On the day we inspected there were 29 patients at Elmleigh some were there informally and some were detained under the Mental Health Act 1983.

We spoke with seven patients and six staff this included nurses, health care support workers and senior staff. We visited all three wards at Elmleigh, the male ward, female ward and psychiatric intensive care unit (PICU).

We had received concerns following the visit from the mental health act commissioners regarding privacy and dignity, care plans and staff training in the Mental Capacity Act 2005.

We found that whilst two rooms had been converted for use as bedrooms they were situated close to bathroom facilities and new doors offering privacy and dignity had been ordered. The feelings from the patient using one of these rooms were that it was “okay” as they knew it was temporary.

Individualised care plans detailed the support and care each patient required. Patients confirmed they received the support they needed. We observed staff being respectful, asking if patients if they needed support and assisting when asked.

Medicines were managed safely and staff were aware of their responsibilities.

The quality of the service provided was monitored by an effective quality assurance processes.

Elmleigh provides inpatient services for up to 28 people. The hospital is divided into two wards the psychiatric intensive care ward (PICU) which can accommodate eight patients and the acute ward. The PICU also has a Section 136 suite, used by the police as a place of safety, a seclusion room and de-escalation area. The acute ward can accommodate up to 20 people and is divided into male and female bays.

On the day of our inspection we spoke with seven members of staff and four patients and observed interaction between staff and patients. We saw that there was good rapport between staff and patients and that staff ensured the safety of everyone on the ward whilst meeting individual needs. Patients told us that they felt involved in their care and life on the ward. They told us about the daily ward meeting and that they could bring up issues and requests.

Staff said that working at Elmleigh was “Very good” there was “Regular support and good quality training”. Another comment was that “I feel comfortable to raise any issues”.

We carried out an inspection on 23 January 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had previously assessed them as non compliant or needing to make improvements. We identified concerns with record keeping, we made a compliance action asking the provider to take action in order that we were reassured that the records detailing how patients were cared for were accurate.

We carried out an inspection on 18 May 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had assessed them as non compliant.

At the visit we spoke with five staff and looked at records from both wards. The manager explained the changes that had taken place for example the male and female wards were integrated sharing staff and had joint meal times. The house keeping staff served meals freeing staff to be with the patients and where necessary complete records such food and fluid charts.

We spoke briefly with two patients it was a busy day and many were engaged with staff, interacting with each other or had gone out. There were also some ‘poorly people’ in the unit and we respected the manner in which staff at Elmleigh were managing these issues.

We carried out an inspection in September 2011 when we identified concerns with Outcome 4 care and welfare, Outcome 7 safeguarding and Outcome 13 staffing. The concerns were in relation to care planning, risk assessments, safeguarding of patients and staffing levels. We made compliance actions asking the provider to take action in order that we were reassured that patients were in receipt of safe and adequate care with regard to outcomes 4 and 13; and that improvement was made to safeguarding.

We carried out an inspection on 23 January 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had assessed them as non compliant or needing to make improvements.

At the visit we spoke with five staff. Twelve new staff had begun work at Elmleigh since our inspection in September. We spoke with one new staff member who told us about their induction and who explained the audit tools that were in place. Staff we spoke with were generally happy with the new working arrangements that had been put in place and they told us about the training they had attended since our visit in September 2011.

We inspected the service following the receipt of whistle blowing concerns and a safeguarding notification. We spent time in all the wards and looked at records relating to the treatment of patients and arrangements for their care. During the visit we spoke with ten staff and six patients. We visited all three wards at Elmleigh, the male ward, female ward and psychiatric intensive care unit (PICU).

Patients were aware of their care plans and some could recall signing their agreement to the support they needed. One patient we spoke with said there were activities on Monday, Tuesday and Friday but there was not much to do the rest of the time. Another patient said they had enough to do and they didn’t get bored. They went on to describe that they spent their time, listening to music, reading and occasionally playing pool. A third patient also commented that there was “not much to do”. Some staff felt that patients did not have enough to do during the day because of staff shortages. Others said there are enough planned therapeutic activities.