During our inspection we spoke with eight people who used the service. They told us that they were well looked after and received the treatment they needed. They told us that plans were discussed with them about their future, and that where possible they were able to makes choices in their day to day lives.

One person told us they used the on-site gym regularly. They said, "This has been good for me, I have lost weight and feel better." Another person told us they enjoyed a dog walking activity in a local village. People we spoke with told us that they felt safe and that staff helped them if they had any concerns.

We looked at the medication procedures in place which we found needed some improvements.

Other records we examined included care records, staff records and maintenance records. These were very clear and showed that the appropriate information was available and actions were being taken.

During the inspection, we spoke with six people who used the service and one of their relatives. We also spoke with three members of staff.

We were told that people were well cared for and treatment was provided in line with their expectations. One person told us that their care and treatment was explained to them so they knew what would happen and why and another said that they talked about their care with a staff member regularly.

People told us that staff treated them well. One person said, "They (the staff) talk to you and listen." They added that, "Staff are very fair with me." Another person explained how the staff met their cultural and dietary needs.

Care records contained details of the person's needs and detailed how those needs were met and the expected outcome. The records detailed how identified risks were managed, and strategies that were in place to deal with difficult behaviours.

We discussed safeguarding procedures with management and staff. The provider's procedures ensured that everyone was aware of actions to take if they witnessed or were told about abuse. Staff we spoke with were familiar with these procedures and confirmed that they received adequate training.

Procedures were in place to ensure that the service monitored the quality of the care and treatment provided.

We rated Burston House as good because:

• Patients were fully risk assessed on admission to the hospital. Staff developed care plans and positive behaviour support plans for patients, all in easy read format, and included risk reduction. We found these to be thorough, informative and personalised to the patient. Physical health care, nutrition and hydration needs were met. Staff supported patients to live healthier lives.
• The hospital delivered a range of psychological therapies suitable for the patient group. The interventions were those recommended by and delivered in line with, guidance from the National Institute for Health and Care Excellence. Staff knew the patients well and supported patients to understand and manage their care, treatment, and conditions. The patients we spoke with said they felt happy, relaxed and calm at the hospital, and that staff cared for them well.
• Family and carers told us that staff were friendly, helpful and informative and communicated well. Carers and family members felt they could contact the hospital at any time. The hospital provided support through the onsite social worker. On admission they received an admission booklet with details of services offered this included information on the Mental Health Act.
• Staff at the hospital felt respected and supported by managers. We observed a positive culture and close working teams during our visit. Staff felt that they really made a difference and the culture at the hospital was person centred care which gave real job satisfaction. Staff, patients and carers had access to up to date information about the work of the hospital and services they used. Patients could meet with members of the organisations leadership and give feedback on service they received.

However:

• The hospital did not ensure medication audits were actioned. We found out of date stock medication and first aid box supplies. There were inconsistencies in the recording of opening dates of medication across the hospital. There was a lack of oversight by managers to ensure those concerns identified by audit were acted upon.