- SERVICE PROVIDER
Hertfordshire Partnership University NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 25 March 2026
Contents
Ratings - Wards for people with learning disabilities or autism
Our view of the service
Hertfordshire Partnership University NHS Foundation Trust (HPFT) provides wards for people with a learning disability or autism. The wards provide an assessment and treatment (AT) service for adults who require admission to a specialist learning disability unit. This is usually due to a decline in the person's mental health and/or behaviour that cannot be safely managed within the community, and the level of support they require not being appropriate for mainstream mental health services.The main aims of the services are to undertake a thorough assessment, identifying appropriate strategies to support individuals towards recovery and a discharge back to the community.
The wards are situated on 3 sites:
Lexden Hospital in Essex provides 6 beds for men and women. There were 5 patients admitted at the time of inspection.
Astley Court at Little Plumstead Hospital in Norfolk, provides 8 beds for men and women. There were 6 patients admitted at the time of inspection.
Elm Ward which is part of the Kingsley Green site in Hertfordshire provides 8 beds for men and women. There were 6 patients admitted at the time of inspection.
All wards accept patients detained under the Mental Health Act 1983 (MHA).
This location is registered with the Care Quality Commission to provide the following regulated activities:
- Assessment or medical treatment for persons detained under the Mental Health Act 1983
- Treatment of disease, disorder or injury.
We carried out an inspection of HPFT Wards for People with Learning Disabilities or Autism on 20, 22 and 27 January 2026. We inspected the service due to an aged rating and visited all 3 wards. This service was last inspected in January and February 2018. At that inspection, the service was rated outstanding overall, and we found no breaches of the Health and Social Care Act regulations (2008).
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.
The service demonstrated how they met the principles of ‘right support, right care, right culture’. Patients received person-centred care that promoted their dignity, privacy and human rights. Patients were treated as individuals and care was provided flexibly in line with their preferences. There was low use of bank or agency staff, and staff knew the people they cared for and their needs very well. Leaders and staff demonstrated a passion for supporting people which shaped the culture across the service.
Our rating stayed the same. We rated the service as outstanding. We found no breaches of regulations.
Mental Health Act and Mental Capacity Act Compliance Summary
The service admitted patients under the Mental Health Act (MHA) 1983. At the time of inspection 12 patients were detained under the MHA, and 1 patient was admitted voluntarily. Five patients were subject to DoLS. The Deprivation of Liberty Safeguards (DoLS) were introduced under the Mental Capacity Act (MCA) 2005. These safeguards were designed to protect the human rights of people aged 18 or over if they do not have the mental capacity to consent to their care arrangements and they need to be deprived of their liberty.
Staff received and kept up to date with training on the Mental Health Act and the Mental Health Act Code of Practice. Mental Health Act Code of Practice training was mandatory for staff, and the compliance rate was 94% at the time of inspection.
Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff received assistance from Mental Health Act administrators within the Trust.
People had easy access to information about independent mental health advocacy and people who lacked capacity were automatically referred to the service.
Mental Capacity Act
Staff received training in the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) safeguards. Compliance rates for the provider training in MCA/DoLS in Principle and Practice was 94% at the time of inspection.
For patients who may have had impaired mental capacity, staff assessed and recorded capacity to consent to decisions appropriately.
Staff gave patients all possible support to make specific decisions for themselves before deciding a patient did not have the capacity to do so. Psychology and speech and language therapy staff worked together to assess patient’s capacity and communicate with patients. Staff assessed and recorded capacity to consent clearly each time a patient needed to make an important decision.
When staff assessed patients as not having capacity, they made decisions in their best interest and considered their wishes, feelings, culture and history. They consulted with patient’s representatives as appropriate when making decisions on a person’s behalf.
People's experience of this service
The people using this service had complex learning disabilities and/or autism. Some patients had communication challenges which meant they could not tell us their views about the hospital. We spent time observing daily life and routines to help us to understand their experiences there. We saw that staff knew patients very well, including their strengths and limitations, and were responsive, kind, treated people with respect and offered them choices. This included in relation to food and drinks, activities and where people chose to spend their time. We observed lovely interactions between patients and staff and could see that patients felt very comfortable and were able to laugh and joke with staff as well as seek support when they felt unsettled. We also gained positive feedback from an advocate who visited the service regularly.
We spoke with 7 patients who were able to communicate their views and opinions. All the patients we spoke with told us they were very happy at the service and felt safe. One patient told us, ‘Staff help me to feel safe and know what helps me to calm down’. Another patient told us, ‘staff are helping me to get better so I can go home’. All the patients told us how much they liked the staff – one patient enthusiastically told us all about his favourite member of staff and how he enjoyed talking to him and having push-up competitions. Patients told us they enjoyed all the activities, including trips out into the community, going to concerts and the zoo, football and basketball, art and educational activities and visits from the therapy dogs and mini donkeys – ‘I enjoy the pet walks and seeing Finn the dog regularly’, ‘I like going on the bus and seeing where we are going to go’.
We spoke with 6 family members of patients. They were, without exception, extremely positive about the service. They told us, ‘the care here is the best he has ever had’; ‘the admission here is the best thing that has happened in the last 5 years….if other services had provided the same level of care as Elm Ward, our lives would have been very different’; ‘It is the best care my daughter has ever had…I want her to stay here forever…staff are amazing’. One family member told us, ‘staff take the time to listen and understand my daughter…. they make a fuss of her on her birthday and at Christmas’. Another told us of how much their son’s life had opened up since being at the hospital following a long period where he didn’t leave the house and they were so grateful for everything staff had done.
All the family members told us that communication with hospital staff was excellent, they felt fully involved in all decisions and could visit at any time – ‘I am always made to feel welcome when I visit’, ‘staff never seem rushed - they are great and take the time to listen’, ‘this is such a positive place to walk into…it is a ray of sunshine in the dark.’