Nottinghamshire Healthcare NHS Foundation Trust

Ratings - Acute wards for adults of working age and psychiatric intensive care units

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Requires improvement

• Responsive

  Requires improvement

• Well-led

  Requires improvement

Our view of the service

We completed an assessment and inspection of Nottinghamshire Healthcare NHS Foundation Trust acute and psychiatric intensive care (PICU) services at Highbury Hospital and Sherwood Oaks Hospital between 27 and 29 January 2026.

Highbury hospital consists of 4 acute wards and 1 PICU. These are Rowan 1 and Redwood 1 male acute wards, Rowan 2 and Redwood 2 female acute wards and The Willows PICU. Sherwood Oaks Hospital consists of Beech and Fir female acute wards and Cedar and Elm male acute wards.

During this assessment we carried out an onsite visit to Redwood 2, Rowan 1 and Willows wards at Highbury Hospital and Elm and Fir wards at Sherwood Oaks Hospital.

This assessment was carried out following CQC’s new approach to assessment; Single Assessment Framework (SAF). We looked at all quality statements under each key question. This was an unannounced risk-based assessment, which means the provider was not told an assessment was going to be starting beforehand. We carried out this assessment in response to several concerns raised following incidents at the service.

At this assessment we identified serious concerns in relation to breaches of regulation 12 and issued an urgent Letter of Intent under Section 31 of the Health and Social Care Act, outlining our concerns and requesting immediate assurances with an action plan. Following our review of the immediate actions taken by the provider, we were assured that patient safety had improved and we did not need to take urgent enforcement action.

We rated the service as requires improvement. We found breaches of regulations 10 (Dignity and respect), 12 (Safe care and treatment) and 17 (Good governance) in relation to management of risk items, medicines management, not treating patients with kindness and compassion and a lack of learning and improvements following previous inspections.

The trust did not ensure a positive learning culture, the trust did not involve patients to manage risks, staff did not always treat patients with kindness, compassion and dignity and the trust had not ensured effective governance systems were in place.

However, the trust provided safe systems, pathways and transitions, ensured effective infection, prevention and control measures, person centred care, equity in access and had a clear direction and values.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Mental Health Act and Mental Capacity Act Compliance Summary

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 service reported that 84% of staff had received training in the Mental Health Act. The provider had relevant policies and procedures that reflected the most recent guidance that staff had easy access to. Patients had easy access to information about independent mental health advocacy.

Mental Capacity Act

Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. The service reported that 84% of staff had completed their training on the Mental Capacity Act. The provider had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it. Staff knew where to get advice from within the provider regarding the Mental Capacity Act, including deprivation of liberty safeguards. Staff took all practical steps to enable patients to make their own decisions. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. The service had arrangements to monitor adherence to the Mental Capacity Act.

People's experience of this service

We spoke with 37 patients across the service about their experiences of care and treatment.

Patients on Redwood 2 gave mixed feedback about feeling safe. Some patients did not always feel safe when incidents occurred on the ward. One patient said that when incidents happened at mealtimes, patients were asked to leave the dining area for safety reasons and their meals were removed. Patients described the ward environment as clean and said facilities were good. They told us staff were available to provide support when needed and that staff discussed their care plans with them, although some patients did not have a copy of their care plan. Patients said they knew what to do in an emergency. They also told us there were many permanent staff on the ward, although bank staff were used more often at night.

Patients on Willows were generally positive about their experience of safety and support. They described staff as friendly, respectful and helpful. Patients told us staff explained restrictions and carried out searches, breathalyser tests and drug testing to help keep people safe. Although patients said the food was acceptable, some felt there could be a greater variety of healthy options.

Patients on Fir Ward reported a more varied experience. Some patients had seen staff fall asleep while carrying out observations, particularly temporary staff. Patients said staff attitudes had a significant impact on the atmosphere of the ward. Some felt welcomed and supported, while others told us they had experienced unhelpful interactions with staff and did not always feel welcomed. Patients generally felt staff had the skills and training to meet their needs, although some had observed staff seeking support from colleagues to complete aspects of their role. Some patients also told us there were occasions when staff were not visible in the main ward area.

Patients told us there were opportunities to take part in activities, including arts and crafts, puzzles, reading and gaming. Some said staff supported them to manage their emotions and behaviours. However, patients raised concerns about the ward environment, including cold bedrooms and shower facilities that flooded. Some patients felt food choices could be improved, particularly through greater access to fruit and other nutritious options. One patient told us they were able to access items from their locker that presented a potential risk without staff noticing or taking action.