People were asked for their consent before they received care or treatment. We saw that a person’s capacity to consent was regularly reviewed during ward rounds. If a person did not have the capacity to consent a decision was made by the multi-disciplinary team in the best interests of the patient.

Care and treatment was delivered to support people’s mental health, physical health, social and financial needs. A full risk assessment was undertaken to identify any concerns regarding the person’s behaviour and whether there was a risk that they may cause harm to themselves or others. The information gathered from the risk assessment and the person’s previous contact with mental health services was used to produce care plans to help support and manage the person’s mental health.

There were processes in place to maintain the safety of patients and staff on the wards. Staff regularly observed the patients to ensure they were safe and this could be increased if there were concerns about their safety or the safety of others. Patients had regular contact with the nursing team and the multi-disciplinary team to ensure they received the support they required throughout their stay on the ward.

The provider had working relationships with other providers to ensure the safety of people on the unit and to ensure that people received the care and treatment they required throughout their stay. There were processes in place to support the admission of people to the wards and to identify when it was appropriate for people to be admitted to the psychiatric intensive care unit.

The wards provided a safe environment for people using the service. However, there were concerns that maintenance was not carried out in a timely manner. For example, there were ongoing concerns on Powell ward with the toilets and showers not working. This meant there were restricted facilities for people to use.

Overall, we found the service provided on Powell and Johnson wards was caring, effective, well led, and responsive to people’s needs, and people were kept safe.

People were generally very positive about the care and treatment they received whilst at the Ladywell Unit, where they spoke about the good attitude of the staff and of getting the right support for their needs.

People said that they felt involved in their care and treatment decisions, and that they could always discuss something if they were not happy about something.

The people said there was usually staff available when they needed them, though they would like more opportunities to be able to talk to staff.

We did not talk to people who use the service during this review.

This review involved us looking at evidence received from the provider following a Compliance Action we imposed on the service, in relation to Hayworth Ward only. This action was taken in response to a review we carried out on 2nd September 2011, where we followed up concerning information we had received about the service.

This review focussed on Hayworth Ward only, where renovation work is taking place on the ward.

Hayworth Ward is a mixed gender 18 bedded assessment and treatment ward for older people aged over 65 with mental health needs and/ or dementia.

People told us that they were generally not happy about the renovation works taking place and said there could be more done to take them off the ward, particuarly when it is noisy, as they do not feel this is beneficial to their mental health needs.

Some people said that they would like to be kept informed about what is happening.

Since our visit to Hayworth Ward we have been informed by the provider that the ward has been closed and the people decanted to an alternative ward within the Trust.

People who use the service told us that they generally feel treated with respect, but that they do not feel particularly involved in the plans for their treatment and support.

Therapeutic engagement and activities, where provided, are valued by people who use the service, however, these are not always available, to everyone.

Staff are trained and receive support to meet the needs of the people, though staffing levels are tight and do not enable much interaction with people, or enable them to take time away from the ward when they want to.