- Independent mental health service
Cheadle Royal Hospital
Assessment report published 19 August 2026
Contents
Ratings - Child and adolescent mental health wards
Our view of the service
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.
People's experience of this service
We spoke with 2 of the young people receiving care on the ward on the day we inspected. Young people were happy overall with the standard of care they were receiving. They said the ward was clean and staff were kind and friendly and helped them to feel safe. Young people benefited from accessing the ward school and felt they were getting good educational support. They felt involved in their care and said they were given sufficient information about their treatment, including the medicines they were taking. Young people said they had regular access to their family during their admission and did not feel they were being subjected to excessive restrictions. They said they knew how to raise concerns if they had any complaints about their care and they would feel safe to do so. They told us they felt well supported by the advocate who regularly visited the ward and who was able to support them at their ward round meetings.
However, we also heard that debriefs were not consistently offered to young people following incidents and that access to the outside space was restricted as the secure garden was down a flight of stairs and staff were not always available to support young people to go outside. Young people also told us that at times there could be a lot of agency staff working on the ward who were not as familiar with their needs and more likely to make mistakes. Young people also did not like the food on the ward and said that there was not enough to do at weekends when the occupational therapist (OT) and OT assistants were not working. We were told that the ward could be too noisy at times and that the maintenance team could be slow to repair things.
We also spoke with 2 family carers. Carers gave us mostly positive feedback. They said they were able to visit their child at times convenient to them and the facilities for visiting in the hospital were clean and fit for purpose. They said they were invited to dial in to ward round meetings and they were happy with the level of involvement they could have in their child’s care. However, feedback from carers about communication was mixed, with some concerns raised about not being informed about incidents in a timely way. Carers felt that their child was kept as safe as possible on the ward and were not concerned about inappropriate restrictive practices being used. They spoke positively about the education their child was receiving during their admission.
None of the young people or carers we spoke with during the inspection raised any concerns which suggested a lack of compliance with the `Right support, right care, right culture' guidance on providing care for people with a learning disability and/or autistic people.