Bromley Road Hospital

Updated 18 December 2018

Bromley Road Hospital is an independent hospital for 24 adult patients. The hospital is provided by Elysium Healthcare Limited. At the time of the inspection, 20 patients were receiving treatment at the service.

The service is registered with the Care Quality Commission to provide the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983
• diagnostic and screening procedures and
• treatment of disease, disorder or injury

The service has a registered manager.

The service is a long term high dependency rehabilitation unit. Most patients are subject to detention under the provisions of the Mental Health Act at the point of admission. Patients at Bromley Road Hospital have a primary diagnosis of mental illness such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression. Some patients had additional complex needs, such as substance misuse or physical health problems.

There are two wards. Olive Ward is a mixed sex ward for up to 17 patients. Jasmine Ward accommodated up to seven female patients.

We previously inspected Bromley Road Hospital in May 2017 when we rated the service as ‘requires improvement’ overall. At that time, we rated safe, effective, caring and well-led as ‘requires improvement’. We rated responsive as ‘good’. At that inspection, we found that some legal requirements were not met. We had concerns that staff did not treat patients with dignity and respect. Staff had imposed inappropriate blanket restrictions on patients. The service did not have adequate medical cover for patient care. Lastly, that managers did not use effective systems to monitor the performance of the service. We issued four requirement notices for breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. These notices related to breaches of regulation nine (Person-centred care), regulation 10 (Dignity and Respect), regulation 17 (Good Governance) and regulation 18 (Staffing).

Updated 18 December 2018

We rated Bromley Road Hospital as good because:

• The service had addressed the concerns raised following the last inspection in May 2017. For example, staff treated patients with dignity and respect. Staff no longer imposed inappropriate blanket restrictions on patients. The service provided adequate medical cover for patient care. The service had made improvements to ensure managers used effective systems to monitor the performance of the service.

• Staff developed personalised, recovery-oriented care plans and supported patients to give their views and develop recovery goals. Staff completed positive behaviour support plans. These plans contained strategies that focused on patients’ challenging behaviour. Staff provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national best practice guidance.

• The ward teams included, or had access to, the full range of specialists required to support patients with their rehabilitation. This included an occupational therapist, social inclusion worker and a clinical psychologist.

• Staff supported patients to live healthier lives. Staff assessed patients’ physical health needs on admission. Patients took part in the service’s programme to encourage patients to think about their physical health and take part in various exercises.

• Staff effectively planned for patients’ discharge and worked well with other agencies to do so. Staff created projected discharge dates on admission for each patient as a goal to work towards.

• Staff treated patients with kindness, dignity and respect. Patients said that they felt staff were kind, friendly and always supported them with their care and treatment. We observed positive interactions between patients and staff. The service held an annual talent contest for patients. Patients really enjoyed taking part and rehearsals were well attended.

• The service provided safe care. Staff completed risk management plans with input from patients and the multidisciplinary team. Staff minimised the use of restrictive practices, managed medicines safely and carried out regular physical health checks such as, blood tests and monitoring patients’ vital signs.

• The service was working towards a model of mental health rehabilitation. The provider had introduced a new rehabilitation model of care to be implemented at the service in January 2019. Improved governance processes ensured that ward procedures ran smoothly. Managers had accessible systems that provided oversight of the quality, safety and performance of the service.

However:

• Staff did not always actively promote the needs of all patients, including those with a protected characteristic. The service could do more to encourage an open and inclusive environment to support patients’ sexual, cultural and spiritual preferences.

• Although patients in the service were low risk in respect of self-harm and suicide; staff assessments of ligature risks in the service did not record all control measures for staff to reduce the risks to patients.

• Some parts of the building were run down and required some maintenance and refurbishment. The service had a schedule of works planned to improve the decoration and maintenance of the building.

• Although staff received regular supervision in the service; staff supervision records were brief and lacked detail. Records did not demonstrate that these sessions were effective in ensuring the learning and development of staff and delivery of high quality care.

Updated 18 August 2017

See overall summary