Spring Wood Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

All staff knew what incidents to report and how to report them. They were able to describe how to submit incident reports and how they would be dealt with. Staff reported all incidents that they should have.

Staff understood the duty of candour. They were open and transparent and gave patients and families a full explanation if and when things went wrong. One carer told us that they were very impressed at how responsive the staff were and how quickly they took action to ensure patients were safe.

Staff received feedback following investigation of incidents, both internal and external to the service. Managers did this via regular team meetings, group supervision, handovers, emails and newsletters. These forums gave staff the opportunity to discuss incidents and the feedback that they received.

There was evidence that changes had been made as a result of feedback. For example, managers had implemented workshops to improve staff confidence in several areas following feedback from incident reviews, these areas included immediate life support and reducing restrictive practice.

Staff on Blake ward told us that they were debriefed and received support after a serious incident.

Referral and admission processes ensured that all essential information was received to determine if their needs could safely be met. Staff said they had a good level of input in making decisions about new referrals and told us that decisions were made in consultation with the whole multi-disciplinary team.

Staff involved all the necessary healthcare and social care services to ensure patients had continuity of safe care, both within the service and post-discharge. We spoke to a number of external stakeholders, and they told us that the hospital worked hard to keep them updated and to work collaboratively to ensure patients received safe care.

Staff received training in safeguarding adults which also contained some contents on safeguarding visiting children. The contents covering visiting children was a small proportion of the training and did not cover the topic in the level of detail recommended in good practice guidance. The service also did not communicate in their training that safeguarding all children, not just children who are visiting, is a key responsibility of all healthcare staff which is outlined in good practice guidelines. The assessment used by the service as part of this training also did not assess staff’s understanding of safeguarding children. We raised this with the provider following this assessment and they agreed to implement training in this area.

Staff could give examples of how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act.

Staff knew how to identify adults at risk of or suffering, significant harm. This included working in partnership with other agencies. There was evidence of good working relationships with the local authority safeguarding team.

Staff received basic training and followed procedures for children visiting the service to keep them safe. There were facilities off the ward where these visits could safely take place.

Staff received accredited training in physical intervention. Restraint, restrictive practice and blanket restrictions were recorded and reviewed regularly, they were in line with a service of this type.

We looked at 4 risk assessment and risk management plans during the assessment. Risk assessments were comprehensive and were updated frequently and following incidents.

There was an appropriate level of restraint used on Blake ward. Data showed that most episodes were low level guides and de-escalation. There was very little use of prone restraint and rapid tranquilisation. Blake ward did not use seclusion or long-term segregation

Staff involved patients in care planning and risk assessment. There was of evidence of patients’ involvement in care plans, participation in multidisciplinary team reviews and those that wanted it could access a copy of their care plan. We saw evidence, including feedback from external care coordinators, that showed patients were very much part of the care planning and risk assessment process, their views were continually sought and considered.

Staff communicated with patients so that they understood their care and treatment, including finding effective ways to communicate with patients with communication difficulties. Care plans were written in a way that people could understand.

Staff enabled patients to give feedback on the service they received. They did this through regular community meetings, a robust complaints process and by actively encouraging patients to take part in meetings and discussions about their care.

Staff ensured that patients could access advocacy.

Staff carried out regular risk assessments of the care environment. These were carried out daily by staff who were on duty and more detailed assessments were regularly carried out.

Ward layout allowed staff to observe all parts of ward. There were potential ligature anchor points but staff had mitigated the risks adequately, for example by increasing observations when patients were at a higher risk. The ward had a courtyard where patients could access fresh air, this area had been assessed by the hospital as needing further work to ensure that it was safe. For example, access to the roof could easily be attempted which meant patients could not use the space without being supervised. We saw that a detailed work plan was in place to rectify these issues, work on this plan had began and was due to be completed over the next 12 months.

The ward complied with guidance on eliminating mixed-sex accommodation.

Staff had easy access to alarms and patients had easy access to nurse call systems. Staff and patients told us that staff responded when they needed support.

Clinic rooms were fully equipped with accessible resuscitation equipment and emergency drugs that staff checked regularly.

Managers had calculated the number and grade of nurses and healthcare assistants required and they matched this number on all shifts. Staff and patients told us that they felt there were always enough staff around to meet the needs of the patients.

The ward manager could adjust staffing levels daily to take account of case mix. Due to fluctuating levels of observations and changing needs, staff were sometimes required at short notice, the managers utilised effective systems to ensure these staff were provided.

There was a vacancy rate across the hospital of 4%, turnover was low and the staff sickness rate was very low at 1%.

When necessary, managers used agency and bank nursing staff to maintain safe staffing levels. Over the past year, 6% of all shifts were covered by agency staff. When agency and bank nursing staff were used, those staff received an induction and were familiar with the ward.

Staffing levels allowed patients to have regular one-to-one time with their named nurse. Staff shortages rarely resulted in staff cancelling escorted leave or ward activities.

There were enough staff to carry out physical interventions, including observations and restraint safely, and staff had been suitably trained to carry out these duties.

There was adequate medical cover day and night and a doctor could attend the ward quickly in an emergency.

Staff had received and were up to date with mandatory training provided by the service. Training was appropriate for the patient group using the service.

Staff maintained equipment well and kept it clean. All ward areas were clean, had good furnishings and were well-maintained.

Cleaning records were up to date and demonstrated that the ward areas were cleaned regularly.

Staff adhered to infection control principles, including handwashing.

Staff followed good practice in medicines management and did it in line with national guidance.

Staff reviewed the effects of medication on patients’ physical health regularly and in line with NICE guidance, especially when the patient was prescribed a high dose of antipsychotic medication.