We rated Brierley Court as requires improvement because

We had concerns about safety in this service. Ligature audits did not reflect the risks throughout the service. Actions identified in the fire safety risk assessment had not been actioned. Staffing establishment figures for registered nurses were too low. Risk assessments were not completed in line with the provider policy and not regularly reviewed. There were restrictive practices in relation to searching patients, locking of rooms and the garden area. Safeguarding notifications were not always made to CQC.

In care records, we noted no patient had a completed discharge plan. Accessible care plans were not in place for those who needed them.

Patients gave mixed feedback about the service. None of the patients we spoke to or who participated in the patient survey had been offered care plans and one did not know if they had any. None of the patients we spoke to or who participated in the patient survey were aware of a discharge plan.

The hospital had limited facilities in terms of rooms for therapy and activity. Patients were not engaged in sufficient meaningful activity to meet the target set by the provider. Patients were not having weekly individual sessions with named nurses in line with the provider’s policy.

We did not feel that the service had a clear direction in terms of the model of care. Both the setting and some individual care plans were restrictive and did not reflect a rehabilitation setting, for example, the escort baseline risk assessments, the locked garden and laundry and the policy for random searching of rooms. Actions were not completed in a timely fashion, for example from provider compliance visits and risk assessments. We noted a reliance on dashboards which presented a different picture when the data relied upon for these was checked. We were concerned about oversight and monitoring in terms of admissions and whether patients’ needs could be met by the service.