This was a follow up inspection to an unannounced inspection on 18 and 19 January 2016 where we found the trust had breached regulations 11, 12, 13 and 18 of the Health and Social Care Act 2008. We issued a warning notice to the trust on 8 February 2016 for significant improvement in these areas.

The warning notice stated that the trust must take action to address concerns within six weeks regarding risk assessments, the use of Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), the safe management of medicines and reporting and recording safeguarding incidents. This inspection was to ensure that the trust had completed these actions, met the requirements of the warning notice, and was delivering a safe and effective service for patients.

We were only able to speak with a small number of people using the service or their relatives. A person using the service told us “it’s great.” A visitor we spoke with was very positive about the care their relative received. They said that they “doubt if you could find anything better” and gave it “99 or 100 percent”. They said their relative was settled and happy in the service.

The visitors we spoke with said that they were usually informed promptly of any changes in the health or treatment of their relative. We were told that the “positive is far more than the negative” and they felt able to voice any concerns they had. A visitor told us that the staff listened to them when they told them what their relative wanted. The visitors we spoke with told us they felt their relatives were safe in the unit, and if they had concerns they felt able to raise them with staff.

Staff told us that people always had their basic care needs met, but if the ward was busy it could be difficult to spend time with people. Staff said that a lot of agency staff were used, although many of these worked regularly in the unit so there was some consistency. A relative told us that “the staff are good”. Staff had completed their mandatory training and told us they felt supported on the unit,

The Trust had processes in place for reviewing the management and quality of the service. We saw that records were maintained of people’s care and treatment, and these were stored securely.

The majority of people being cared for on this ward were diagnosed with dementia. It was therefore not possible to interview them because they could not engage with the process. We spoke with three people in the day room during our visit. One person told us they had enjoyed having a manicure that morning and another said, “Staff have all the time in the world, they are very good.” They also told us that the ward was always clean and that they never had to wait long if they needed staff to help them.

Everyone we talked with confirmed that the food was good and there was always enough, and that they felt safe. We saw that people were treated with respect and were involved as far as possible in decisions made about their care and treatment.

• This was a second follow up inspection to an unannounced focussed inspection on 18 and 19 January 2016. During the inspection in January, CQC found the trust had breached regulations 11, 12, 13 and 18 of the Health and Social Care Act 2008. CQC issued a warning notice to the trust on 8 February 2016 for significant improvement in these areas.
• The warning notice stated that the trust must take action within six weeks regarding risk assessments, the use of Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), the safe management of medicines and reporting and recording safeguarding incidents.
• The warning notice stated that the trust must complete a comprehensive review of patient assessment and care planning and to review staffing levels and skill mix within three months of the date of the warning notice.
• This inspection was to ensure that the trust had completed all actions set out in the warning notice and was delivering a safe, effective and caring service for patients.