- Independent mental health service
Cheadle Royal Hospital
All Inspections
During an assessment of Child and adolescent mental health wards
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.
During an assessment of the hospital overall
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.
During an assessment of Acute wards for adults of working age and psychiatric intensive care units
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.
During an assessment of Child and adolescent mental health wards
The CAMHS service was last inspected in February 2023 and was rated Inadequate overall. We served a warning notice in relation to effective management processes. At this current assessment the service had met all of the warning notice actions except in relation to the environmental concerns. The overall rating for the service has changed from Inadequate to Requires Improvement.
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Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
- 96% 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.
- Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
- Patients had easy access to information about independent mental health advocacy.
- Staff 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 it.
- Staff mostly ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted. However, three of the four young people we spoke to told us about delays to leave on occasions due to acuity on the ward and staff availability.
- 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 and 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 and there was evidence of learning from those audits.
Mental Capacity Act
- 97.8% 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 took all practical steps to enable patients to make their own decisions.
- For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions, for example for food and dietary preferences.
- When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person's wishes, feelings, culture and history.
- Staff made safeguards applications when required and monitored the progress of applications to supervisory bodies.
- The service had arrangements to monitor adherence to the Mental Capacity Act.
- Staff audited the application of the Mental Capacity Act and took action on any learning that resulted from it.
- The provider has a Gillick competency policy for consent in healthcare settings (a test in medical law to decide whether a child of 16 years or younger is competent to consent to medical examination or treatment without the need for parental consent or knowledge).
During an assessment of the hospital overall
- We assessed Cheadle Royal Hospital from 9 to 12 December 2024.
- We assessed the service to review the progress made against the warning notices that were served on the provider following the inspection in February and March 2023. We found that the service had made improvements and had met the actions of the warning notices.
- 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.
We visited the following wards as part of the assessment:
Alder ward, adult acute ward for men and women with 14 beds
Evergreen ward, adult acute ward for men and women with 15 beds
Featherstone ward, adult psychiatric intensive care unit for men with 10 beds
Maple ward, adult acute ward for men and women with 15 beds
Pankhurst ward, adult psychiatric intensive care unit for women with 10 beds
Redwood ward, adult acute ward for men and women with 12 beds
Willows ward, adult psychiatric intensive care unit for men with 10 beds
Woodlands ward, CAMHS Low Secure Unit with 10 beds
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- At this assessment we identified breaches of regulations 9 Person Centred Care, 12 Safe Care and Treatment, 15 Premises and Equipment, 17 Good Governance and 18 Staffing.
- At this assessment we assessed 2 assessment service groups; Acute wards for adults of working age and psychiatric intensive care units where we assessed 26 quality statements and Child and adolescent mental health wards where we assessed 33 quality statements.
- We have assessed 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.
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Requires Improvement rating
We rated the service as Requires Improvement. In the acute wards for adults of working age and psychiatric intensive care units, we found 5 breaches of regulations in relation to: reasonable adjustments for patients with protected characteristics, medicines management, cleanliness and maintenance of the environment, oversight and implementation of policies and procedures and ensuring staff receive an induction into the ward they are working on and receive regular supervision. In the child and adolescent mental health wards we found 3 breaches of the regulations in relation to reasonable adjustments for patients with protected characteristics, cleanliness and maintenance of the environment and oversight and implementation of policies and procedures.
We have asked the provider for an action plan in response to the concerns found at this assessment.
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21,22,23 February & 8 March 2023
During a routine inspection
Our rating of this location stayed the same. We rated it as requires improvement because:
- On this inspection we inspected the acute wards for adults of working age and psychiatric intensive care units. We rated these as: requires improvement overall; inadequate for safe, requires improvement for well-led; and good for effective, caring and responsive.
- We have used ratings from previous inspections of other core services to aggregate ratings to location level in line with our guidance.
- This inspection did not change the overall location rating which remains as requires improvement. However, the location rating for safe went down to inadequate. The location rating for well-led remains as requires improvement. The location rating for effective, caring and responsive remains as good.
