The Care Quality Commission
  • Mental Health
  • Independent mental health service

Lea Court

Overall: Good read more about inspection ratings

30 Hawleys Lane, Dallam, Warrington, Cheshire, WA5 0EZ (01925) 243577

Provided and run by:
Alternative Futures Group Limited

All Inspections

29 & 30 November 2023

During a routine inspection

Our rating of this location stayed the same. We rated it as good because:

  • Patients gave positive feedback about the care and treatment they received from the service. Patients felt safe in the hospital and described staff as kind, caring and attentive to their needs. Patients were engaged and listened to by staff. Staff included and informed patients about their care and treatment.
  • The service had made improvements in respect of staffing issues and was reducing the usage of agency staff. The service had reducing vacancy rates and was continuing to recruit to vacant posts. Staff sickness and turnover rates were reducing.
  • Staff were positive about working in the service and felt supported by management and as a team. We observed positive interactions between staff and patients including when patient behaviours started to escalate. Managers were aware of how to support staff and encouraged a positive working environment.
  • There was evidence of occupational therapy involvement throughout patient records. Patients gave positive feedback about the engagement and work done by the Occupational Therapist, along with the activities that were on offer in the service. There was also evidence of ongoing monitoring, checks and support regarding physical health and this was documented in patient records.

However:

  • There was no overarching care plan in 1 of the 6 patient records that we reviewed in either the paper folder or the electronic record, despite the patient being in the service since August. The front sheet of the paper folder had indicated that this was not present as per a review of the folder on the 11 November. Whilst this had been identified in the file review, it was not clear how this was escalated or identified for action.
  • There were inconsistencies and gaps identified with some of the processes around governance and audit. For example, when we reviewed some of the agency checklist templates, 1 of the forms had not been fully completed and it was confirmed there was no audit or checking of these forms. We also identified issues with the completion of daily bedroom checklists where some of the forms had not been dated or recorded who had completed the checklist. There were also some environmental risk assessments which had not been completed and were in the process of being updated.
  • During the tour there were some rooms that were locked which were noted that they should have been open. It was not clear as to why the rooms were locked or for how long they had been locked. There was no specific audit of potential blanket restrictions for the hospital as a whole to understand where these issues may be occurring, although the service had had a restrictive practices audit in February 2023 and most patients we spoke to did not raise any concerns about restrictions.

21 May 2018 and 1 June 2018

During a routine inspection

We rated Lea Court as good because:

  • The hospital complied with the Department of Health guidance on same sex accommodation.
  • There was enough staff to provide recovery-based care and treatment to patients.
  • Patients’ risk assessments were well completed and reviewed.
  • There were minimal significant incidents but when incidents did occur, staff learnt lessons.
  • Staff carried out regular physical health checks with patients.
  • Patient recovery plans were well completed and personalised.
  • There was good multidisciplinary working with thorough occupational therapy assessment and input.
  • Staff were receiving specialist clinical skills training to provide more effective care and treatment to patients with a personality disorder.
  • Staff were trained in, and adhering to, the Mental Health Act and Mental Capacity Act.
  • Comments from patients on the standards of care and treatment were positive.
  • Patients were involved in identifying their own goals to aid meaningful recovery and developing their care plans.
  • There were regular weekly patient community meetings occurring for patients to discuss day to day issues.
  • Staff had regular contact with community mental health team professionals and the hospital had links with the wider community.
  • There were no patient complaints and managers had put in systems so that if informal complaints were made they were managed well.
  • Staff morale was good and there was good local leadership.
  • Governance arrangement and checks in place were good.

However:

  • There was a domestic sink in the clinic room with plug and overflow which did not meet good infection control measures. The provider was taking action to address this.
  • Following a recent incident, managers at Lea Court had not been able to fully clarify the pathways into acute mental health inpatient and psychiatric intensive care for deteriorating patients with local partners.
  • There was no designated on-site psychologist but patients had access to psychological services.
  • Managers were working to improve formal supervision uptake rates.
  • Although staff were regularly informing detained patients of their rights, we found a small number of patients’ files where staff had not revisited patients’ rights at particular intervals such as, in one case, when a patient’s detention was renewed.
  • While overall adherence to the Mental Capacity Act was good; we did see in one case, nursing staff had applied for a standard Deprivation of Liberty Safeguards application and were still awaiting a decision but had not applied for an urgent authorisation alongside this. This was rectified at the earliest opportunity.
  • Written minutes of community meetings did not always clearly record what action was needed or what action had been taken to show that patients’ concerns had been fully addressed.

