- NHS mental health service
Callington Road Hospital
All Inspections
10, 11 February 2014
During an inspection in response to concerns
Prior to our inspection we requested further detailed information from the police, the Bristol CCG and from the provider Trust, Avon and Wiltshire Mental Health Partnership NHS Trust (AWP).
We visited Silver Birch, Lime, Larch, Alder, Laurel, and Hazel units. We spoke with staff and managers. Because of the nature of our lines of enquiry, we did not speak with patients, other than a few brief conversations. We looked at a sample of patients' records, in particular those who had a history of absconding and/or AWOL. We looked at ward security, the processes for observing patients and the arrangements for patients who took periods of leave from the hospital.
We found that staff had a detailed knowledge of their patients needs', including the risks that they posed to themselves and others. However this was not supported by accurate record keeping, with inconsistent information recorded about patients, posing the risk that their supervision, care and treatment may not be appropriate.
There were established systems in place to ensure that patients were properly supervised to ensure their safety, and this included arrangements for periods of leave form the hospital. Leave was an integral part of people's rehabilitation and recovery plans, and as such, 'positive risk taking' was encouraged. We were unable to judge whether the level of AWOL incidents or missing persons at CRH was excessive. However we were concerned that the systems to monitor risk, both on an individual and on a ward/hospital wide basis, were not effective.
11 July 2012
During an inspection looking at part of the service
We met 25 patients and two relatives during our visit. Patients told us how they were supported with their mental health needs by the staff team and the managers. We were told 'They are sound'. 'They are kind and considerate and they don't play head games'. 'The staff are very approachable'. 'I would have liked to talk to the staff more". 'They are very good, I could have spent more time with them "."They're good ".
We met three psychiatrists, five hospital managers, two domestic staff, seven nurses, and ten care staff as part of our inspection of the service.
Patients detained under a section of the Mental Health Act were helped to understand why they were detained. The reasons would be for their safety and /or the safety of others. We saw in the records of detained patients that their right to use an independent mental health advocacy service had been explained. It had also been recorded when patients had been made aware of their legal rights. Patients told us that staff had advised them of their legal rights were while detained in hospital. This was an improvement from we visited Larch Unit on 2 July to review the care of people detained under the Mental Health Act. At that visit we found that patients were not being properly involved in making decisions about their care in accordance with the requirements of the Mental Health Act and the associated code of practice.
Patients' care plan records explained what support and treatment they required to meet their mental health needs. There were informative daily progress records kept by the staff about patient's mental health and wellbeing. Patients were supported with their safety and well being with informative risk assessment records. The risk assessment records set out the risks patients faced and what actions were required to take to keep them safe.
Patients were cared for and treated by staff who had an understanding about different complex mental health needs and the impact this had on all aspects of their lives.
Staff told us they felt supported by managers at Callington Road. Hospital staff benefited from regular formal supervision meetings to help them in their work.
There were systems in place to review and learn from critical incidents and occurrences that impacted on patient's health, safety and wellbeing. There were systems in place to ensure care and treatment that patients received was checked and monitored and revised where needed.
19 January and 21 February 2012
During an inspection looking at part of the service
They told us they "feel safe" most of the time and staff do what they can to ensure the safety of all patients. However one person told us they did not always feel safe with some other patients.
People we spoke with told us they felt care was provided that respected their privacy and dignity and enabled them to be as independent as possible.
7 April 2011
During an inspection in response to concerns
People also told us they feel care is provided that respects their privacy and dignity and enables them to be as independent as possible. They feel safe.
We saw people are accommodated in single rooms and corridor areas are designated single sex areas.