Long stay and rehabilitation mental health wards rated 'good' by independent regulator

The Care Quality Commission (CQC) inspected Alder ward in Bristol (10 beds), Windswept ward in Swindon (14 beds) and Whittucks Road in South Gloucestershirer (15 beds). All wards provided support to both male and female patients, including patients detained under the Mental Health Act 1983. The CQC did not visit Elmham Way in North Somerset.

Inspectors assessed the services in three areas. The current ratings following this inspection (and the rating at the previous inspection) are:

• Are the services safe? Requires improvement (no change).
• Are the services effective ? Inspected but not rated.
• Are the services well-led? Good (no change)

The overall rating for this service is good (no change). The rating for Avon and Wiltshire Mental Health Partnership (AWP) is requires improvement.

You can download a full copy of this report below.

Are the services safe?

Inspectors found staff managed risks and patient safety incidents well. The wards complied with guidance and there was no mixed sex accommodation. Staff on Whittucks Road told us that they had addressed the concerns raised during the last inspection regarding mixed sex accommodation. The layout had been rearranged so that patients did not have to pass through opposite sex areas to reach facilities, such as the lift or the bath. This meant they had met the breach from the previous inspection.

However, not all of the matrons or managers had received the appropriate level of safeguarding training. None were aware of the Oliver McGowan training for patients who may require support with learning disability or autism. This was not in line with the Health and Care Act of July 2022 which introduced a requirement that regulated service providers ensure staff receive training on learning disability and autism appropriate for their role.

Managers said adjusting staffing levels according to the needs of the patients was often challenging and they were regularly dependent on the goodwill of staff. Staff rotas showed that all shifts had been covered and the wards matched the staffing requirements to support patients to stay safe. There was evidence of high agency and bank use at times, but managers told us they used those who were familiar with the service and patients.

The service did not always have access to daytime and night-time medical cover or a doctor available to go to the ward quickly in an emergency. Managers said they did not have access to junior doctors and that it was often difficult to get an on-call doctor to respond quickly should a patient deteriorate. They said they had to regularly chaser up the request for a response from the doctors. 

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.

Are the services effective?

The CQC did not review this rating at this inspection.

Are the services well led?

Managers had a good understanding of the service they managed. They had a clear focus on what they wanted to achieve and how they proposed to deliver and motivate staff to succeed. They could explain clearly how the teams worked together to provide high quality care.

Managers were visible and approachable for patients and staff and confirmed they had an open-door policy for informal discussions, advice and support when required. Staff felt supported by their managers and were comfortable and confident in approaching them if they had any concerns.

There were high levels of staff satisfaction. Staff survey results showed 63% of staff said they were recognised and rewarded and 70% said they worked as a team. Staff said they were proud of the service and where they worked. Staff were attentive to the needs of patients. Feedback was overwhelmingly positive across the service with many staff described as "nice" and "helpful".

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