Cheadle Royal Hospital

Updated 19 August 2026

Our overall rating at Cheadle Royal Hospital has remained the same. Cheadle Royal Hospital was rated as requires improvement at the previous inspection and at this inspection the rating has remained requires improvement. The rating for child and adolescent mental health wards has improved. Child and adolescent mental health wards were rated requires improvement at the last inspection and at this inspection the rating has changed to good.

We inspected Cheadle Royal Hospital on 21 April 2026.

We inspected the service due to information of concern received since the last inspection about the child and adolescent mental health ward (Woodlands). This was information shared by the Greater Manchester Children and Young People’s Mental Health Provider Collaborative who identified concerns from early 2026 onwards. These concerns related to a number of issues including the management of incidents, therapeutic observations not being correctly documented, staff wellbeing and lack of support from the provider for staff. Young people did not always have access to food to meet their needs or access to adequate bedding. There were also environmental, infection prevention and control and medicines management issues. In February 2026 this led to the provider collaborative increasing the frequency of their visits to the ward in line with their quality assurance framework. A follow up visit by the provider collaborative in March 2026 found improvements in relation to all the identified issues.

Cheadle Royal Hospital was registered with CQC in December 2010 to deliver the regulated activities: Assessment or medical treatment for persons detained under the Mental Health Act 1983 and Treatment of disease, disorder or injury. The service had a controlled drugs accountable officer and a Registered Manager.

At the previous inspection of Cheadle Royal Hospital, in December 2024, we rated the child and adolescent mental health wards as requires improvement overall with requires improvement ratings for safe, responsive and well led and good ratings for caring and effective. We identified breaches of Regulation 9: Person-centred care, Regulation 12: Safe care and treatment, Regulation 15: Premises and equipment, Regulation 17: Good governance and Regulation 18: Staffing. At this inspection we found the breaches of Regulations 9, 15, 17 and 18 to be resolved. However, we found a number of issues which evidenced an ongoing breach of Regulation 12: Safe care and treatment including issues with the care environment, management of incidents and the storage of medicines.

We visited the following wards as part of the inspection:

- Woodlands ward, CAMHS Low Secure Unit with 10 beds

- Featherstone ward, due to 1 young person being nursed in long term segregation on this ward

At this inspection we assessed 1 assessment service group: Child and adolescent mental health wards, where we assessed all 33 quality statements.

We have inspected the service against `Right support, right care, right culture' guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

At the time of the inspection there were 6 young people admitted to the main ward and 1 young person in long term segregation on another ward, which was not in general use.

We carried out a tour of both wards and inspected the clinic room and the ward seclusion suite. We spoke with 2 young people and 2 family carers. We interviewed the ward manager and 6 other members of staff including registered nurses, healthcare support workers and the responsible clinician (a consultant psychologist). We reviewed 5 sets of care records, the prescription charts for all young people and records of incidents including restraints, seclusion and the administration of rapid tranquillisation medication. We observed the multidisciplinary ward round for 1 young person and a shift handover meeting. We reviewed records relating to staffing and the governance and management of the ward.

We rated the child and adolescent mental health wards as good overall. We found 1 breach of the regulations in relation to Regulation 12: Safe care and treatment.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Updated 6 February 2026

We rated the children and adolescent mental health service (CAMHS) as good. The service had made improvements and was no longer in breach of Regulations 9, 15, 17 and 18. We identified an ongoing breach of Regulation 12 in relation to clinical risk management, safe environments, infection prevention and control and safe management of medicines.

We have asked the provider for an action plan in response to the concerns found at this assessment.

The CAMHS service was last inspected in December 2024 and was rated Requires Improvement overall. We issued an action plan request in relation to reasonable adjustments for patients with protected characteristics, cleanliness and maintenance of the environment and oversight and implementation of policies and procedures. The overall rating for the CAMHS service has now changed from Requires Improvement to Good.

Mental Health Act and Mental Capacity Act Compliance Summary

Mental Health Act

Most staff (90%) on Woodlands ward were up to date with their Mental Health Act training. Staff told us they had access to advice and support from a Mental Health Act administration team which covered the whole hospital, and they could access the relevant policies and the Mental Health Act Code of Practice via the staff intranet. Young people had easy access to information about independent mental health advocacy. This was displayed on the ward and was also included in the written information young people and their carers received on admission. Records confirmed that staff explained to young people their rights under the Mental Health Act (or as an informal patient) in a way that they could understand at regular intervals during their admission.

Staff ensured that young people were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted. Care records showed that staff requested an opinion from a second opinion appointed doctor when necessary. Staff stored copies of young people’s detention papers and associated records (for example, Section 17 leave forms) correctly and so that they were available to all staff that needed access to them. Where young people had been nursed in seclusion, their care records showed that medical, nursing and multidisciplinary team reviews were taking place at the intervals required by the Mental Health Act Code of Practice. However, young people did not always have specific care plans on their records in relation to their episode(s) of seclusion, which would have been good practice.

Mental Capacity Act

Staff told us they received training on the Mental Capacity Act and records showed that 91% of staff were up to date with this mandatory training module. The provider had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it and they had access to Mental Health Act administrators who could also give advice and support in relation to the Mental Capacity Act. There were no deprivation of liberty safeguards applications made in the 12 months prior to inspection, to protect people without capacity to make decisions about their own care. All the young people admitted to the service who had lacked decision making capacity were detained on the ward under the Mental Health Act.

Staff took all practical steps to enable young people to make their own decisions, and during our observations of care we observed staff asking young people for consent where appropriate. For young people who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately, in line with the requirements of the Mental Capacity Act and legal requirements for assessing children’s capacity to consent. They did this on a decision-specific basis with regard to significant decisions. However, some of the records did not specifically document the assessment of Gillick competence (a test in medical law of whether a child under the age of 16 is competent to consent to medical examination or treatment) on the capacity assessments for young people aged under 16 years which would have been good practice.

