Archived: The Willows

Updated 8 October 2021

The Willows is an independent hospital owned by Coveberry Limited and is part of the CareTech group.

The hospital is a 14-bed recovery and rehabilitation ward for male patients aged 18 and over.

On the day of inspection there were 13 patients admitted to the ward. Eleven patients were detained under the Mental Health Act (MHA). Two patients were informal.

The hospital was registered with the Care Quality Commission in March 2020. This is the first inspection since registering.

The hospital is registered to carry out the following regulated activities:

• Treatment of disease, disorder or injury

• Assessment or medical treatment for persons detained under the 1983 Act

The Registered Manager has been with the hospital since it opened.

What people who use the service say

We spoke with six patients and one carer.

Most patients told us they could access a wide range of activities that included playing table tennis, cooking, going for walks and going fishing.

Patients’ comments about the hospital were generally positive. A patient who had been in different hospitals over several years told us The Willows was the best. However, one patient told us that it did not feel like a rehabilitation unit because some patients were unwell.

Patients told us they got on well with the staff. They said they were respectful, and they listened. They had one to one time with nurses if they requested it.

Feedback from the carer was overall positive. They felt their relatives were safe and were happy with the care their relatives received. Staff had spoken to them had given them time to ask questions and they felt encouraged to be involved.

Updated 8 October 2021

Updated 23 March 2018

Updated 8 October 2021

We rated this service as requires improvement because:

• The ward environments were not always safe. Not all ligature risks were identified nor removed or reduced if they were. Maintenance work identified as needing repair to keep patients safe had not been completed.
• The treatment room was not clean and there was a gap in the kitchen cleaning rota.
• The service had a high number of vacancies for nursing and support staff and relied heavily on bank and agency staff to cover shifts. There was not sufficient medical cover in an emergency.
• Not all safeguarding incidents were reported to the local safeguarding authority. Staff were not up to date with safeguarding training.
• Records were paper-based and cumbersome and were not always complete. There were no plans in place to introduce a more effective and accessible electronic based system.
• There were no records of patients being offered debrief after an incident of restraint.
• It was not clear from records that patients had their physical health assessed on admission or that discharge plans were recorded in patient notes.
• Staff did not always follow the service's search policy or complete search records.
• Staff did not update risk assessments prior to patients taking section 17 leave and records did not demonstrate that staff reviewed the outcome of leave.
• There was evidence that smoking opportunities were removed from patients as a punishment.
• Staff did not always follow systems and processes when safely prescribing, administering and recording medicines.
• There was a lack of information for patients displayed within the ward.
• The provider had not ensured that all staff had completed or were up to date with their mandatory training
• There were governance structures and risk management processes in place. However, these had not yet been fully embedded or were effective in identifying and addressing all the issues found in this inspection.

However:

• Physical interventions were used as a last resort and restraints were low.
• Patients with on-going physical health conditions had relevant care plans in place and staff regularly monitored patients’ physical health.
• The multidisciplinary team were all involved in completing patient risk assessments, so all aspects of care and treatment were considered.
• Patients had access to psychological therapies and the service had recently recruited an occupational therapist.
• Managers ensured staff had the right skills, qualifications and experience to meet the needs of the patients in their care, including bank and agency staff.
• Patients told us that staff were respectful, polite and they felt listened to.
• Patients were able to personalise their bedrooms and held their own bedroom door keys.
• Patients told us the quality of food was very good.
• Staff ensured there were opportunities for patients and carers to be involved in care and treatment and give feedback on the service.
• The hospital manager was visible and approachable for patients and staff.
• Staff felt respected, supported and valued.