The Care Quality Commission
  • Mental Health
  • Independent mental health service

Ellern Mede Barnet

Overall: Good read more about inspection ratings

2 Warwick Road, Barnet, Hertfordshire, EN5 5EE (020) 8959 6311

Provided and run by:
Oak Tree Forest Limited

All Inspections

During an assessment of Specialist eating disorder services

Date of inspection 25-26 March 2026.

Ellern Mede Barnet is an inpatient specialist eating disorder service for adults aged 18-65. It is based in the London Borough of Barnet and is run by Oak Tree Forest Limited, an independent provider group.

Ellern Mede Barnet admits both privately funded patients and those funded by NHS commissioners from across the UK and patients from abroad. The hospital comprises 14 beds across 3 wards for male and female patients, some of whom are detained under the Mental Health Act 1983.

The service registered with CQC in 2017 to deliver the regulated activities: Assessment or medical treatment for persons detained under the Mental Health Act 1983; Treatment of disease, disorder or injury. There was a registered manager in post at the time of our inspection.

We carried out an unannounced site visit from 25 to 26 March 2026. We visited all 3 wards:

  • Rowan Ward, 4 beds
  • Ash Ward, 7 beds
  • The Annex, 3 bed pre-discharge unit

At the time of our visit, a total of 14 patients were admitted across all wards. We spoke with 7 patients and 17 staff members including the hospital director, ward manager, clinical services manager, consultant psychiatrist, 7 registered and non-registered nurses, a physiotherapist, social worker, family therapy, chef, Mental Health Act administrator, and maintenance staff. We also spoke with an expert by experience autism trainer. We reviewed 6 patient records, 5 medicines records, and conducted a tour of the hospital environment. We attended and observed ward rounds, a morning meeting and a community meeting. Following the inspection we spoke with 5 carers/relatives of patients at the service.

We previously inspected Ellern Mede Barnet in 2024 and rated it good, with no breaches of regulations identified.

The current inspection was comprehensive and covered all key questions and quality statements. We have combined the scores for these to achieve the overall rating.

Following this inspection, the overall rating has remained good.

We found several areas of good practice.

Patients and carers spoke positively about this service compared to other eating disorder settings they had experienced. Relatives/carers were particularly positive about the consultant psychiatrist and multidisciplinary team’s communication with them, and the flexibility and responsiveness of staff at the service. Some noted that their relative was making progress in a way not experienced previously.

Staff we spoke with were dedicated and clearly knew patients well. We observed caring interactions between staff and patients and detailed and holistic ward rounds.

There was a clear commitment to reducing restrictive practices. Staff had appropriate training in deescalation and used physical restraint as a last resort.

There were clear safeguarding and complaints processes in place with all concerns taken seriously.

Care planning was highly personalised, with a range of individualised support provided including trauma work, virtual reality headsets, and use of a musical punch pad.

Medicines were managed well. Patients received the medicines they needed when they needed them. There were effective governance arrangements in place, with patients’ views considered to improve the service.

We also identified some areas that needed improving.

Several patients told us they did not feel able to speak up about their care. Some patients wanted more support during and after meals.

Records did not always demonstrate that risk formulations led to a clear and cohesive strategy to help manage risk. Intermittent observations of patients were not always carried out at varied times in line with the provider’s policy, to make them less predictable.

Bedroom doors were not fitted with the most up to date features to support safe care in mental health settings. Only 2 patient bedroom doors had viewing panels, and no bedroom doors were anti-barricade. The service was aware of this and had plans in place to review and replace doors.

Clinic rooms were not large enough to support the maintenance of a clear and orderly environment and an appropriate space for nasogastic feeding without removing several items. As a result, this took place in other areas of the ward. Feedback from a patient was that they did not like having nasogastric feeding take place in personal areas such as bedrooms.

There was no occupational therapist in post at the time of the inspection, but one was recruited shortly afterwards.

Patients within the annex noted that there had been plumbing problems in recent months and they could not access their bedrooms or toilets during the day, when the building was unstaffed. The provider advised that refurbishment work was being undertaken in the annex, and access to the unit was being reviewed.

Mental Health Act and Mental Capacity Act Compliance Summary

Mental Health Act

Staff had a good understanding of the Mental Health Act (MHA), the Code of Practice and the guiding principles. Staff had access to the provider’s dedicated mental health administrator.

Patients had access to independent mental health advocacy, in line with their statutory rights. The independent advocate visited the service weekly, and patients were aware of how to contact the advocate.

The care and treatment records we reviewed demonstrated that when patients were detained under the MHA, staff read and explained their rights to them and repeated this regularly.

Staff stored copies of patients' detention papers and associated records correctly and they were available to staff who needed access to them. Relevant audits took place regularly.

Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.

Staff requested an opinion from a second opinion appointed doctor (SOAD) when necessary.

Mental Capacity Act

Staff had a good understanding of the Mental Capacity Act (MCA), with 98% having completed training in the MCA and Deprivation of Liberty Safeguards.

We saw clear evidence that staff had obtained and documented consent from patients and carers appropriately. Carers we spoke with said staff had explained consent, confidentiality and information sharing clearly.

We saw evidence that staff had assessed capacity on a decision-specific basis and documented the outcome appropriately. Application of the MCA was part of the provider’s regular audit schedule.

During an assessment of the hospital overall

We assessed Ellern Mede Barnet on 25 - 26 March 2026.

Ellern Mede Barnet is registered with CQC to deliver the regulated activities: Assessment or medical treatment for persons detained under the Mental Health Act 1983 and Treatment of disease, disorder or injury. The service had a Registered Manager in post.

We visited the following wards as part of the assessment:

  • Rowan Ward, 4 beds
  • Ash Ward, 7 beds
  • The Annex, 3 beds

We assessed 1 assessment service group: Specialist eating disorder services, across all key questions and quality statements. The assessment service group of specialist eating disorder services has been rated as good.

