Bromley Road Hospital

This means we looked for evidence that people were protected from abuse and avoidable harm.

Our rating of safe stayed the same. We rated it as good because:

Patients were cared for in a safe environment. All wards were safe, clean well equipped, well furnished, well maintained and fit for purpose.

Patients were protected by systems and processes that supported the delivery of safe care. Medicines management arrangements were well organised and supported by appropriate monitoring and oversight. Staff demonstrated a good understanding of safeguarding responsibilities and escalation processes, with evidence of appropriate action when concerns arose. The service had addressed the previous recommendations relating to physical healthcare and medicines management.

We found that patients receiving high-dose antipsychotic medicines had an annual physical health review. Staff were using a consistent system to monitor physical health, which supported the timely identification and escalation of concerns. Governance arrangements for physical healthcare had been strengthened, with clear oversight and accountability. The provider had also formalised its out-of-hours medical cover arrangements to ensure patients could access medical support when needed.

The service had systems and processes in place to assess and manage risks to patients.

We identified some inconsistencies in the timely review of risk assessments following incidents, and some clinical documentation, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, was not always stored in a way that made it immediately accessible to staff.

However, staff demonstrated a clear understanding of patients' current risks, support needs and DNACPR decisions. Staff were able to describe patients' wishes and the actions required to manage identified risks safely.

We saw evidence that risk information and DNACPR decisions were shared effectively within teams and acted on appropriately. Improvements were needed in documentation and access to records. However, we found no evidence that patient safety or the quality of care had been affected.