Kneesworth House

Ratings - Acute wards for adults of working age and psychiatric intensive care units

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Good

Our view of the service

The assessment of acute wards for adults of working age and psychiatric intensive care units took place on 12 August to 14 August 2025. This assessment service group was made up of 1 psychiatric intensive care unit (PICU) and 2 acute wards. The PICU ward was called Wimpole and admitted female patients. It had capacity for up to 10 patients and had 6 patients admitted at the time of the inspection. One of the acute wards was called Bourn. Male and female patients were admitted to Bourn with a split of 10 females and 5 males, giving the ward capacity for 15 patients. The ward was full at the time of the inspection. The other acute ward was called Nightingale and admitted male patients. It had capacity for 14 patients. The ward was full at the time of the inspection.

We rated the service as good. The service had made improvements and is no longer in breach of regulations. Staff now ensured that patients’ access to bedrooms, mobile phone chargers and outdoor space were only restricted where this was required through individual risk assessment. Staff now ensured patients were secluded in line with the Mental Health Act Code of Practice and the provider’s policy. Staff now ensured essential learning and information was passed between the hospital’s senior management team and the ward managers and this was shared with all staff and recorded appropriately.

Mental Health Act and Mental Capacity Act Compliance Summary

The service admitted patients under the Mental Health Act 1983. Staff received and kept up-to-date with training on the Mental Health Act and the Mental Health Act Code of Practice and could describe the Code of Practice guiding principles. Training on the Mental Health Act was mandatory for staff and the compliance rate was 94.7%.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff received assistance from designated Mental Health Act staff, based at the hospital.

The service had clear, accessible, relevant and up-to-date policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice. For example, there was a process in place to monitor patient’s legal status and renewal dates, which meant staff were able to ensure reviews took place in a timely manner.

Staff explained to each patient their rights under the Mental Health Act in a way that they could understand, repeated as necessary and recorded it clearly in the patient’s record each time. Discussions in patients’ ward rounds included information about the right to appeal against detention.

Staff made sure patients could take section 17 leave (permission to leave the ward or hospital) when this was agreed with the responsible clinician and ministry of justice where applicable. The use of leave from the ward was agreed by the multidisciplinary team. Arrangements for leave were made at daily planning meetings and nurses carried out an assessment of each patient’s mental state before each occasion of leave was utilised.

Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to.

Staff stored copies of patients’ detention papers and associated records correctly and staff could access them when needed.

Mental Capacity Act

Staff received and kept up to date with training in the Mental Capacity Act and had a good understanding of the five principles. Training on the Mental Capacity Act was mandatory for staff and compliance figures across the hospital were 95.5%. Training on the Mental Capacity Act was provided as part of the induction process.

Staff assessed and recorded capacity to consent clearly each time staff had reason to doubt whether a patient had capacity to make a particular decision. Staff completed an assessment of each patient’s capacity to consent to admission and treatment on admission. Further assessments took place during reviews by the multidisciplinary team.

People's experience of this service

We spoke with 6 patients and 4 carers. Feedback was both positive and negative. Patients in the psychiatric intensive care unit (PICU) felt they did not experience good communication from staff, did not feel listened to, and did not feel involved in their care. They expressed there were limited activities for them to do. Carers of patients in the PICU service told us it was difficult to contact the ward and speak to staff who knew about their relatives. They told us the bathrooms were not clean. Patients across the acute and PICU service told us they found observations could be intrusive. Patients across the service told us they did not know who their named worker was.

Patients in the acute service told us they had a good choice of activities, they felt involved in their care and treatment and found ward rounds helpful. They were able to share feedback and concerns in community meetings. All patients we spoke to throughout the service told us that they knew how to access an independent advocate and were supported to stay connected with their families and friends. Carers of patients in the acute service told us staff were friendly, they were invited to attend ward rounds, and they received regular updates about their relatives.