During an assessment of Specialist eating disorder services

Date of assessment: 26 March 2024 to 10 July 2024

Ellern Mede Barnet provides eating disorder inpatient services for young people and adults aged 16 – 24 years. This hospital is for young people and adults of all genders. At the time of our assessment the patients were all female. The hospital has 2 wards and an annex.

We undertook a site visit on 26 and 27 March 2024 and carried out further offsite activities.

We last inspected this service in November 2022. The service was rated requires improvement in safe, effective, caring and well-led. We rated responsive as good. At that inspection we rated the hospital as requires improvement overall. We required the provider to make improvements to staffing, medicines management, patient observations, post rapid tranquilisation monitoring, implementation of the therapeutic model and governance arrangements.

At this assessment we found improvements in all these areas. Our rating of this service improved. We rated it as good.

We inspected 31 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with scores from the last inspection to give the rating.

During an assessment of the hospital overall

Date of assessment: 26 March 2024 to 10 July 2024

Ellern Mede Barnet provides eating disorder inpatient services for young people and adults aged 16 – 24 years. This hospital is for young people and adults of all genders. At the time of our assessment the patients were all female. The hospital has 2 wards and an annex.

We undertook a site visit on 26 and 27 March 2024 and carried out further offsite activities.

We last inspected this service in November 2022. The service was rated requires improvement in safe, effective, caring and well-led. We rated responsive as good. At that inspection we rated the hospital as requires improvement overall. We required the provider to make improvements to staffing, medicines management, patient observations, post rapid tranquilisation monitoring, implementation of the therapeutic model and governance arrangements.

At this assessment we found improvements in all these areas. Our rating of this service improved. We rated it as good.

We inspected 31 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with scores from the last inspection to give the rating.

16 & 17 November 2022

During a routine inspection

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

  • The providers systems and processes to manage medicines safely were not always implemented and followed to keep patients safe.
  • Staff did not always carry out and document patient observation checks as per hospital policy.
  • When rapid tranquilisation was administered, staff did not always carry out physical health observations as per hospital policy. Staff did not always report incidents of rapid tranquilisation.
  • The service had a high number of vacancies and a high use of agency staff. Agency staff did not always know the patient’s care plans or receive training for the specific patient cohort which impacted upon the quality of care. At the time of inspection, the occupational therapist position and the clinical psychologist position were vacant. Due to these vacancies there were limited activities and therapeutic support offered to patients. The two consultant psychiatrists working at the hospital were both adult psychiatrists.
  • Ward areas were small. Ward areas also had blind spots.
  • The service was not always using information gathered through its governance systems to ensure that the quality of services were improved with appropriate mitigations taken with regards to risk. Whilst the service participated in clinical audit, they did not always use the findings to create action plans and make improvements. Team meetings did not always follow the set agenda points. This could lead to important information not being shared with the wider team. Discharge plans were not always documented within patient records. Induction checklists for agency staff did not document that agency staff were shown the ligature points on the ward.

However:

  • Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed and were visible in the service. Managers were approachable for patients, families and staff.
  • Most staff felt respected, supported and valued. They said the hospital provided opportunities for development and career progression for most team members. Managers supported staff with appraisals, supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff. Staff could raise any concerns without fear.
  • Patients, carers and staff were able to provide feedback to the service. Managers used this feedback to make improvements.
  • 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 patient’s assessed needs, and were personalised, holistic and recovery-oriented. Staff involved patients and their families in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff assessed patient risk well.
  • Staff ensured that had good access to physical healthcare and supported them to live healthier lives. Staff used recognised rating scales to assess and record severity and outcomes.
  • Permanent staff treated patients with compassion and kindness. Permanent staff understood the individual needs of patients and supported them to understand and manage their care, treatment or condition.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The hospital and provider had a named safeguarding lead.
  • The service managed patient safety incidents well. Staff recognised most incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.

6 & 7 February 2018

During a routine inspection

We rated the service as good because:

  • The service had a full range of healthcare professionals and nursing staff to provide safe and effective treatment for patients. The multidisciplinary team came together on a weekly basis to discuss patient care. The service ensured young people were able to continue with their education during their admission, providing flexible tuition as needed. The service increased the numbers of nursing staff according to patient risk or need.
  • The service was committed to reducing restrictive practices on the wards and had introduced their own tool to ensure that patients were involved as far as possible. Staff consulted with patients and planned any physical interventions that might take place.
  • The service provided staff with a range of training to keep patients safe. This included safeguarding, prevention and management of violence and aggression in patients of low weight, and specialist training in eating disorders.
  • Staff administered medicines safely. Staff carried out regular physical health checks such as, blood tests and monitoring patients’ vital signs. The dietitian worked in collaboration with the multidisciplinary team to provide guidance around safe refeeding protocols.
  • Patients and their family members knew how to complain. When patients did complain staff responded in writing in a timely and appropriate way. Patients felt involved in their care and treatment and able to tell staff if they wanted to change things. The service ran a monthly support group for carers to attend if they could. Parents, carers, and young people had access to a family therapist for support in their care and treatment.
  • The majority of patients gave positive feedback about the way staff treated them. We observed positive interactions between staff and patients, and appropriate support at meal times.
  • Staff morale was high. Staff received regular supervision to discuss their role and development. Patients were involved in recruiting new staff, and could vote for their ‘employee of the month’.

However:

  • Patients’ bedroom doors were not fitted with an anti-barricade mechanism. This meant that staff could not open the doors outwards to access in an emergency. Bedroom doors did not have viewing panels for staff to observe patients at night-time. Since the inspection, the provider has fitted outward opening doors with viewing panels on two bedrooms.