17, 18, 19, 24 and 25 January 2023
During an inspection looking at part of the service
Our rating of this location went down. We rated it as requires improvement because:
- On this inspection we inspected the child and adolescent mental health wards and this changed the location ratings to requires improvement overall and requires improvement for safe and well-led.
- On this inspection, we rated the child and adolescent mental health wards as inadequate overall and inadequate for safe and well led, requires improvement in effective and responsive and rated caring as good.
- We have used ratings from previous inspections for other core services to aggregate ratings to location level in line with our guidance.
26, 27, 28 April 2022
During a routine inspection
Our rating of this location improved. We rated it as good because:
- The environmental issues identified in our previous inspection in June 2021 had been addressed. All wards had been comprehensively redecorated and refurbished. Every ward had new furniture, fittings, and flooring had been fitted throughout. Improvements had been made to the maintenance systems and processes throughout the service.
- Ward teams had access to multidisciplinary staff and specialists. The eating disorder service had a dietician and two assistant dieticians. Staff could access additional training to develop their skills. The model of care on Fern ward (a female personality disorder ward) was a dialectical behaviour therapy model. All staff were trained in the approach, and staff could progress to undertake training to deliver group-based therapy sessions. The ward was decorated with prompts for patients and staff. Staff could follow up therapy-based sessions and practise techniques with patients between therapy. Nursing and support staff could describe the model and theory well and the approach was understood and embedded with staff and patients who we spoke to. The provider had a rolling programme of clinical audits for benchmarking and quality assurance.
- Patients said most staff were discreet, respectful, and responsive when caring for patients. Most patients told us that they felt that staff respected their privacy. The hospital had recruited two experts by experience who were due to start work imminently. Patients could give feedback on the service and their treatment and staff supported them to do this.
- 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:
- On two CAMHS wards we found doors that had been graffitied by patients who had chipped away the paint and this damage had not been addressed. It was not clear that any measures were in place or had been considered to prevent this from happening in the future. A damp patch on the ceiling of the laundry room on Orchard ward had not been addressed since the last inspection.
- The service had not ensured that clinic rooms within CAMHS were checked and maintained appropriately. On Orchard and Woodlands, there were areas of the clinic rooms that were dusty, cluttered and unorganised. Expired equipment such as gloves, needles and syringes were stored on all three wards and had not been removed. These were stored alongside in date items so it was not clear to staff which equipment they should use. On Orchard, there was medication that had been opened with no start or expiry date recorded. The hospital’s governance processes had not ensured that the issues regarding the clinic rooms and medications were addressed in a timely and appropriate manner.
- On three of the wards (Pankhurst, Alder and Featherstone) patients told us of concerns about a negative culture that had developed in relation to night. Patients said they did not always feel safe on these wards, they found staff were less supportive and less respectful. Patients on two wards told us there had been mistakes made at night with their medication which they had had to report. These issues were similar to those we found on one ward at our last inspection which the provider had addressed.
- Whilst overall governance had improved, there were issues with oversight of some areas of practice, including ward-based audits and checks and physical health assessment and monitoring.
27 July 2021 28 July 2021 29 July 2021
During a routine inspection
Due to the concerns we found during this inspection, we asked the provider to take urgent and immediate action.
The provider addressed the most serious concerns immediately. We have also issued warning notices for two breaches of regulation to ensure that swift action is taken, and plans put in place to maintain improvements.
Our rating of this location went down. We rated it as requires improvement because:
- We found evidence that maintenance of ward areas and furniture was not being kept up to a good standard. It was not a caring environment which respected patient’s dignity and did not aid recovery.
- The service had not maintained medical equipment such as defibrillators and weight scales.
- The service had not ensured that corridors and exits were free from obstructions, in the case of an emergency or fire. We found one corridor was blocked with chairs.
- The service had not ensured that all staff had access to alarms to alert other staff in case of an emergency. We found that one ward did not have the required number of alarms for the number of staff working on that day.
- The service had not ensured that there was always a place for patients to relax. We found a female lounge was being used as a visitor’s room for large parts of the day.
- Staff were not always following the providers policy in relation to checks on controlled drugs and sharps boxes.
- Our findings demonstrated that governance processes did not always operate effectively.
However:
- 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. 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.
- Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
- 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.
