- NHS mental health service
Blackberry Hill Hospital
Important:
We are carrying out a review of quality at Blackberry Hill Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.
All Inspections
17 October 2013
During a routine inspection
We spoke with patients on both wards. However, there were patients who were acutely unwell and some who did not want to speak with us. Patients told us they were generally satisfied and involved with the care, treatment and support they received. Patients spoken with on Teign Ward were unanimous in their praise for the ward and the staff. Comments made by patients were that the staff were 'brilliant', 'well trained' and 'knew what they were doing'. One patient told us that they felt safe.
There were systems in place to ensure staff were trained and that they provided a safe service. This included training in safeguarding vulnerable people from abuse and learning from adverse events.
Patients who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises. We found some areas were not maintained to provide a clean, welcoming and appropriate environment.
Patients were not fully protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.
14, 15 March 2013
During an inspection looking at part of the service
Patients generally experienced care, treatment and support that met their needs and protected their rights. This was because they had access to a range of therapeutic activities in addition to planned community leave as prescribed within their plan of care and treatment.
We spoke with five patients about staffing levels. One person told us 'It is getting a bit better'. Another told us 'Staffing levels are still up and down but it has improved a little bit'. Another person told us 'Things are improving. Most of the time I get my leave'.
We found that since our last inspection the provider had increased the dialogue with patients about their leave entitlements. This had happened in ward rounds, in 1-1 sessions and in patients' group meetings. A patient on Siston ward told us 'Community escorted leave is now happening as it should. Since CQC's last inspection we have noticed a significant improvement in this area. I have spoken with the service manager on behalf of patients. We have been listened to and things are much better'.
14 March 2013
During an inspection looking at part of the service
At the time of our follow up review the trust confirmed that discussions were ongoing with the commissioners of the service about possible re provision of this service in alternative premises. The trust confirmed that there were no plans to re open the Landowne Unit on the Blackberry Hill Hospital site. We went to the Lansdowne Unit and saw for ourselves that the unit was no longer being used as an inpatient unit. Staff told us that they had been supporting a previous patient in Local Authority accommodation but that arrangement had now ceased. The staff team were using this 'down time' for supervision support, training and team reflection. Staff had been advised that they were to be redeployed in other parts of the trust, pending a decision about the future of the service for people with learning disabilities.
Due to the closure of this unit, we were unable to assess compliance with the essential standards. The unit was therefore deemed to be compliant.
5 December 2012
During an inspection in response to concerns
People told us that they attended fortnightly reviews with their consultant psychiatrist. This was weekly on Ladden Brook. Some people felt that these meetings were rushed and they did not feel able to say all they wanted to say.
There were not enough qualified, skilled and experienced staff to meet people's needs. We saw that people's planned community leave was regularly cancelled or disrupted because there were not enough staff to escort them. People told us that this caused disappointment, frustration and anger. One staff member told us that 'when people are deprived of their leave, it definitely affects their rate of progress'. Two staff members separately told us that staffing situation was so serious that they believed it represented 'a serious incident waiting to happen.'
On the day of our visit one person had been due to go shopping with their family but this arrangement had been cancelled because two staff members had been absent at short notice. They told us that they were permitted one period of leave per week and this had been cancelled the week before.
11 September 2012
During a routine inspection
During the inspection visit we met five patients who were being supported at the Landsdowne Unit. We spoke briefly to three patients but they had limited capacity to provide meaningful feedback. We were however able to observe them throughout the day and to note how staff interacted with them. None of the patients we spoke to were able to show us their care plans.
We were able to speak to four relatives on the telephone. One relative told us that they had seen a marked improvement in their family member's mental health since they had been on Lansdowne Unit. They told us that their relative had bonded with the staff, who they referred to as their friends. One relative told us that the staff were very nice, friendly people' but there were a lot of agency staff and they didn't think this was helpful as many of the patients on the ward needed continuity and familiarity. One relative reported that a staff member had told them they were exhausted because they had had to work seven consecutive shifts without a day off, due to staff shortage.
One relative told us that their family member had participated in a range of activities on the ward, including cooking and art work. They also said that their relative enjoyed watching television and sitting in the garden. They said that had been supported to go out in the community when staffing levels allowed. They said that sometimes they had been frustrated that their freedom was restricted and sometimes they said they were bored. Another relative told us that their family member had been escorted on trips to the shops or gone out for lunch, although they were aware that there were occasions when staffing levels would not allow this. A third relative told us that their family member was bored, saying 'there's nothing there to occupy them'. They said that their relative, who had been on the unit for over a year, needed one to one support and the unit was not staffed to allow this. They said that they felt the unit was 'alright as a stop gap' but it was 'very basic' and not suitable for their family member's needs.
Relatives said that they thought their family members were safe on the ward. One relative said that sometimes other patients were loud but they did not think that this disturbed or distressed their relative. One relative told us that when they spoke to their family member on the ward they could hear shouting, crying and banging and they thought this was distressing.
Relatives said that staff were 'patient and understanding'. They were aware that the ward sometimes experienced staff shortages and sometimes this meant that people were restricted as to what they were able to do. One relative told us that their family member didn't like unfamiliar faces and took some time to get used to people. Another relative said that their family member did not mind seeing new faces as long as there was one familiar staff member on the ward.
One family member told us they frequently had difficulty contacting their relative on the ward in order to speak to them over the phone, and they thought that this was because the ward was short of staff.
9, 10 November 2011
During a themed inspection looking at Learning Disability Services
We were able to speak to four patients about the care they receive.
A member of the inspection team asked three people about their care plans. One person said that they received copies of their plan on a regular basis and another person said that they had not seen a plan and were unsure if they had one. When asked about involvement in planning their care one patient said that they did not think that communication from staff was good and that they were not involved in their care plan meetings.
As part of our inspection of the Landsdowne Unit we asked the manager to supply us with the contact details of patients' relatives. We were able to speak to two relatives on the telephone and the parents of one patient who were visiting the unit.
All of the relatives we spoke to said they were mainly happy with the care being provided. They said that they felt patients were treated well by the staff and were kept safe.
One relative said that they felt that there is very little to do on the unit, which could at times lead to patients getting bored. 'I think that activities are not always what the individual enjoys or wants and maybe this can lead to boredom and difficult behaviour'