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Inspection Summary


Overall summary & rating

Good

Updated 29 June 2018

We rated Meadow Park as good because:

  • Concave mirrors situated in the ceiling allowed full view of the corridors, thereby allowing staff to observe all parts of the ward. Ligature points were noted during the inspection, and the environmental risk and assessment plan showed that these points were considered and action was in place to address issues. The hospital furniture was well maintained, the hospital itself was very clean. Staffing levels were good, and followed policy. Care plans showed evidence of positive risk taking on the part of the staff at Meadow Park.
  • Patient care plans were comprehensive, personalised, holistic, and recovery orientated. Each patient had signed that they agreed with their care plans. Positive behavioural support plans were in place. There was evidence of patient involvement in all aspects of their care. There was evidence that staff participated actively in clinical audit. Staff were regularly supervised and appraised. Discharge planning was evident in care records and case files. There was active physical health monitoring at Meadow Park, with a registered general nurse employed to take the physical health lead. Mental Health Act documentation was in order and audited. There was training in the Mental Capacity Act.
  • We saw staff interacting with patients at Meadow Park, and it was clear that there were good relationships. Patients stated that staff were respectful, approachable, and interested in patient well-being. Staff were clearly knowledgeable about their patients, and this was reflected in their interaction and notes on case files. Patients commented favourably on the available activities, their named nurses and their plans for the future.
  • Patients who were on leave did not have their beds filled in their absence, ensuring the bed was available on return. Patients had access to their bedrooms, and could securely lock the room. There was access to a telephone with a privacy hood, as well as patients having their own mobile telephones. On admission to Meadow Park, patients completed a questionnaire relating to dietary requirements. Likes and dislikes, allergies, and religion were considered.
  • Staff knew senior managers; both qualified staff and support workers said that senior managers visited the hospital. Staff used key performance indicators to gauge and improve performance. Clinical audit was being carried out with full staff involvement. Staff felt they could raise concerns without fear of victimisation, and morale was reported as being high among staff. We saw evidence of good team working, and there was a high level of support from the hospital manager and senior staff.
  • However
  • Although patients had signed to agree with their care plans, there was no evidence to show that patients had received a copy of the care plan. Some patients told us they did not have copies, but that they were involved in the production, so they knew what the care plan entailed.
  • Psychologist input was initiated through a service level agreement, but we could not fully determine the levels of input by the psychologist; guidance suggests 0.4 whole time equivalent for a psychologist in a 14-bedded unit, and Meadow Park is a 20-bedded unit.
  • There was one full-time Occupational therapist at Meadow Park, a 20-bedded unit. This is the accepted guidance for a 14-bedded unit, and it was felt that an occupational therapy assistant could be utilised to ensure therapies were fully utilised.
Inspection areas

Safe

Good

Updated 29 June 2018

We rated safe as good because:

  • Concave mirrors situated in the ceiling allowed full view of the corridors, thereby allowing staff to observe all parts of the ward. Ligature points were noted during the inspection, and the environmental risk and assessment plan showed that these points were considered and action was in place to address issues.

  • Staff had personal alarms and all rooms had wall-mounted call buttons.

  • Meadow Park was fully compliant with same-sex guidance.

  • The outside area was well maintained, and had exercise equipment in good repair.

  • The hospital furniture was well maintained and the hospital itself was very clean.

  • Staffing levels were good, and followed policy.

  • Patients told us that there was always a qualified member of staff in the main area, and that they were always approachable.

Effective

Good

Updated 29 June 2018

We rated effective as good because:

  • The care plans were comprehensive, personalised, holistic and recovery orientated. Each patient had signed to show they agreed with their care plan.

  • There was evidence of patient involvement in all aspects of their care.

  • There was physical health monitoring taking place under the lead of a registered general nurse.

  • There was evidence that staff participated actively in clinical audit.

  • There was a range of mental health disciplines employed at Meadow Park, including a consultant psychiatrist, qualified nurses and support workers, and an occupational therapist. There was a service level agreement with a local GP and a psychologist.

  • The multi-disciplinary meetings were attended by the consultant psychiatrist, a qualified nurse, a care coordinator, the occupational therapist, and other staff as required ensuring patient needs were met.

  • Staff were regularly supervised and appraised.

  • Discharge planning was evident in care records and case files.

  • Staff received training in the mental health act as part of their mandatory training, with additional training in the Mental Capacity Act.

However,

  • There was no recording of whether a patient had received a copy of their care plan, even though there was a note to say they agreed with the care plan.

  • Psychologist input was by service level agreement, and we could not fully determine the levels of input by the psychologist for a 20-bedded unit.

  • There was one full-time Occupational therapist at Meadow Park, a 20-bedded unit. This is the accepted guidance for a 14-bedded unit, and it was felt that an occupational therapy assistant could be utilised to ensure therapies were fully utilised.

Caring

Good

Updated 29 June 2018

We rated caring as good because:

  • We observed kind, caring and positive interactions between staff and patients.

  • Patients said that staff were respectful, approachable and interested in patient well-being.

  • Staff were clearly knowledgeable about their patients, and this was reflected in their interaction and notes on case files.

  • Minutes of community meetings that involved the patients were reviewed and shown to reflect the feelings and demands of patients.

  • Patients commented favourably on the available activities.

  • Multi-disciplinary team reviews showed participation and consideration over all aspects of care.

  • Carers we spoke to said that they had been involved in meetings with their relative and the multi-disciplinary team, and felt that their opinions had been taken into consideration.

Responsive

Good

Updated 29 June 2018

We rated responsive as good because:

  • Patients who were on leave did not have their beds filled in their absence, ensuring the bed was available on return.

  • Meadow Park had a range of rooms and equipment to support treatment and care.

  • Patients had keys to their bedrooms and all-day access, and could securely lock the room.

  • There was access to a telephone with a privacy hood, as well as patients having their own mobile telephones.

  • Meadow Park had a range of activities for patients, available seven days per week.

  • Meadow Park had capacity to take patients with various physical disabilities as well as mental health problems.

  • We saw evidence of consideration of physical health aspects such as sugar intake and smoking cessation initiatives.

  • Complaints were fully investigated, and there was a low number of complaints in the 12-months prior to inspection, as well as a compliment to the service.

Well-led

Good

Updated 29 June 2018

We rated well-led as good because:

  • Staff knew senior managers; both qualified staff and support workers said that senior managers and executives visited the hospital.

  • Staff used key performance indicators to gauge and improve performance.

  • Mandatory training figures showed that none of the training was below 75%, and that updated training and refresher training had been organised and booked for staff.

  • Clinical audit was being carried out with full staff involvement; the audit and assurance framework showing comprehensive auditing across the service.

  • Staff felt they could raise concerns without fear of victimisation, and morale was reported as being high among staff.

  • Trained staff had the opportunity to receive leadership training, and this was part of the management induction training.

  • We saw evidence of good team working at Meadow Park, and there was a high level of support from the hospital manager and senior staff.

Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Good

Updated 29 June 2018