• Mental Health
  • Independent mental health service

Archived: St Mary's Hospital

Overall: Good read more about inspection ratings

Floyd Drive, Warrington, Cheshire, WA2 8DB (01925) 423300

Provided and run by:
St George Care UK Limited

Important: The provider of this service changed. See old profile
Important: The provider of this service changed. See new profile

All Inspections

1 November 2016

During an inspection looking at part of the service

When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence.

We undertook an unannounced focused inspection to review two requirement notices we issued following our last comprehensive inspection in January 2016. We published our inspection report in May 2016. The requirement notices related to the responsive key question, which we rated as requires improvement due to breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014, We found breaches of regulation 9, person centred care and regulation 18, staffing. The provider submitted an action plan to outline how they would meet the required improvements.

We inspected St Mary’s Hospital on 1 November 2016 to see if these improvements had been made. We also asked two key questions within the safe domain in relation to safe and clean environment and managing and assessing risk. We did this after we received some information about the hospital. We visited all five wards at the hospital. We found areas of good practice:

  • The wards were clean tidy and there was ongoing maintenance work to ensure the buildings were adequately maintained. The hospital had systems and processes in place to ensure there was ongoing monitoring of the cleanliness of the hospital.

  • There were adequate numbers of staff who were trained in basic and immediate life support across the hospital. This meant trained staff could respond and act in a medical emergency. The hospital had a clear policy in place for safe and supportive observations of patients. Staff followed the policy and governance audits took place to monitor staff compliance with the policy.

  • The hospital had clear medicines management procedures in place. Staff had received refresher training in the administration of medication, and regular prescription chart audits were taking place.

  • Staff were knowledgeable about safeguarding and were able to demonstrate the strategies used to safeguard patients and this was evidenced in care records.
  • A weekly referrals meeting took place that assessed the suitability of all referrals and assessments. The hospital ran a permitted earnings scheme, where patients could apply for roles within the hospital and be paid for their services.
  • Patients had access to a private pay phone, hot and cold drinks throughout the day and were able to personalise their bedrooms. The wards had streamlined the information displayed making it more accessible for patients.

  • There had been a significant improvement in how the deaf patients’ communication needs were considered and met which was clearly documented in their care records. There was an increase in the number of staff trained in and receiving training in British sign language.

  • The hospital managed complaints in line with the provider policy and patients knew how to raise a complaint. Staff received feedback on complaints through team meetings.

The provider had met the required improvements within six months from the date of the last report being published. This meant we were able to re-assess the responsive domain of the report to a rating of good.

This did not affect the overall rating as this was already good.

However, we also found some areas for improvement:

  • Patients told us there were not many diversionary activities that took place on the ward leaving them feeling bored.

  • Patients had mixed views about the quality of the food they received.

05.01.2016

During a routine inspection

We rated St Mary’s Hospital as good because :

  • Staff had created clear plans to manage all environmental risks and could identify risks at a ward level. Security systems were in place to maintain the safety of patients and staff.
  • The organisation recognised that they used a high number of bank and agency to cover supportive observations, and had begun the process of over recruiting to those posts to ensure there was more consistency in staffing.
  • A ‘no force first’ ethos was evident across the ward, and prone restraint and rapid tranquilisation was not used except in exceptional circumstances.
  • Safeguarding procedures were in place and staff were able to tell us how they would identify and report any issues.
  • Care plans were comprehensive and holistic; these were written from the patients’ perspective. Patients on Leo and Hopkins ward had positive behavioural support plans in place.
  • There was a range of psychological therapies available in line with National Institute of and Health Care Excellence guidance.
  • The hospital employed a wide range of professionals who all worked effectively as part of the multi-disciplinary team (MDT). The MDT listened to patients and their wishes and concerns and addressed these with the MDT.
  • We observed staff being kind and caring with patients, and we found them to be knowledgeable about the patients they cared for.
  • Weekly referrals meetings took place that assessed the suitability of all referrals and assessments for admission.
  • The hospital had a complaints procedure and this was seen to be followed. The majority of patients felt confident in the complaints system and that changes would be made if things went wrong.
  • Patients were able to personalise their bedrooms and have equipment such as televisions and radios in their rooms. A private phone booth was also available for patients to make telephone calls.

However:

  • Some staff were not bare below the elbow.
  • Fewer than 75% of staff had completed some elements of the mandatory training programme.
  • There was no evidence of any additional training to support the specialist patient groups such as acquired brain injury or autistic spectrum conditions that would support staff in their role. Care plans and information available on the wards was not written in a way which was adapted for the reader, and was often lengthy or wordy.
  • British sign language interpreters were not used on a day-to-day basis, only for scheduled meeting or appointments.
  • The patients commented negatively about the quality and the portion size of the food available.
  • The visions and values of the trust were not completely embedded at ward level and supervision for staff was not always in line with the organisation’s policy. 

19 November 2013

During a routine inspection

On admission to the service, patients were provided with a range of information to help people understand the choices available to them. These were written in clear concise words and were supported with easy read pictures.

All patients said that they had received support to complete the "My shared pathway" which is a planning document enabling the patient to write and be closely involved in their care and support. All spoken with were aware of these plans and we saw that some patients had written them themselves.

Patients spoken with throughout the hospital said that the service had improved greatly and was a "good place to be in terms of support".

We saw evidence of group therapy sessions to enable patients to be supported in making life choices such as the achievers group, social skills group and healthy lifestyles and when we discussed this with patients they said it was " a road to getting out of the hospital".

All spoken with said the food was very good. Comments such as " I think the food is lovely" "the lasagne is gorgeous" and " the shepherds pie is brilliant" were seen in comment forms.

Staff members also stated, "I really enjoy my work", "we have a good team" and "I feel proud of the ward and the service".

Staff said that the registered manager was "very good and knew his stuff, he lets you use your own initiative but is there to support and guide you."