Archived: Cambian - The Willows

Updated 23 March 2018

Cambian – The Willows is a specialist Child and Adolescent Mental Health independent hospital located in Gorefield. Wisbech is the nearest town, which is approximately four miles away. The hospital provides mixed gender inpatient service for up to 14 people aged between 12 and 18.

At the time of inspection, there were 10 patients admitted, four were detained under the Mental Health Act (1983) and six patients were admitted informally for their care and treatment. An informal patient means the patient has agreed to stay in hospital voluntarily. Informal patients are not subject to any restrictions on leaving the ward and are not detained under the Mental Health Act. A detained patient can be admitted, detained and treated in hospital for a mental disorder without their consent.

The hospital had a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Registered persons have a legal responsibility for ensuring the service meets the requirements of the Health and Social Care Act 2008, and associated regulations.

The Hospital was registered to carry out the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983
• treatment of disease, disorder and injury

The location was last inspected on 17 January 2017 where the following concerns were identified:

Action the provider MUST take to improve:

• The provider must ensure patients have access to seating areas and quiet space between education sessions.
• The provider must ensure unsafe equipment is well maintained.

Action the provider SHOULD take to improve

• The provider should ensure that systems are in place to communicate effectively with patients regarding their individual concerns.
• The provider should ensure that systems are in place to communicate effectively with family and carers regarding the care and treatment given to that patient.
• The provider should ensure that all equipment is stored securely and individual items accounted for.

During this inspection, we found that the provider had addressed the identified concerns.

Updated 23 March 2018

We rated Cambian- the Willows as good because

• The registered manager had established staffing levels that met the needs of the patients and had autonomy to increase staffing levels if required. Staff received up to date training, regular supervision and annual appraisal in line with the provider’s policy. We saw the provider had completed a ligature assessment of the environment and took steps to reduce the risk where possible.

• Patients received comprehensive assessments upon admission. The multidisciplinary team used this information to formulate a treatment plan. The hospital offered a range of therapy interventions recommended by the National Institute for Health and Care Excellence, such as cognitive behavioural therapy.
• Patient’s care files were thorough, person centred and outcome focused. Patients were involved in planning of their care and took part in weekly care reviews. The hospital provided family and carers weekly updates on the patient’s progress.
• Patients knew the complaints process and had regular access to an independent mental health advocate. Staff knew the whistle blowing process and told us they felt confident raising concerns without being victimised.
• The clinical team completed regular quality audits and analysed incident data. Where patterns were identified the hospital manager implemented control measures.

However:

• We found a prescription pad in the controlled drugs cabinet that did not have a record for used pages. This did not meet the National Health Service guidance and best practice guidelines set out in the safe management of prescription pads.
• The emergency bag contents did not reflect the checklist although it was signed to say it was checked regularly.
• There was a lack of pharmacy input; it was the nurse’s responsibility to reconcile and audit medication.

Updated 23 March 2018