Archived: Maryfield Court

Updated 29 October 2019

Maryfield Court is an independent hospital owned and operated by ASC Healthcare Limited. It is located in the Whalley Range area of Manchester. It provides acute mental health inpatient care for up to 27 patients. The service is divided into four distinct apartments - each apartment accommodates between six to eight patients. At the time of the inspection, apartments one and two were open providing accommodation for up to 13 patients.

• Apartment one had 7 beds for women.
• Apartment two had 6 beds for men.

Maryfield Court is registered for the regulated activities:

• assessment and treatment for persons detained under the Mental Health Act 1983
• treatment of disease, disorder or injury.

All the patients at Maryfield Court are placed there on a spot purchase agreement by NHS trust bed managers when they cannot secure a local acute mental health bed. Patients are admitted for short-term assessment and/or treatment before they are transferred to a hospital bed in the patient’s local NHS Trust or discharged home with community based mental health support. At the time of this inspection, two patients were receiving assessment and treatment at Maryfield Court.

There is a registered manager in place, currently they are acting as the registered manager for another hospital as well.

Maryfield Court opened in August 2018. It has been inspected once before in February 2019. At that inspection we rated the service as requires improvement overall and for the effective and well-led key questions; the other key questions (safe, responsive, and caring) were rated as good. At that inspection we identified two regulatory breaches:

• Regulation 12 - safe care and treatment due the lack of physical health checks when patients were admitted; and
• Regulation 17 - good governance due to records shortfalls as agency staff did not identify themselves as the author when they put entries on to the electronic care recording system.

The provider sent an action plan and stated they would make improvements by August 2019. On this inspection, we found these matters had still not fully been resolved and we found continuing issues. The hospital also shut for a short period in March 2019 and reopened on 25 May 2019 due to ongoing contract negotiations and a lack of referrals.

Updated 29 October 2019

Our rating of this service went down. We rated it as inadequate because we rated two key questions as inadequate (safe and well-led), two as requires improvement (effective and caring) and one key question (responsive) as good. This was because:

• The service did not provide safe care.
• The ward environments were not fully safe, secure and clean. We issued a warning notice to the provider to make sure they improved maintenance and cleanliness of the premises.
• Staff did not always review or manage risk well. Staff did not always update patients’ risk assessments following incidents.
• Managers did not fully identify all ligature risks and did not fully review restraint incidents to ensure they accurately recorded and minimised the use of restrictive practices.
• Staff did not develop individualised holistic, recovery-oriented care plans.
• Staff did not fully record how they actively involved patients and families and carers in care planning and decisions.
• The service was not well led and the governance processes did not ensure that ward procedures ran smoothly. There was too much responsibility placed on one senior manager to manage strategically and operationally this hospital and another of the provider’s hospitals.
• We identified shortfalls not picked up by the provider’s own audits. The provider had not addressed the shortfalls we found on the last inspection. We issued a warning notice to the provider to make sure they improved the governance arrangements.

However:

• Staff provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice.
• The wards had enough nurses and doctors. The ward teams included or had access to a range of specialists required to meet the needs of patients on the wards.
• Managers ensured that staff received supervision and appraisal. The ward staff worked together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness and understood the individual needs of patients.
• The service managed referrals well so that patients were admitted quickly and patients were discharged promptly once their condition warranted this.

Updated 29 October 2019