Spring Wood Lodge

Updated 11 January 2022

Spring Wood Lodge is an inpatient rehabilitation service provided by Elysium Healthcare Limited. The service provides care to a maximum of 21 female patients.

There are two wards: Bronte ward and Byron ward.

• 9 bedded high dependency inpatient rehabilitation (Bronte ward)
• 12 bedded inpatient rehabilitation (Byron ward)

At the time of our inspection there were 11 patients on Byron ward and 9 patients on Bronte ward. Spring Wood Lodge has been registered with the Care Quality Commission since October 2016 to carry out the following regulated activities:

• Assessment and treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder, or injury
• Diagnostic and screening procedures

The Care Quality Commission last carried out a focused inspection of this service on 18 November 2020. At that inspection we rated the service as ‘good’ overall with ratings of ‘requires improvement’ in the safe key question, and ‘good’ in the effective, caring, responsive and well-led key questions. We issued the provider with one requirement notices under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to safe care and treatment.

The service had been subject to a large scale safeguarding enquiry implemented by the local authority due to agency staff sleeping whilst on duty, high incidents of self-harm and a high amount of complaints. Due to improvements made by the service, the enquiry was closed in April 2021. The Care Quality Commission monitored the service through regular engagement and completed this full inspection to enable a review of the whole service.

At this inspection, we rated the hospital as requires improvement overall with good in the caring and responsive domains. We issued the provider with three requirement notices under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to person centred care, safe care and treatment, and good governance.

What people who use the service say

We spoke to eight patents and nine carers of patients. Three patients told us there was a delay in getting prescriptions following a change in medicines at ward round and five patients told us there was not enough cleaning provision. Seven patients told us that mealtimes were too early, and four patients said the service regularly ran out of snack options such as bread and milk. Following the inspection, the service changed mealtimes to a later time and ensured there was always a range of snacks available for the patients. All patients said the new menu at the service was good and that staff were respectful and interested in their wellbeing.

Four carers told us they had visited with their relative in a communal area of the hospital and one of the carers was not happy that it had not been a private room. One carer said that the lack of a psychologist had impeded their relative's progress. Four carers said they were not routinely updated on their relative's care, whilst four carers said that communication from the service was good, and they were kept updated. All carers’ said staff were supportive, respectful, and interested in the patient’s wellbeing.

Updated 11 January 2022

Our rating of this location went down. We rated it as requires improvement because:

• Although we found the service largely performed well, it did not meet legal requirements relating to safe, effective, and well led, meaning we could not give it a rating higher than requires improvement.
• There was no formal psychological provision in place for patients.
• Medicine charts did not match the appropriate Mental Health Act documentation and were not routinely updated as soon as reasonably practicable.
• Not all patient areas were well maintained and cleaned regularly.
• Cleaning records and clinic room records were not regularly completed and audited.
• Patient outcomes for occupational therapy were not routinely measured and reviewed.

However:

• The service had enough nursing and medical staff, who knew the patients and received basic training to keep people safe from avoidable harm.
• Staff participated in the provider’s restrictive interventions reduction programme, which met best practice standards. Staff made every attempt to avoid using restraint by using de-escalation techniques and restrained patients only when these failed and when necessary to keep the patient or others safe.
• Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Care plans reflected patients’ assessed needs, and were personalised, holistic and recovery oriented.
• Staff supported patients to make decisions on their care for themselves. They understood the providers policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity.
• Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of patients and supported patients to understand and manage their care, treatment, or condition.
• Staff planned and managed discharge well. They liaised well with services that would provide aftercare and were assertive in managing the discharge care pathway. As a result, patients did not have excessive lengths of stay and discharge was rarely delayed for other than a clinical reason.

Updated 11 January 2022

Our rating of this service went down. We rated it as requires improvement. See the summary above for details.