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Inspection Summary


Overall summary & rating

Good

Updated 26 March 2018

We rated Raglan House as Good because:

  • Morale amongst staff at the service was excellent. The registered manager and head of care were described as providing consistent, effective and visible leadership and staff reported that working as part of the multi disciplinary team was like being part of a family.
  • Staff at the service completed a range of environmental and individual risk assessments to ensure the safety of patients receiving care. Detailed contingency plans were in place in the case of emergencies and all patients received a review of their presenting risk on a daily basis.
  • Care plans were detailed, holistic and recovery focussed. We found evidence that patients were assisted from the point of admission to identify and achieve their rehabilitation goals, and to work towards increasing independence and eventual discharge from the service.
  • Sufficient numbers of skilled staff were available and patients were able to access nationally recognised therapeutic interventions, including psychology and occupational therapy. Professional development was encouraged by senior staff and monitored through the routine use of clinical and managerial supervision.
  • A comprehensive audit programme was in place and completed by staff to ensure the delivery of a high quality service. Action plans were developed based on audit results and improvement was evident where previous results had not reached the required standard set by the provider.
  • Patients and carers that we spoke with provided positive feedback in relation to the care and treatment provided by staff at the service. We were told that staff treated patients with kindness, dignity and respect, and that families and carers were routinely involved in the care planning process.
  • Effective governance procedures were in place at a local and national level to monitor the quality of the service. The registered manager met routinely with the leaders of other hospitals to share good practice and to ensure lessons were learnt as an organisation when things did not go as planned.
  • Staff and patients reported an open culture where they felt safe to raise concerns if necessary and were assured they would be supported by to do so. We found that where complaints or concerns had been raised, staff had responded promptly and duty of candour was evident where appropriate.
Inspection areas

Safe

Good

Updated 26 March 2018

We rated safe as good because:

  • A range of environmental checks and health and safety assessments were routinely completed by staff. The hospital had a detailed contingency plan in case of emergencies including in the event of a fire and the outbreak of infectious diseases.
  • A range of nationally recognised assessments and rating scales were used to measure patient risk. A daily review of all patients was carried out by the senior management team for the hospital and risk mitigating factors identified.
  • Procedures were in place for the safe dispensing and reconciliation of medication stocks. Audits of the medication management were carried out weekly and action plans developed to address any areas where improvement was identified.
  • The hospital had a culture of reflective practice and learning lessons from incidents. We were able to see that changes had been made following incidents to improve patient safety.
  • There were sufficient staff who were suitably skilled and qualified to ensure safe care. Sickness levels were low and staff were able to attend a range of statutory and mandatory training opportunities.

Effective

Good

Updated 26 March 2018

We rated effective as good because:

  • Records relating to the planning of patient care were detailed, addressed a range of patient strengths and needs and were updated regularly by staff.
  • Patients could access a range of nationally recognised clinical interventions, including psychology. Rating scales and outcome measures were in place to monitor the effectiveness of the care provided and staff routinely completed case formulations and patient reviews.
  • Supervision and appraisal rates for staff were high and allied health professionals were able to access peer support and supervision as required.

  • A range of meetings routinely took place to ensure that the service operated effectively and communication was shared amongst staff from all disciplines.

  • Audits were completed as part of an annual schedule to ensure the delivery of a high quality service. Action plans were developed as a result of audits findings and we found that actions identified were completed by staff.

Caring

Good

Updated 26 March 2018

We rated caring as good because:

  • All patients that we spoke with told us that staff treated them with kindness, dignity and respect. We were given examples of staff working collaboratively with patients to enhance their recovery.
  • Staff worked with patients from the point of admission to develop person centred care plans which identified a range of strengths and needs and provided a range of interventions to assist them in their recovery.

  • Families, carers and support networks were routinely involved in the planning of patient care. All patients were able to have a copy of their care plan and were supported to do so by staff.
  • Weekly community meetings were held to give patients the opportunity to provide feedback on the quality of the service provided.

  • Advocacy services were available for patients and had been independently commissioned in line with the 2015 Mental Health Act Code of Practice, with a focus on patient involvement and feedback.

Responsive

Good

Updated 26 March 2018

We rated responsive as good because:

  • The average length of patient stay at the hospital was two years and in line with national guidance for community mental health rehabilitation settings.
  • Discharge planning was evident in care records reviewed. Patients that we spoke with were aware of their treatment goals and were able to describe how they were working towards discharge from the service.
  • A range of occupational activities were provided by staff to meet the social, leisure and recovery needs of patients and there were a full range of facilities to support treatment and care.
  • The service had a target of offering each patient 25 hours of meaningful occupation per week and had an average achievement rate of 94% in the three months prior to our inspection.
  • Information was available throughout the service for patients on the hospital's complaints process and policy. Staff responded promptly to complaints and duty of candour was evident where required.

Well-led

Outstanding

Updated 26 March 2018

We rated well-led as outstanding because:

  • Morale amongst staff at the service was excellent and staff we spoke with described the team as being part of a small family who worked collaboratively to provide high quality patient care.
  • The registered manager and head of care at the service were described as providing consistent, visible and strong leadership. They were supported by a multi disciplinary team who worked collaboratively to ensure high quality and safe care.
  • Staff told our inspection team that they were proud of the standard of care they offered and the sense of achievement gained from the improvements they could make to patients' recovery and quality of life.

  • Effective governance structures were in place at a local and regional level. The registered manager was able to measure the performance of the service using key indicators and we saw evidence of this during our inspection.

  • The service had established a philosophy and values and staff were able to describe how this was incorporated into their approach to providing care.

  • All staff told us they felt able to raise concerns using the provider's whistleblowing policy if required. Staff at the service said they would be supported by the registered manager or head of care to raise concerns and felt safe to do so.

Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Good

Updated 26 March 2018