163 Durham Road

We completed this inspection over a number of days. We visited 163 Durham Road on 17 March 2014 to speak with people who used the service, speak with staff and review records. We spoke on the telephone with the relatives of two people who used the Aysgarth unit on 20 March 2014. We asked the Trust for some additional information which they provided on 3 April 2014.

The Dale Unit - Teasdale and Eskdale wards

We found the provider did not plan and deliver care and treatment in a way that met individual needs of patients and ensured their welfare and safety.

Patients told us the service had helped them get better. However, they also raised concerns about the level of activities on the ward. We were concerned that not enough meaningful or therapeutic occupation was offered to patients, increasing the risk of patients becoming bored and therefore also the likelihood of challenging or disruptive behaviours. The service had not fully implemented a positive behaviour support approach for patients with a learning disability, who have complex or challenging behaviours. It was planned for training in this approach to have been delivered to staff at 163 Durham Road by the end of May 2014. The Trust planned to have completed training and roll this approach out to all services for people with learning disabilities within the Trust by the end of 2014.

We found care delivered on the Teasdale ward in relation to observation and engagement did not match the planned interventions for two people.

We found that each patient had their needs assessed. They also had plans for care developed from this assessment, based on their individual needs. We found patients were having their physical healthcare needs monitored and treated appropriately.

We found staff did not always support and promote the independence and autonomy of people who used the service.

We found people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People who used the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements.

Aysgarth Unit

The two relatives we spoke with told us they were generally happy with the service provided. We found evidence that demonstrated an assessment of people's needs was completed before they used the service to ensure their needs could be met. We found staff had the knowledge needed to provide individual, person-centred care to people who used the service. We found care and treatment was planned and delivered in line with individual care plans. There were appropriate arrangements in place to deal with foreseeable emergencies.

We found people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People who used the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements.