The hospital was purpose-built in the summer of 2009 and provides high-quality accommodation. Furnishings and equipment are to a very high standard and all bedrooms have en-suite shower facilities. The hospital was bright, comfortable and welcoming. There are places for up to 32 male patients and the hospital is secure. When we visited there were 25 people in residence. All were detained under the Mental Health Act 1983.
A wide range of activities are lead by the occupational therapy team who work to produce a tailored programme providing individual support, with sufficient staff for people to achieve their personal goals. The main objective is to provide rehabilitation for patients. The average length of stay was 18-24 months.
During our visit some people were involved in external activities. Three had spent the morning horse-riding and one person was on overnight leave at home.
We spoke with at least half the patients who told us about their life at St. Augustine's. They were keen to tell us how they spent their time. They understood fully their status as detained patients but most focussed upon the positive motivation to obtain 'Section 17 leave.' People are only able to leave the hospital if leave is approved by the responsible clinician who must approve leave under Section 17 of the Mental Health Act 1983.
In practice the majority of people were accessing the community, people progressing through different levels of leave ranging from 1:1 escorted with a member of staff, unescorted group leave and ultimately unescorted leave as they made progress in their rehabilitation programme.
People gave us examples of activities in the community that included: attending local colleges, cinema, swimming, social club, football bowling and a range of other leisure activities through to local museums and Alton Towers.
A patient who had to return to the hospital following a trial in the community under a community treatment order told us why things had not worked out for him and why he now had restricted leave. We asked him about his care and treatment, he said, 'The staff are really good to us, they treat us like they would their own family'.
Throughout the day of the inspection visit there was a very relaxed atmosphere. Some people were involved in activities, others were not. Some spending time in the main communal areas, talking, playing pool and other games. We observed good levels of engagement and communication between patients and staff at all levels. We saw that a potential for escalation of behaviours was identified swiftly by staff who sensitively defused the situation.
People we spoke with were generally positive about the service and the staff group. Comments included: 'I have been here 18 months and want to stay.' 'Yes, I like the staff, they always listen and do their best for me.' 'I go out a lot into the community and do the things I like, staff used to come with me but now I can go alone, they obviously trust me.'