- NHS mental health service
Brooklands
Important:
We are carrying out a review of quality at Brooklands. We will publish a report when our review is complete. Find out more about our inspection reports.
All Inspections
22 January 2014
During an inspection
21 - 24 January 2014
During a routine inspection
Janet Shaw
Core service provided: Medium secure forensic
Male/female/mixed: male
Capacity: 15
Jade
Core service provided: Specialist assessment and treatment, 16–25 years
Male/female/mixed: male
Capacity: 15
Amber
Core service provided: Specialist assessment and treatment 18+
Male/female/mixed: male and female
Capacity: 12
Malvern
Core service provided: Low secure
Male/female/mixed: male
Capacity: 15
Snowden
Core service provided: Low secure
Male/female/mixed: male
Capacity: 11
Eden
Core service provided: Low secure
Male/female/mixed: female
Capacity: 15
1 Tuxford
Core service provided: Adolescent Specialist Assessment and Treatment 12–19 years
Male/female/mixed: mixed
Capacity: 6
3 Tuxford
Core service provided: Adolescent Specialist Assessment and Treatment 12–19 years
Male/female/mixed: mixed
Capacity: 6
We found at this inspection that Brooklands was not compliant with the safety and suitability of premises. This was because the security systems in place in Janet Shaw were not sufficient to protect the safety of people who used the service and staff. The gate lock had failed and whilst the perimeter was secure, the measures introduced limited people’s access to outside space.
People were at risk in the seclusion rooms in Malvern and Eden units of being cold and of harming themselves.
People’s privacy and dignity were not respected if they needed to use the seclusion room in Amber unit.
We saw that the medicine management systems were generally safe and ensured people had the medicines they were prescribed to promote their health and wellbeing. Staff did not have updated rapid tranquilisation training which could put people at risk of harm if they needed this.
Safeguarding processes were robust and all staff had received training to ensure they knew how to safeguard people from harm who used the service. However, for some staff this needed to be updated.
We saw that people received support from a team of professionals who worked together to ensure they had the care and treatment to meet all their needs effectively.
People’s physical health needs were monitored and met.
We found that each unit worked in isolation and did not share best practice which could mean that people’s care and treatment may not have been as effective as it could be.
People told us they did not like the food provided. We saw this was discussed at meetings held with people who used the service; however people were not aware of what they could do to make changes where possible.
Staff in Tuxford units were qualified and competent so that the treatment that children received was effective in meeting their needs and enabled them to move on to more suitable placements.
Some staff in other units required further training in how to meet individual needs to ensure they supported people to be safe.
People told us, and we saw, that they were supported to be involved in their care plans and to attend their reviews.
We saw that staff interacted well with people who used the service to promote their wellbeing and self-esteem.
We saw that some people did not participate in regular meaningful activities to ensure their treatment was effective and met their needs.
Generally we found that staff respected people’s privacy and dignity to promote their wellbeing.
We found that people knew why they had been detained under the Mental Health Act and what their rights to appeal to this were.
10 July 2013
During an inspection in response to concerns
We spoke with two patients about their experiences on the unit; however, as their responses were limited due to their complex health needs we observed the treatment provided to patients on the unit. We also reviewed information from the Mental Health Act commissioner who had spoken with further patients and relatives about the unit.
We looked at five care plans and found that overall, patients or family members were not involved in patient's care planning.
We observed most staff treating patients with dignity and respect but on occasions saw instances where patient's privacy and dignity was not respected.
We found care plans were not always person centred for patients and risk assessments had not been reviewed. We saw staff knew how to support patients on the unit.
Staff members told us about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns or potential abuse and felt supported on the unit.
30 April 2012
During an inspection looking at part of the service
This review was carried out to look at all the information we had received since we told the provider where they needed to improve. We visited the service to check the improvements.
We spoke with patients that used the service and the observed the care that was given.
Patients told us that they had no concerns with their treatment and that they liked the food that was provided.
We observed the care given to patients to help us understand the experiences of using the service, because the patients using the service had complex needs which meant they were not always able to tell us their experiences.
We observed the lunchtime meal and noted that patients had a 'protected' mealtime when there were no distractions, for example loud music or medication administration.
We saw that during the lunchtime meal there was additional staff available. This meant patients were able to get the support they required during the meal time and one to one support was maintained.
We noted that staff kept an awareness of any risks in regard to individual patient's mental wellbeing giving them the space they needed to enjoy their meal.
We saw staff giving support to patients with their meal sensitively and allowing them the time they needed to eat their meal if necessary, for example, when a patient had some disability.
We saw that patients had access to the kitchen at certain times to make their own drinks or snacks. This meant that where appropriate they had the opportunity to be independent and develop life skills.
12 October 2011
During a themed inspection looking at Learning Disability Services
We asked patients about the activities they enjoyed. One patient told us they liked relaxing and watching television, going to the pub and out for meals with staff. He told us he liked all the staff and got on well with them.
Another patient we spoke with was positive about his time at Brooklands and looking forward to moving in the new year. He spoke of family visits, his activities in the on-site day centre, of having regular health checks and attending meetings about his care.
We met briefly with a patient who had recently transferred to Brooklands from another placement. The patient told us he was in good health and saw a doctor weekly. He said he enjoyed going to college, and 'chatting up the girls' and was looking forward to talking to his carer about what he was doing the rest of the day. He said his family lived a good distance away, but he kept in touch by telephone.
We spoke with three relatives by telephone and asked them about their family members care and treatment at Brooklands. They told us that staff were 'good' and 'supportive'. One relative told us that staff were good at helping their family member manage their money.
Two relatives we spoke with told us that the care and treatment of their family member was regularly reviewed and that they were invited to attend the care review meetings. The opinion of the relatives was however that the trust was slow in moving plans for their family member forward.
17 February 2011
During a routine inspection
We spoke with a number of people about the care, support and treatment they receive. One person told us she was involved in her care plan, " I go to meetings about it, and I have signed it". We were also told by a couple of people that they understood that "a team approach which includes a number of different people" was used to plan their care and treatment.
People told us that they were happy with the level of activities available commenting that 'there's always plenty to do" and 'I enjoy getting out of here and doing something different". One person we spoke to told us 'I like playing football, but the pitch is too slippy.' In one unit we were told about a lack of televisions in bedrooms, with one person telling us "we have been waiting since before Christmas for TV aerials to be fitted so we can have our own televisions to watch".
In general people commented that they enjoyed their meals, 'the food we get is really nice, and I like that we have a choice', however one person said 'the pre prepared meal portions are too small', and 'there isn't enough choice for my evening meal'. People told us that they felt "safe and secure" at Brooklands, and that "staff are always there for you". Another comment made was "if you have a problem, you can always talk to staff"
We found the environment to be a pleasant place for people, with comments such as 'the place is generally clean', and 'I keep my bedroom clean and tidy, I like it to smell fresh", being made.
One person in a medium secure unit told us "it's much better to have my own toilet and bathroom, so I don't have to go down the corridor and share one", however in a low security unit we were told that the lack of such facilities was a concern. " I used to have my own en suite where I was before but I don't here".
People felt that there were 'enough staff around'; however one person told us that the staff numbers on her unit had 'reduced quite a bit over recent months'. Other people told us they were happy with the numbers and calibre of staff around.
People commented that they had not had cause to make any complaints but felt that the staff would listen to them if they did.