Lambeth Hospital

Before patients received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. If patients did not have the capacity to consent the provider acted in accordance with legal requirements. Patients' capacity to consent was reviewed weekly. Patients were provided with information about their rights, what to expect on the ward and, as much as possible, they were involved in the development of their care plan.

Patients had their needs assessed during admission. The assessment identified any mental health, physical health, social, financial and housing needs they had. Care plans were developed with information on how to meet the identified need. Risk assessments were carried out to identify any concerns to the person or others' safety and management plans were put in place to address the risks identified. 'Intentional roundings' (daily meetings between staff and patients) had been introduced on Luther King ward to identify any additional support needs patients had on a daily basis. Staff reported that this had helped them to be responsive to patient's needs.

Both wards we visited were visually clean. Staff we spoke with were knowledgeable in infection control processes and the prevention of cross infection. The trust had processes in place to regularly monitor the cleanliness of the units and infection control processes. We saw that concerns identified through a recent infection control audit on Luther King ward had been addressed. This meant patients were protected from the risk and spread of infections.

There were processes in place to support staff. Reflective practice groups and case discussion groups had recently been re-established to provide ward staff with additional support and a space to discuss any challenges or concerns they had. Staff were up to date with their required training and had the opportunity to access additional courses to expand their skills and knowledge. Supervision and appraisal processes were in place to review staff performance. This ensured patients were provided with care and treatment from staff that had the appropriate skills and knowledge.

Overall we found the service provided on Tony Hillis Unit and Luther King ward was caring, effective, responsive to patients' needs, well led and maintained the safety of patients and staff.

We found that people were appropriately assessed and received care and treatment in line with their individual needs. People had a care co-ordinator allocated to them and from the records we saw people had regular contact with their care co-ordinator. People also had contact with their consultant psychiatrist as frequently as required. The care co-ordinator ensured that people's mental and physical health needs were met, and supported people to manage their finances and access their benefits, if appropriate. They also ensured that people had appropriate accommodation and liaised with local housing services if there were any concerns.

We saw that staff liaised with other providers to ensure the health, safety and welfare of people using the service. Staff remained in contact with their patients when they were residing on inpatient wards or were in prison. The staff also had regular contact with the patient's GP to ensure their physical health needs were being met. There was contact between the service and the local pharmacy service to ensure that people were receiving the required blood tests and monitoring in line with their clozapine medication.

Detainees we spoke with said that their experience of the services provided were positive, that they had been provided with appropriate diagnoses and treatments and that they had been referred to other appropriate professionals as necessary. Individual care, support and treatment plans were drawn up on the basis of SLaM staff's individual assessments of prisoners as well as the initial assessments detainees underwent when they arrived at the prison.

SLaM staff consulted the other healthcare providers within the prison, as well as prison staff, on a regular basis about the ongoing care, treatment and support for prisoners.

SLaM staff underwent annual mandatory training including what to do in a medical emergency, equality and diversity and mental capacity. Staff had annual appraisals where their performance would be discussed and development plans put in place for the coming year.

Senior staff from SLaM met regularly with senior staff from the prison, as well as other healthcare providers within the prison, to discuss the quality of services being provided. They reported on a monthly basis on any audits completed, staffing levels, any incidents as well as the amount of care and treatment they were providing.