- The service managed beds well so that a bed was always available locally to a person who would benefit from admission and patients were discharged promptly once their condition warranted this.
14th and 15th October 2019
During an inspection looking at part of the service
This was a focused unannounced inspection just looking at the safe domain of the child and adolescent mental health wards at Cheadle Royal Hospital.
Our rating of safe of the child and adolescent mental health wards at Cheadle Royal Hospital stayed the same. We rated it as requires improvement because:
- We found that the provider’s policy on prevention and management of disturbed/violent behaviour was not being followed when prescribing “when required medicines”. The policy stated that prescribing should be tailored to the patient and be part of their individual plan. It should not be administered routinely or automatically and should be reviewed regularly. One patient had no record of a review of the need for two “when required” medicines even though these had not been administered for five and nine months respectively.
- Staff did not directly record incidents onto the hospital’s electronic system, instead a separate paper system had been developed where staff completed a form and another member of staff then entered the details into the electronic system at a later date. We found the paper system to be poorly maintained with loose sheets and a back log waiting to be uploaded. There was no audit for this process, so the hospital could not be certain that incidents were being accurately recorded.
- The record of physical observations that had taken place after the administration of rapid tranquilisation were poorly organised although we were confident the observations were taking place in practice. We found post rapid tranquilisation forms which had been completed but were stored in different locations, for example we examined 27 records of episodes of intramuscular administration recorded on prescription charts and 19 of these had no post rapid tranquilisation monitoring form attached.
- We found inconsistent recording within care records. We saw examples where incidents were not included in notes and information was recorded in different places.
- Mental Health Act paperwork was not always completed in relation to patients’ treatment.
However:
- The wards were clean and tidy and being renovated to improve safety.
- Staff assessed and managed risks. There was a comprehensive risk assessment for all patients and a daily communication sheet provided for staff which included all patient risks.
15 -17 August 2017
During a routine inspection
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. Patients were empowered to become active participants in their care which required good communication skills from staff to enable them to address patient needs effectively.
All patients underwent a thorough assessment of need, care plans were holistic and recovery oriented and included physical health assessments, these were completed in collaboration with the patients, progress was regularly reviewed. Regular multidisciplinary meetings were held and attendance by outside agencies was encouraged. Good communication was evident with external agencies such as local authorities and community mental health teams. Families and carers were involved in this process where appropriate. Advocacy services were accessible and available to support patients.
The hospital followed national guidelines on cleaning standards and monitoring procedures to provide and maintain a clean and appropriate environment to prevent and control healthcare associated infection. The wards were clean and tidy and there was an established cleaning regime. All clinic rooms were fully equipped with accessible emergency equipment which was maintained appropriately. Medicines were dispensed and stored securely and weekly audits were undertaken to ensure safe practice.
There were arrangements in place to provide safe and effective care in the event of a failure in major utilities, fire, flood or other emergencies. We had sight of the hospital's fire risk assessment, service evacuation plans and details of fire training for staff.
The ward environments were situated in older buildings and were subject to constraints in observation. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. Regular environmental quality checks were conducted and patients were able to discuss and resolve environmental issues in community meetings. Ongoing refurbishment plans had seen improvements to the ward environments.
Staffing levels were determined using a staffing ladder model. Electronic rostering was used to support staff management and staffing was reviewed regularly to ensure there was enough staff with the relevant skills to deliver safe patient care. Patients were supported by a skilled multidisciplinary team of staff which included nursing, psychiatric, psychological, occupational and dietetic support. 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.
Treatment practices including physical health care and prescribing practices were based on nationally recognised guidance. Care planning was holistic and positive risk management was evident. Care planning, risk and review were undertaken regularly and patients and their carers were involved in this process. Any identified spiritual needs and cultural requirements were supported and families and carers groups were active in the service.
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.
Restrictive practices were reviewed regularly and patients were involved in the process, the service had a patient representative who met with patients regularly and acted as their voice in communication with senior managers. Regular patient surveys and community meetings informed improvements in patient care across the hospital.
Referral systems and admission criteria were in place and admission waiting times monitored. Delayed discharges and length of stay was also monitored, procedures and strategies were in place to reduce the length of stay.
