Archived: Butterworth Centre

Updated 31 March 2023

The Butterworth Centre is an independent mental health hospital operated by Sanctuary Care for up to 42 patients. The service offers inpatient care and treatment to older people with mental health needs, many of whom also require support for their physical health needs or end of life care. Most patients have additional physical frailties and some degree of dementia. Care and treatment included personal care. All beds at the hospital are commissioned by the North-West London Integrated Care Board. On the day of the inspection, there were 25 patients at the hospital. Seven patients were detained under section 3 of the Mental Health Act 1983. Other patients were subject to Deprivation of Liberty Safeguards. There are three separate wards providing single-sex accommodation to men and women. Each ward can accommodate up to 14 patients. There is a registered manager in place at the service.

The centre sits within the grounds of St Johns and Elizabeth Hospital. St John and St Elizabeth own the building and are responsible for building maintenance. The Butterworth Centre has developed strong links with the acute hospital and shares training and expertise where appropriate.

We last inspected this service in February and July 2020. We rated the service as good overall but found the provider had failed to ensure that staff were following policies and procedures when managing medications, including the administration and reporting of covert medication. Staff were not always wearing the correct personal protective equipment. These were breaches of Regulation 12 of the Health and Social Care Act 2008. We also found that relationships within the nursing team did not always support a positive work culture, but this had not directly impacted patient care or treatment.

The service will be transferring back to the National Health Service in April 2023.

What people who use the service say

We spoke with 3 patients and 3 carers during our inspection. The patients and relatives were very positive about the staff, they said staff treated them with dignity and respect. All patients told us that they felt safe in the service. Patients told us that that there were good interactions with staff and that they were well-looked after. Relatives told us that staff kept them informed about developments to patient’s care and felt they were able to approach staff for advice easily. Patients and relatives were aware of how to provide feedback should they need to. The service provided a carers’ support group that operated every 2 months. This provided them the opportunity to provide feedback about the service and meet other carers for peer support. The service held a feedback survey last year and an open call meeting. They planned to send out a survey in 2023.

Updated 31 March 2023

We rated wards for older people with mental health problems at Butterworth Centre as good because;

• Staff kept patients safe from avoidable harm. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to specialists required to meet the needs of patients on the wards. Managers ensured that these staff received supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing care.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They involved patients and families and carers in care decisions.
• The service managed beds well as part of the local continuing care pathway.
• The service was well led by an interim management team, and governance processes ensured that most ward procedures ran smoothly. A new registered manager was due to start after our inspection.

However;

• Some staff who were delivering care and treatment had not completed or kept up-to-date with their basic training.
• Some areas of the hospital environment had not been well maintained and kept in good working order.

Updated 31 March 2023

See overall summary above.