- Independent mental health service
Ellern Mede Barnet
Assessment report published 3 August 2026
Contents
Ratings - Specialist eating disorder services
Our view of the service
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.
People's experience of this service
We spoke with 6 patients and 5 relatives/carers of patients. We observed a community meeting and 2 patients’ multidisciplinary team (MDT) ward round meetings (with consent from patients).
Patients told us they felt safe at Ellern Mede Barnet, although it could be very difficult being in hospital. Most said they found staff kind and supportive. They were positive about the activities on offer, including crafts, sensory equipment, yoga, dance, boxing, board games, and trips out to museums, shows, and local cafes. Most patients said that when staff carried out restraint, this was done safely and considerately. Staff supported patients to complete their own restrictive intervention management plans. All said that they had good access to physical health professionals as needed. We observed staff interacting with patients in a kind, respectful and responsive manner.
Patients we spoke with told us they found staff supportive and respectful. However, several patients said that they did not feel able to speak up about concerns they might have. One patient told us that they did not like being restrained in their bed for nasogastric feeding. Patients felt that some staff did not always interact with them as adults, and some felt that the terms ‘bed rest’ or talk of being moved to the downstairs ward was sometimes used as a threat. Patients in the annex said that it was difficult for them to access toilets during the day, when the annex was not staffed. Some patients felt that there was not always enough post meal support.
Carers described staff as kind, welcoming and patient, although some said staff could sometimes be sharp with patients and that meal support could be improved. They described good communication, a helpful multidisciplinary team, good safeguarding protections, and involvement of the local community mental health team. They particularly praised the consultant psychiatrist who would call them directly with updates, which they had never experienced before.
Carers felt listened to, and able to make complaints or suggestions. They said the service was open to questions. They were aware of the provider’s policy to minimise restrictions on patients when possible, including providing ‘restraint holiday’ periods (planned periods of time when patients had no physical restraints to provide naso-gastric feeding.) They were very appreciative of the parents’ support group and family therapy provided by the service. Overall, they felt that ‘managers were all over everything,’ and were pleased with the progress their relatives were making.
Patients and carers spoke positively about the service in comparison to other eating disorder settings they had experienced. Some carers said that their relative was making progress in a way not experienced previously.