23rd March 2016

During a routine inspection

We rated Lea court as good because :

  • effective systems and processes were in place to monitor and manage environmental risks
  • there were adequate staffing levels, with staff on duty that were knowledgeable, and experienced. Staff had all attended their mandatory training and had additional training to support their role
  • patients’ care plans and risk assessments were in place and up to date. They all reflected the patients’ needs and were recovery focused
  • safeguarding procedures were in place and staff were able to tell us how they would identify and report any issues
  • we observed staff being kind and respectful to patients. Staff were also very knowledgeable about the patients they cared for
  • patients were able to personalise their bedrooms, and had access to a pay phone in a private area of the ward. Blanket restrictions were limited and individualised based on risk
  • there were no restraints or complaints over the 12 months period prior to inspection
  • physical health care was prioritised and monitored. This included those patients on high dose antipsychotics
  • multi-disciplinary team meetings and care programme approach meetings took place that were patient centred and focused on the person’s recover journey
  • the visions and values of the organisation were embedded, and there was evidence of positive leadership
  • staff and team morale was good, staff had access to regular team meetings, supervision and work performance appraisals.

However,

  • there were not enough panic alarms available for all staff, which put the staff at risk of harm
  • the service did not log informal complaints therefore there were no records of how these were managed.

4 February 2014

During a routine inspection

We saw that care plans had been signed by people who live at the service and their named nurse.

Most of the people spoken with said they were asked to consent to treatment and felt they were given sufficient information to enable them to make informed choices. One person said 'the Dr explained all the side effects about my medication to me it was the way he told me that made the difference, he told me the good and the bad and I thought, I trust you, your right up front'.

All of the people we spoke with told us they received the care and support they needed and they said staff responded well to their needs. One person said, "I get really good support. I am doing so well."

Another said they were asked to put their own ideas and suggestions into their care plan and explained how their key worker encouraged him.

The staff we spoke with had a good understanding of people's individual support needs and the majority of staff were good at identifying behaviours which may present risks to the person or to others.

People were encouraged to cook meals for themselves as part of rehabilitation and they were supported by the occupational therapist and key worker to budget, shop and cook meals sometimes for their peers.

The people who lived in Lea Court we spoke with told us they thought there was enough staff to support them in the way that they needed. One person commented 'There always seems to be enough staff.'

21 December 2012

During an inspection looking at part of the service

The purpose of this visit was to follow up on what actions the provider had taken to improve the service since our last visit in July 2012 in which several areas of the service were judged as non compliant. At this visit we met with the provider and they sent us regular updates on the action they had taken to meet the compliance actions we had issued in July 2012.

During our visit on 21 December 2012 we saw that improvements had been made in the areas of safeguarding; care and welfare of people who use the service; supporting staff; assessing the quality of the service and records.

4 July 2012

During a routine inspection

People who use the service told us that they were consulted and supported to make decisions about their treatment and care. They told us that they have regular opportunities to discuss their plan of care with the staff and their doctor. People told us that the staff team always respected their privacy and dignity. One person told us 'staff have been very good and help me.'

People told us during our visit that they regularly had the opportunity to get involved in the planning of their care. People told us that they had regular access to mental healthcare professionals and their GP. They told us they felt safe living at Lea Court and that they knew who to speak to if they were not happy or had a concern.

People told us positive things about the staff who supported them. Comments included 'they are great'; 'they are very supportive and listen to me.'

23 February and 6 May 2011

During a routine inspection

People told us positive things about the service they received. They told us that they were encouraged to participate in the planning of their care and treatment.

People told us that they liked the environment that they lived in. They told us that they felt safe.'

People told us they liked the food that was served at Lea Court and that they had a choice of what they wanted to eat.

People told us that the staff listened to them and that they could approach the staff with any concerns they may have.

Overall people were very happy with the service they received.

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.