Nottinghamshire Healthcare NHS Foundation Trust

Ratings - Wards for people with learning disabilities or autism

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

Date of Assessment: 25 and 26 June 2025

An assessment has been undertaken of a specialist service that is used by autistic people or people with a learning disability. The Orion Unit is part of Nottinghamshire Healthcare NHS Foundation Trust and is an 8 bedded mixed gender inpatient unit providing assessment and treatment for patients with learning disabilities, behaviours that challenge and mental health issues. The unit provided accommodation for adults over the age of 18 who are treated informally or under the Mental Health Act. The service was last rated good (published August 2018). The report was published following the CQC’s old inspection approach using key lines of enquiry (KLOEs), prompts and ratings characteristics. This assessment has been completed following the Care Quality Commission (CQC) new approach to assessment; Single Assessment Framework (SAF). This was an unannounced assessment, which means the provider was not told an assessment was going to be starting beforehand. During this assessment we looked at 15 quality statements across 2 key questions; Safe and Well Led and re rated these 2 key questions. During this assessment we found breaches in regulation under safe care and treatment and dignity and respect . We have asked the trust to provide action plans on how they aim to improve on issues raised through the breaches in legislation. As we did not assess the other key questions we used the ratings from the previous inspection to rate the key questions Effective, Caring and Responsive. The service was based at Highbury Hospital. The service was made up of various clinicians and they worked alongside other partners. At the time of the onsite assessment the unit was supporting 7 patients.

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.’

People's experience of this service

During this assessment we spoke with 4 patients using the service and reviewed 4 care and treatment records. Patients we spoke with told us staff were kind and looked after them. Patients told us staff help them to get them drinks and food and gave them space when they need it.

We found patients’ care and treatment records were not written in the patient’s voice. However, they were holistic in their content.

Patients had access to several communal areas including lounges, outdoor spaces and horticulture areas within the hospital location.

We saw patients were supported to keep relationships with external support including their home teams, with their staff team that they knew to continue those vital relationships.

We found improvements had been made to accessible information around the unit, with easy-read information in communal areas, and within patient bedrooms.

We saw patients interact with staff through activities and staff supported them in conversations to de-escalate anxiety and worry.

However, we saw patients’ privacy and dignity not being upheld when patients utilised the extra care facility on the unit.