- SERVICE PROVIDER
Dorset Healthcare University NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 2 July 2026
Contents
Ratings - Forensic inpatient or secure wards
Our view of the service
Dorset Healthcare University NHS Foundation Trust provides forensic/secure inpatient services for adults with mental health conditions. Patients are detained under the Mental Health Act 1983. The trust provides 15 inpatient beds on Twynham Ward at the St Ann's Hospital site in Poole.
We visited Twynham Ward on 18 and 19 November 2025. Twynham Ward is a low secure forensic ward for male offenders with mental health problems. This inspection was in response to concerns raised by external stakeholders about relational security, professional boundaries, the level of oversight on the ward and whether the team culture supported openness and staff confidence in raising concerns.
During this inspection, we inspected and rated safe and well led. Ratings for effective, caring and responsive have been pulled through from the previous inspection. The service is rated as good overall.
The staff team was in the process of developing the culture and leadership on the ward. Staff, including managers and members of the multidisciplinary team (MDT), had taken steps to strengthen team cohesion and psychological safety, including reflective practice sessions and a staff development day focused on professional boundaries, team bonding and psychological safety. Incident and seclusion rates were low.
However, we found some environmental and infection control issues that required improvement. Patients in seclusion could not access outside space, and some cleaning and audit processes were not consistently followed. Privacy screens were not in place in all areas, and aspects of medicines management, including equipment checks and clinic room organisation, did not always support safe practice. Infection control arrangements, such as bathroom cleaning schedules and waste management, were not always robust. The ward also lacked some adaptations for patients with mobility needs, and there was no clear log of blanket restrictions to support consistent review and communication with patients.
Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. The average compliance of staff across the forensic directorate was 95%.
Staff had access to administrative support and legal advice on the implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were in the trust.
Patients had easy access to information about independent mental health advocacy.
Staff members had relevant policies and procedures that reflected the most recent guidance.
Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it. Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.
Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly so that they were available to all staff that needed access to them.
Staff did regular audits to ensure that the Mental Health Act was being applied correctly.
Mental Capacity Act
Staff demonstrated good understanding of the Mental Capacity Act. They had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. They knew where to get advice regarding the Mental Capacity Act, including deprivation of liberty safeguards. They took all practical steps to enable patients to make their own decisions whenever possible.
The trust had arrangements to monitor adherence to the Mental Capacity Act and staff audited the application of the Mental Capacity Act and took action on any learning that resulted from it.
People's experience of this service
Overall patients were positive about the care and treatment they received from the staff team. They told us they were confident in the staff teams’ ability to keep them safe. They felt well informed about their care and treatment and what was happening on the ward.
However, three patients told us they often clean the bathrooms before use. They said that once they were in the shower room, there was nowhere to store their clothes so some patients chose to go to the shower wearing a towel.