Over the course of our last inspection in November 2013 we found the provider did not have suitable arrangements to reduce the risk to people’s safety and wellbeing and people were not always protected against the risk of abuse because the provider failed to respond appropriately to allegations of abuse. Furthermore the systems in place to identify, assess and manage risks to the health, safety and welfare of people were not always effective.

In view of our concerns we served three warning notices for the care and welfare of people, management of the environment, and assessing and monitoring the quality of service, informing the provider that they needed to take action to address the areas of non-compliance identified by March and April 2014. In addition we found further non-compliance with the involvement of people in their care, consent, medicine management, and staffing levels. The provider submitted an action plan showing they would achieve overall compliance by the end of April 2014.

We carried out this inspection to check whether improvements had been made since our last inspection of the service. We found significant improvements had been made across all of these areas and the service had met the warning notices and remaining areas of non-compliance.

However we found that people were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.

Overall people we spoke with and results from surveys demonstrated that people were positive about the care and treatment they received in the service. One person told us ''they are very good here at sorting out my long term illness'' and went on to say ''generally this place is very good and has saved my life.'' A small number of people we spoke with did not feel engaged with staff and in aspects of their care.

This inspection was carried out in response to: information of concern received by the Care Quality Commission (CQC) about recent serious incidents in the service, anonymous concerns raised by staff, patients or their relatives, and follow up compliance actions served during a previous inspection.

We visited The Campbell Centre on 28 November 2013. There were 29 patients admitted to the service with three of those on leave on the day of the inspection. The visit was unannounced.

We observed a ward round and saw that a number of patients were treated respectfully and encouraged by staff to discuss their feelings and concerns.

We looked at the governance and quality monitoring of the service and identified areas in need of improvement. We found that care plans and risk assessments were not always updated. Processes in place to protect patients from the risks associated with the management of medicines and safeguarding were not always adhered to. There was a heavy reliance on agency staff which impacted on the continuity of care and welfare of patients.

We visited the Campbell Centre on 21 March and 2 April 2013 to review improvements from concerns identified at our last inspection in August 2012. On both days there were 31 people admitted to the unit.

Over the two days we spoke with ten of the 31 people and asked them about the care and support they were offered. People told us they were generally happy with the treatment and support provided. One person said, “I know that I need to be here, so I accept it and it’s ok.” Another person said, “Staff are kind and I’m looked after.” Two other people said they felt involved with, and had agreed to their care.

We observed the interactions between staff and people, and spoke with 13 members of staff who worked in different roles, to help us understand the care provided and people’s experiences.

We looked at the care records for 13 people and saw that whilst information was comprehensive at times, people’s needs had not always been risk assessed or the information translated into an effective care plan to guide staff. We also reviewed the processes in place to maintain people’s safety and prevent the risk of abuse, including the risk of self harm.

We looked at the governance and quality monitoring of the service and identified areas in need of improvement.

During the course of our inspection, a new provider took over responsibility for the service. This had led to a significant increase in senior support, and action was in progress to drive improvements.