Archived: The Cloisters

We rated The Cloisters as good because:

• Wards were clean and well maintained and patients told us that they felt safe.

• There were enough suitably qualified and trained staff to provide care to a good standard.

• We found that patients’ risk assessments and plans were robust, recovery focussed and person centred. The assessment of patients’ needs and the planning of their care was thorough, individualised and had a focus on recovery. Staff considered the needs of patients at all times.

• There was evidence of best practice and that all staff had a good understanding of the Mental Health Act 1983 (MHA), the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and the associated Codes of Practice.

• Skilled staff delivered care and treatment. Throughout The Cloisters the multidisciplinary team was consistently and pro-actively involved in patient care and everyone’s contribution was considered of equal value.

• The staff were kind, caring and motivated and we saw good, professional and respectful interactions between staff and patients during our inspection.

• We saw evidence of initiatives implemented to involve patients in their care and treatment. These included the ‘recovery star’ approach to care planning and regular ward briefings with all patients and staff. Patients told us that the staff at The Cloisters consistently asked them for feedback about the service and how improvements could be made. One patient was an appointed clinical governance representative and met regularly with other patients to receive feedback, which in turn was discussed with staff. The service was particularly responsive to listening to concerns or ideas made by patients and their relatives to improve services. We saw that staff took these ideas into account and used them when they could.

• The management of the beds at The Cloisters was effective.

• The service model optimised patients’ recovery, comfort and dignity.

• There was a clear care pathway through the service into non hospital, community living. A mental health supported housing organisation was working with the provider to ensure that patients were appropriately placed and had a plan to leave the unit when clinically appropriate.

• All patients and staff told us that the quality and range of food offered was of a high standard.

• There was a varied, strong and recovery-orientated programme of therapeutic activities available every week.

• All staff had good morale and that they felt well supported and engaged with a visible and strong leadership team, which included both clinicians and managers. Staff were motivated to ensure the objectives of the organisation were achieved.

• Governance structures were clear, well documented, followed and reported accurately. These are controls for managers to assure themselves that the service is effective and being provided to a good standard. Managers and their team were fully committed to making positive changes. We saw that changes had been made to ensure that quality improvements were made, for example through the use of audits. The service had clear mechanisms for reporting incidents of harm or risk of harm and we saw evidence that the service learnt from when things had gone wrong.

However:

• Emergency equipment in the reception area was not stored securely. Emergency equipment and medication was available in reception but not on the wards.

• Equipment such as weighing scales and blood pressure machines was not calibrated regularly.

• Two patients on self-medication programmes did not have an associated care plan.