Kneesworth House

Ratings - Forensic inpatient or secure wards

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Good

Our view of the service

The assessment of forensic inpatient or secure wards took place on 12 August to 14 August 2025. This assessment service group was made up of 2 medium secure wards and 1 low secure ward.

Clopton ward was a medium secure ward admitting male patients. It had capacity for 12 patients; the ward was at full occupancy at the time of the inspection.

Ermine ward was a medium secure ward admitting male patients. It had capacity for 18 patients and had 16 patients admitted at the time of inspection.

Orwell ward was a low secure ward, admitting male patients. It had capacity for 16 patients and had 10 patients admitted at the time of inspection.

We rated the service as good. The service had made improvements and is no longer in breach of regulation. Staff now ensure patients were secluded in the right environment and seclusion was recorded in line with the Mental Health Act Code of Practice and the provider’s policy.

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. Staff had a good understanding of the Mental Capacity Act. The training was initially provided as part of the induction process and thereafter staff had regular refreshers.

Staff assessed and recorded capacity to consent clearly each time a person needed to make an important decision. Staff took all practical steps to enable people to make their own decisions. Staff completed an assessment on admission of each person’s capacity to consent to admission and treatment. Further assessments took place during reviews by the multidisciplinary team.

Staff knew where to get advice regarding the Mental Capacity Act, including deprivation of liberty safeguards.

People's experience of this service

We spoke with 18 patients and 4 carers. We received both positive and negative feedback across the 3 wards.

Patients on Ermine ward gave mostly positive feedback, they said that the staff were good, worked hard and were always available for support, they met with their named nurse regularly and felt safe on the ward. Patients felt involved in their treatment, 1 patient said, “I have been listened to and have worked together to get my medication right”. Patients said they had access to advocacy and knew how to make a complaint. A patient said, “whenever a problem comes up, we all work together to make it a problem no more”. Most patients we spoke to said they did not enjoy the food and there were not enough activities.

Patients on Clopton ward gave mixed feedback, patients said most staff were nice, they met regularly with their named nurse, and they felt safe on the ward. Patients said there was very little to do and they got bored, they also said they did not like the food. Mostly patients said they were involved in their care and treatment; however, some did say they didn’t feel they were listened to. Patients said they could access an advocate if needed and knew how to make a complaint. Some patients said there had been occasions where their leave had been cancelled.

Patients on Orwell ward gave mixed feedback, they said they felt safe on the ward but didn’t feel supported or listened to by all staff, some patients said staff could be rude. Patients said they met with their named nurse regularly and were involved in their care and treatment, patients said they could access an advocate and knew how to complain. Patients said there was very little to do on the ward and they did not enjoy the food.

Carers gave mixed feedback about the service, mostly carers said the wards were friendly and staff were kind. Some carers said they found it difficult to get through to the ward on the telephone, and they were not always contacted with updates. Other carers said that the communication was good, and they attended all ward rounds. One carer said that staff celebrated their relative’s culture with them.