During the visit some people using the service said they were generally treated with dignity and respect by staff whilst others felt otherwise. Comments included "Staff are fine", "They don't help you write to people or find out more about where you can move to", "It is good to live here but some of the staff are not all that" and "Quite hospitable and feel I can speak to staff".

Some people were positive about the treatment they received, felt well supported, were involved in their treatment and felt they were making progress. "I'm making progress". Others saw their treatment and the support they received more negatively. "I'm not happy here and would like to transfer back to the Maudsley".

People said they were satisfied with the accommodation and happy with the cleanliness of wards and their rooms. "My room is fine, no problem".

There were suitable activities provided, although some people said they would rather not be there at all.

They were aware of the complaints procedure and how to use it.

We saw that people using the service were treated with dignity and respect by staff during our visit.

The sample of assessment information and support plans we looked at were comprehensive and up to date with the required information on file. The admissions criteria was followed and risk assessments were in place and regularly updated.

We walked around the building and found the wards and other areas were clean, fit for stated purpose, well maintained and appropriate to the type of support and treatment provided.

Staff told us they were well supported by the management team and we saw that appropriate background checks were carried out on them including Disclosure and Barring Service (DBS) checks. "My manager and staff have been very helpful going through my preceptorship".

Staff said and records demonstrated that they had good access to training and development.

There was a robust complaints procedure that people had access to and was followed.

During our inspection the people using the service said they were generally treated with dignity and respect by staff although some more than others. Comments included "I don't have a problem with any staff", "Staff facilitate progress", "Some staff make flippant comments that aren't appropriate" and "If you want anything done ask the nursing team". They were positive about the treatment received, confirmed they were fully involved and contributed to their care plans. We also saw this in the care plans we looked at. They were up to date with all the required information on file. There was also a thorough admissions criteria that was followed and risk assessments in place. We toured the building tour found the wards and other areas were well maintained and appropriate to the type of support and treatment provided. Staff were well supported by the management team and appropriate background checks were carried out on them including Criminal Records Bureau (CRB) checks. Staff also had good access to training and development. There were comprehensive audit based quality assurance systems in place that were regularly updated and contained identifiable performance indicators and trigger levels. People using the service that we spoke to were happy with the cleanliness of wards and their rooms. They service did not comment on the hospital assessment, monitoring and recording systems or the support staff received.

We rated Battersea Bridge House as good because:

• The service supported patients’ recovery by providing treatments recommended by national guidance. This included prescribing appropriate medicines, providing a comprehensive range of occupational therapy and providing psychological therapies. Patients had individual therapy sessions with a psychologist as needed and others attended group therapies.
• Patients said that staff treated them well. Patients described staff as nice, helpful and respectful. Patients were involved in decisions about their care and treatment. Patients met with staff every day in a relaxed and friendly environment to plan activities and groups for the day.

• Staff managed risks presented by patients well. All patients received a full risk assessment on admission, including a full risk assessment. Staff reviewed patients’ risks every day and adjusted the level of restriction placed on each patient to reflect the risks they presented. The service had introduced a programme to reduce restrictive practices. This had resulted in the use of seclusion falling from 24 incidents in 2016 to eight incidents in 2018.

• The service provided care and treatment to patients in a clean and pleasant environment. All patients had their own bedroom with ensuite facilities. There were appropriate facilities available for patients’ care and treatment.
• Patients had good access to physical healthcare. A GP visited the hospital at least once every two weeks. Staff referred patients to specialists when necessary. Staff completed regular health checks of patients receiving high doses of medication.
• The service employed experienced staff who were well supported through supervision, annual appraisals and team meetings. The service addressed poor performance appropriately.
• The service supported patients’ discharge well. Staff planned patients’ discharges over a number of months. Patients were granted leave to visit and stay at their new accommodation before the full discharge took place. Only one of the current patients had experienced delays to their discharge for non-clinical reasons.
• The service supported patients to engage in many activities in the local community to support their recovery. This included access to a choir, sports clubs and community cafes. Patients’ feedback about these activities was very positive.
• The service had a structured system of governance that ensured staff and managers reviewed learning from incidents, safeguarding matters and complaints. The service had addressed concerns raised at our last inspection about ensuring there was oversight of patients’ physical health, including the physical health of patients receiving high doses of medicines, and that the service notified the CQC of incidents. Staff felt the hospital director provided good leadership.

However,

• Some nurses and support workers said they did not feel listened to by the management team or involved in decisions about patients’ care. Some members of staff said morale was low.
• There were some environmental risks such as poor sight lines on the wards and low risk potential ligature points that the service needed to address.
• The service had a high vacancy rate for registered nurses but all shifts were covered and the provider was recruiting to these posts.