We rated Broomhill as good because:

• Patients reported feeling safe on the wards.
• Six of the seven wards were clean, tidy, and well maintained.
• Staff demonstrated the provider’s visions and values in their behaviours.
• We observed staff to be passionate and motivated to meet the patients’ care needs.
• Staff demonstrated a good understanding of patients’ individual needs, including care plans, levels of observations and risks.
• Staff completed assessments for all patients following admission.
• The Mental Health Act administrators had good oversight of the service and provided support to the wards.
• Shift to shift handovers were taking place daily.
• Senior managers had good oversight of the wards and clinical governance. There was a robust process in place to drive up standards and compliance.
• Staff consistently reported that managers were supportive and would listen to concerns.
• Staff morale was good and teams were striving to provide good care and treatment to patients. Managers were responsive in making improvements.

However:

• The management of medication, specifically stock control was not robust across all wards. Not all medical equipment was in date or checked regularly.
• Ligature risk assessments did not cover the hospital communal areas. The ward assessments were not robust.
• Not all staff had personal alarms and there were areas across all wards where there was no immediate access to an alarm point.
• The service employed four health care assistants that were under the age of 18 and legally a child. There were no additional risk assessments, support, or supervision in place for these staff.
• Overall, compliance with mandatory training was poor at 51% between April and November 2017. Not all staff received regular supervision and compliance for appraisal was low.
• Capacity assessments were present but not always detailed; they did not document rational for decision making.
• Care plans were not always holistic or recovery focused. They did not routinely capture the patient’s views or identify strengths.
• Some staff did not receive feedback from investigations or were aware of lessons learnt across the service.
• Regular ward team meetings were not taking place and attendance at the service wide staff meeting was low.