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Inspection Summary


Overall summary & rating

Good

Updated 7 February 2018

We rated The Dallingtons as good because:

  • The service had good medications management in place. Resuscitation equipment and emergency drugs were available. Staff checked these regularly.
  • The wards were clean, had appropriate furnishings and equipment, and were well maintained by staff.
  • Shifts were consistently covered with a sufficient number of staff.
  • Staff used restraint as a last resort. There was emphasis upon verbal de-escalation and using non-physical techniques to calm patients who were distressed.
  • All staff knew what constituted an incident and knew the reporting system in place. Managers ensured that staff received feedback and learning from incidents.
  • All patients had a physical examination upon admission. Physical healthcare monitoring was undertaken routinely. Patients had care plans in place to reflect physical illness.
  • Staff received supervision in line with the provider’s policy.
  • Staff adhered to consent to treatment and capacity requirements.
  • Where possible, staff encouraged patients and relatives, to be involved in their care and treatment.
  • Staff responded to complaints appropriately, and within a timely way. An apology was given if necessary.
  • All staff knew the senior management team, who were visible and approachable.
  • Morale among the staff was good across both wards. Staff genuinely enjoyed their roles at the hospital.

However,

  • There had been one occasion when the provider failed to notify the CQC of a safeguarding concern in a timely way.
  • Only 67% of staff had received training in manual handling.
  • Not all care plans were evaluated in detail.
  • Appraisals undertaken did not detail discussions around personal development and future goals.
Inspection areas

Safe

Good

Updated 7 February 2018

We rated safe as Good because:

  • The clinic rooms were fully equipped. Resuscitation equipment and emergency drugs were available and staff checked these regularly.
  • The service was clean, had appropriate furnishings, and was well maintained.
  • There was enough staff on duty on each shift, which enabled the staff to meet patients’ needs.
  • Any restrictions placed upon patients were individually risk assessed.
  • Staff used restraint as a last resort, and placed emphasis upon de-escalation.
  • Each ward had good medication management in place.
  • All staff knew what incidents were, explained the reporting process, and reported what should be reported.
  • Manager’s cascaded feedback and learning from incidents to staff across the two wards.

However:

  • On one occasion, there had been a significant delay in reporting a safeguarding concern to the CQC

Effective

Good

Updated 7 February 2018

We rated effective as good because:

  • Staff completed a comprehensive assessment for each patient upon admission.
  • Patients had their physical health examined upon admission and routinely thereafter. Appropriate care plans were in place to identify ongoing illness.
  • Staff were receiving regular supervision in line with the providers policy.
  • Staff adhered to consent to treatment and capacity requirements.
  • Staff had an understanding of the Mental Capacity Act and assumed capacity unless a capacity assessment demonstrated otherwise.

However,

  • Staff did not always undertake detailed evaluations of care plans.
  • Staff appraisals did not demonstrate discussions around development and forward progression.
  • Not all staff had received training in the Mental Health Act.

Caring

Good

Updated 7 February 2018

We rated caring as good because:

  • We observed some kind, thoughtful and respectful interactions between staff and patients during the inspection.
  • Most patients were very positive about how staff cared for them.
  • Staff offered patients copies of their care plans. Patients were encouraged to be an active part of care reviews (where possible).
  • Families and carers were invited to relevant meetings to discuss care and treatment, when the patient had consented.
  • Patients were able to express ideas and views of the running of the service through community meetings and daily meetings.

However,

  • Not all care plans demonstrated the patient’s views and wishes.

Responsive

Good

Updated 7 February 2018

We rated responsive as good because:

  • The service completed all assessments within seven days of referral.
  • The service had a range of rooms and equipment to support treatment and care, including outside space.
  • The service had achieved a five star food hygiene rating. Patients spoke positively of the food and choices available.
  • The service accommodated patients who may have physical disabilities or who may require a wheelchair.
  • Staff responded to complaints in a timely way.

Well-led

Good

Updated 7 February 2018

We rated well-led as good because :

  • Staff demonstrated the vision and values of the hospital in their day to day work.
  • All staff knew the senior management team, and told us they were visible and supportive.
  • Senior staff undertook regular audits as part of their ongoing quality assurance programme.
  • Shifts were covered with a sufficient number of staff, of the right grades and experience.
  • Most staff knew of the whistle-blowing policy and felt they could use if required, without fear of victimisation.
  • Morale among the staff was good across both wards.

However,

  • The provider did not follow their policy to monitor the fitness of directors of St Matthew’s Healthcare Ltd.

Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Good

Updated 7 February 2018