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Inspection Summary


Overall summary & rating

Good

Updated 5 September 2018

We rated Ashwood Court Nursing Unit as good because:

  • The environment was safe, and where there were risks these were identified and managed. The service complied with guidance on mixed sex accommodation. All patients had their own bedroom, and there were designated corridors for men and women. The clinic room was clean and appropriately stocked. Medical devices and resuscitation equipment were readily available.
  • The service did not use restrictive interventions such as restraint and seclusion. One-to-one observations and rapid tranquillisation were rarely used. Staff were aware of the safeguarding policy, and knew how to raise concerns. Incidents were reported and responded to appropriately.
  • The service had enough staff with the right skills, training and experience. Patients received care and treatment from a multidisciplinary team of staff which included occupational therapy and psychology. All staff received supervision and appraisal.
  • Medication was safely prescribed, administered, stored and managed by the service. All patients had an assessment of their needs, and care plans developed in response to identified needs. All patients had a physical examination on admission, and ongoing monitoring of their physical health. Staff used rating scales to monitor patient’s progress.
  • Patients were mostly positive about the care they received and the service that was provided. The service held weekly community meetings, where patients gave their opinions about the service, and raised their concerns. Patients had access to an advocacy service. Patients were involved in their care, and this was reflected in some of the care records.
  • All patients had a key to their own room, and access to a phone, computer and wifi. Patients had access to outdoor, space, and were encouraged to engage in activities inside and outside the unit. Food was prepared and cooked in the onsite kitchen. Patients could make hot and cold drinks when they wished.
  • The Mental Health Act was implemented effectively. Staff were trained in the Mental Health Act and the Mental Capacity Act. They could access additional advice and support when required. There were systems for the implementation and monitoring of the Mental Capacity Act and Deprivation of Liberty Safeguards.
  • The building was accessible to people using a wheelchair. The service had carried out care and treatment reviews for patients with a learning disability, in accordance with national guidance.
  • There were governance structures in place. These ensured that key elements of the service were monitored, and areas for improvement identified and action taken. Regular audits were carried out, and the findings reviewed and implemented at both local and board level. Key performance indicators were used to monitor the service both inside the organisation, and by external bodies such as the clinical commissioning group.

However

  • The quality of the care plans varied and they were not consistently person centred.
  • There was no specific documentation in patient’s records regarding the use of high dose antipsychotic therapy.
  • New medical equipment had not been routinely checked in accordance with the manufacturer’s instructions. Some of the disposable items in the clinic room were beyond their printed expiry date.
Inspection areas

Safe

Good

Updated 5 September 2018

We rated safe as good because:

  • The service had enough staff with the right skills, training and experience.

  • The service complied with guidance on mixed sex accommodation. All patients had their own bedroom. There were designated corridors for men and women, that included bathrooms and toilets.

  • The environment was safe, and where there were risks these were identified and managed. There were no unjustified blanket restrictions.

  • The service did not use restrictive interventions such as restraint, rapid tranquillisation and seclusion. One-to-one observations were rarely used.

  • Staff were aware of the safeguarding policy, and how to raise concerns.

  • Medication was safely prescribed, administered, stored and managed by the service.

  • Incidents were reported and responded to appropriately.

  • Staff understood the duty of candour. The service ensured that there were clear policies about being open and transparent with patients

  • The clinic room was clean and appropriately stocked. Medical devices and resuscitation equipment were readily available, and in most instances they were appropriately serviced and maintained.

However

  • Some of the disposable items in the clinic room were beyond their printed expiry date.

  • There was no specific documentation in patient’s records regarding the use of high dose antipsychotic therapy.

  • New medical equipment had not been routinely checked in accordance with the manufacturer’s instructions.

Effective

Good

Updated 5 September 2018

We rated effective as good because:

  • All patients had an assessment of their needs.

  • All patients had a physical examination on admission, and ongoing monitoring of their physical health.

  • Staff used rating scales to monitor patient’s progress.

  • Patients received care and treatment from a multidisciplinary team of staff which included occupational therapy and psychology.

  • All staff received supervision and appraisal.

  • The Mental Health Act was implemented effectively. Staff had access to support to administer the Act as required. Staff were trained in the Mental Health Act and the Mental Capacity Act. There were systems for the implementation and monitoring of the Mental Capacity Act and Deprivation of Liberty Safeguards, when necessary.

  • Care records were stored securely and were accessible by staff.

  • All patients had care plans developed in response to the assessments of their needs.

However

  • The quality of the care plans varied and they were not consistently person centred.

Caring

Good

Updated 5 September 2018

We rated caring as good because:

  • Patients were mostly positive about the care they received and the service that was provided.

  • Patients had access to an advocacy service.

  • Patients had weekly community meetings. At these meetings they were given information about the service. They gave their opinions about the service, and raised their concerns about the service.

  • Patients were involved in their care, and this was reflected in some of the care records.

However

  • The care records were not consistently completed in a person-centred way.

Responsive

Good

Updated 5 September 2018

We rated responsive as good because:

  • The service tracked the time taken from referral, and through the patient pathway. The service had a target for how long a patient would remain in the service, and monitored how this progressed.

  • All patients were from the local area. There was no waiting list for the service.

  • The building was accessible to people using a wheelchair.

  • The service had carried out care and treatment reviews for patients with a learning disability, in accordance with national guidance.

  • All patients had a key to their own room which they had personalised.

  • Patients had access to a computer, and to the service’s own wifi. Patients had access to the garden.

  • Patients were supported to engage in activities inside and outside the unit.

  • Food was prepared and cooked in the onsite kitchen. Patients could make drinks when they wished.

  • The service had a process for receiving and responding to complaints.

Well-led

Good

Updated 5 September 2018

We rated well led as good because:

  • The registered manager had the necessary authority and support to carry out their role.

  • There were governance structures in place. This ensured that key elements of the service were monitored, and areas for improvement identified and action taken.

  • Key performance indicators were used to monitor the service both inside the organisation, and by external bodies such as the clinical commissioning group.

  • Staff were positive about working in the service, and felt able to raise concerns.

  • Regular audits were carried out, and the findings reviewed and implemented at both local and board level.

  • The provider had been peer reviewed through the Royal College of Psychiatrists accreditation for inpatient rehabilitation units scheme.

Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Good

Updated 5 September 2018

See main report.