Staff were trained in and had a good understanding of the Mental Health Act and Mental Capacity Act. Staff followed local procedures and support was available from Mental Health Act administrators. Patients were given information and support to ensure appropriate representation and aid understanding of their rights.
There was an established governance structure with a defined hierarchy of reporting and decision making within the service. There were clear systems of accountability and senior managers were actively involved in the operational delivery of the service. 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.
All staff we spoke with were 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 continually improving the quality of care provided to patients.
However:
The hospital had a policy and action plan in place regarding reducing the use of restrictive practices including the use of restraint in line with national guidance. However on the child and adolescent mental health wards two patients reported painful holds were used during restraint. This raised concerns about the use of pain compliance in the form of wrists holds being taught to staff in the management of violence and aggression training.
- On the acute wards for adults of working age and psychiatric intensive care units and the child and adolescent mental health wards there was inconsistent monitoring and recording of physical observations following the use of rapid tranquilisation.
- On the acute wards for adults of working age and psychiatric intensive care units staff had not received training around personality disorders.
- Within the psychiatric intensive care units there were higher levels of seclusion reported than levels of restraint.
- On the long stay/rehabilitation mental health wards for working age adults, 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.
15, 24 April 2014
During an inspection in response to concerns
The inspection team spent time speaking with young people, we invited them to share with us their experience of the care provided at The Priory Cheadle.
People were positive about the staff team and the care they received. They told us “He’s a good doctor, he makes the right decisions.”
Throughout the two days we visited the services we observed staff engaging with people in a kindly manner and involving them in decisions about activities related to their care needs.
The hospital had effective policies, procedures and systems in place to manage medicine and the administration process. We did highlight some concerns with regards to the following and completion of some of the procedures to support medicine management.
The hospital managed staffing levels appropriately and there were suitable arrangements in place to deal with foreseeable emergency cover. Staff told us they felt well supported by their team.
As part of the inspection process we reviewed the incident and complaints policies and procedures. We found evidence of good investigation and reporting processes but felt the learning had not been embedded following an investigation to minimise the future risks of similar incidents.
17, 22 October 2013
During a routine inspection
The young people presented as relaxed and comfortable in the presence of staff. They spoke openly and confidently about the staff and the quality of care and treatment they received. They told us that they were helped to identify and understand their mental health needs and behaviours and were involved in the development of care and treatment plans tailored to their individual needs and personal preferences.
We found that the young people who used the service received safe and appropriate care that met their needs and protected their rights.
Some of the young people spoken with told us that they were unhappy with quality of food provided. However, we were told that these concerns had already been identified and the manager showed us that action was being taken to improve quality and presentation of food.
We could see the quality of treatment, care and service provided was continuously monitored so patients were protected from the risks of unsafe or inappropriate care.
We observed staff carrying out their duties and responsibilities in good humour and in a relaxed and positive manner. We found that there were enough qualified, skilled and experienced staff to meet people's needs.
26 September 2012
During an inspection looking at part of the service
Comments from patients included:
‘’I feel safe here, everything is fine’’
‘’I have been told about my medicines I know what they are’’
‘’Sometimes other patients frighten me but I can go to my own room where I feel safe’’
Overall we found good improvements in the management of medicines.
6 August 2012
During an inspection in response to concerns
18 June 2012
During a routine inspection
We spoke with some of the patients at Cheadle Royal Hospital.
Some of the comments from people included:
'The food and the staff are ok.'
'Have been doing the care plan with staff.'
'Can talk to staff and doctor if not happy about anything.'
As part of this review process we saw a draft report following a visit to the service from Stockport Local Involvement Networks (LINks). LINKs are groups of individual members of the public and local voluntary/community groups who work together to improve health and social care services. They gather the views of local people and use them to influence how health and social care is commissioned and delivered. No concerns were raised in the report.
We spoke with a representative of Pennine Foundation Trust who monitors the care of the people who have been placed at Cheadle Royal Hospital by the Trust. She told us that she was happy with the care and attention people received and had no concerns.
23 September 2011
During a routine inspection
At the same time a Mental Health Commissioner colleague was also doing an announced inspection of The Willows ward.
Mental Health Act Commissioner reports
Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.
Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.