Updated 22 November 2024

The acute and PICU service was last inspected in February and March 2023 and was rated Requires Improvement overall. We served a warning notice in relation to medicines management. At this assessment the service had met the actions from the warning notice and the rating of the Safe key question had changed from Inadequate to Requires Improvement.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

• 93% of staff had received training in the Mental Health Act.
• Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
• Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
• The provider had relevant policies and procedures that reflected the most recent guidance.
• Patients had easy access to information about independent mental health advocacy.
• Staff mostly explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done so. However, we found on Alder ward, rights were not available in a patient’s first language.
• Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.
• Staff requested an opinion from a second opinion appointed doctor when necessary.
• Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly so that they were available to all staff that needed access to them.
• Staff did regular audits to ensure that the Mental Health Act was being applied correctly including section 17 leave audits, findings from these were discussed at clinical governance meetings.

Mental Capacity Act

• 94% of staff had had training in the Mental Capacity Act.
• Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles.
• Staff knew where to get advice from within the provider regarding the Mental Capacity Act, including Deprivation of Liberty Safeguards.
• Staff mostly took all practical steps to enable patients to make their own decisions. However, we saw on Evergreen ward, for an autistic patient, staff did not tailor their communication to improve the patients understanding and engagement. Their care plan did not include any reasonable adjustments or how best to communicate with them.
• For patients who might have impaired mental capacity, staff mostly assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions. Examples included assistance with personal care and need for antibiotics.
• When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. We saw the rationale being discussed in a very person centred way on Pankhurst ward.
• The service had arrangements to monitor adherence to the Mental Capacity Act.

Updated 18 July 2022

Our rating of this service improved. We rated it as good because:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• The service clinic rooms were safe with all equipment regularly serviced.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. All patients had been assessed by a dietician within 24 hours. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare. New staff had been employed to work in the dining areas only to offer more support to patients.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions. Patients thought staff cared about them.
• Leaders were visible in the service and approachable for patients and staff. The ward managers were experienced and skilled and performed their role well. Staff told us they were visible, approachable, listened and supported them in their day to day tasks.

However;

• Patients told us that issues connecting to the internet were still unresolved from our previous inspection.

Updated 16 March 2018

We rated long stay/rehabilitation mental health wards for working age adults as good because:

There were enough staff for patients to receive the care and treatment they required.

Staff identified ligature points (places where someone intent on self-harm might tie something to strangle themselves) and took action to remove or minimise risks.

The wards were clean and tidy and maintained to a high standard.

Staff were caring and treated patients in a respectful and dignified manner.

There was good multidisciplinary team working and staff engaged well with community teams as well as outside organisations.

There had only been one formal complaint in the last twelve months and patients told us that they were cared for by caring staff.

The clinical leadership on the ward was clear and all staff said that they felt supported and listened to.

Staff were aware of the provider’s vision and values and were committed to providing good care in line with this.

However:

Staff were not always specifying clearly the decisions leading to capacity assessments and recording the decisions made in patients’ best interests when patients were assessed as lacking capacity.

Food in the patients’ kitchens was not always stored in a way that minimised risk of food-borne viral infections.

Updated 16 March 2018

The Wellbeing Centre was located within the grounds of Cheadle Royal Hospital; the building was clean and pleasant and decorated to a high standard. Environmental checks were regularly undertaken, health and safety, risk assessments and monitoring was undertaken in line with hospital policy. Lone working procedures were in place.

Patients were protected from avoidable harm, and staff were supported to fulfil their responsibilities to raise concerns, report incidents and monitor and review risk. Lessons were learnt and communicated to all to improve services. Improvements to safety were made and changes monitored.

Safeguarding processes were in place which reflected national guidance, and understood by all staff. There was a clear structure of reporting and responsibility for safeguarding adults and children. Any concerns relating to adult and child protection were communicated to the relevant protection agencies.

Staffing levels and skills mix was planned, implemented and reviewed to keep people safe.

The service delivered a range of psychological therapies and had skilled staff to deliver these services. Risk to people who used the service was assessed and monitored, risk assessment was person centred and reviewed regularly. Plans were in place to respond to emergencies and major incidents.

The service was accessible and responsive and there was no delay from initial referral to assessment to treatment. Waiting times for patients wanting to access appropriate psychological therapies through the service, as part of their treatment were minimal.

Patients using the service told us that they were treated with kindness, dignity and respect. We observed that staff took time to communicate with patients in a respectful and compassionate manner. Appointments were scheduled at the patient’s convenience and the service was open to patients in the evenings to support working patients.

Patients care and treatment was planned and delivered in line with current evidence based guidance. Information about patients care and treatment was routinely collected and monitored. It was easy for patients to complain or raise a concern about the service; complaints were taken seriously and responded to in a timely manner. Improvements were made to the quality of care in response to complaints to the service.

Staff were supported to deliver effective care and treatment they told us that they received meaningful and timely supervision and were supported to maintain their professional skills and experience.

There was a clear statement of visions and values, staff knew and understood the vision, values and strategic goals of the service. Processes and systems of accountability and governance were in place and performance management and quality reporting was clearly set out. Risks were identified and monitored. Performance issues were escalated and discussed at relevant governance forums and action taken to resolve concerns.

Staff we spoke with were all positive about their roles and were passionate about service development. Staff felt able to raise concerns without fear of victimisation and spoke positively about the organisation. They told us that they felt valued, had input into the service and were consulted and involved in service quality developments. The service was committed to improving the services on offer and was looking at increasing accessibility of the service.