and manage patients’ physical health and identify any deterioration.

Staff developed care plans that met the needs of patients identified during their assessments. Care plans were personalised, holistic and recovery oriented. However, there was limited evidence of nurse‑led activities documented in daily entries or regular 1:1 sessions, staff advised that these were sometimes recorded on a different electronic system.

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. This included medication, psychological therapies and occupational therapy support. The medical team prescribed medicines to treat patients’ conditions, which were safe, effective, and evidence based. For example, when doctors prescribed anti-psychotic medication, staff regularly monitored the patients’ physical health.

Staff took part in clinical audits and used results from audits to make improvements. Managers had access to quality assurance dashboards including current information about performance with medicines administration, infection control procedures, care plans, risk assessments, and the Mental Health Act 1983. The multidisciplinary team (MDT) employed by the nearby NHS mental health trust worked with the hospital’s nursing team, alongside relevant services outside the organisation.

Staff had access to a reflective practice group. Staff shared information about patients and any changes in their care during handover meetings.

Managers provided staff with supervision and appraisal of their work performance and completed detailed supervision and appraisal records for each member of staff. There were daily MDT meetings that staff from all disciplines attended. There was also a referrals and admission meeting where new referrals were discussed.

Staff supported patients to attend appointments for their physical healthcare and made referrals to other hospitals if they required advice or treatment about their physical health needs.

Staff had access to the provider’s Mental Health Act (MHA) policies and procedures, as well as the Code of Practice. Staff explained to patients their rights under the MHA in a way that they could understand. Staff ensured that patients were able to take escorted Section 17 leave (permission for patients to leave hospital) when this had been granted, and this was evident in their records. Patients had access to an independent mental health advocate (IMHA).

Staff had a good understanding of the Mental Capacity Act (MCA) and the five statutory principles. Records confirmed staff completed patients’ consent to treatment and capacity assessments following their admission.