We rated Nelson House Hospital as good because

:

• The staff carried out checks of the hospital to ensure it was safe and the hospital was in a good state of repair. There was a good incident reporting culture and staff learnt from incidents to help prevent them happening again.
• There was a multidisciplinary team working at the hospital and they offered a full therapeutic programme to meet the needs of the patients. The hospital followed National Institute of Health and Care Excellence guidance and completed comprehensive assessments of patients on admission to meet their needs. Staff completed and updated risk assessments for each patient and used these to understand and manage risk.
• The staff understood their responsibilities under both the Mental Health Act and Mental Capacity Act.
• Patients and carers reported that staff treated them with respect and that the care given was good. Staff actively encouraged patients to give feedback to help develop the service. Care focused on increasing independence.
• Patients were involved in discharge planning.
• Staff planned activities based on patients’ likes and needs. There were activities both on and off the wards seven days per week.
• The service had an open culture when dealing with complaints.
• Local managerial and clinical leadership was strong. The service used the providers visions and values to plan the future of the service. There were governance structures in place that helped drive improvements.

However:

• The senior management team had not identified that a wide range of blanket restrictions where being used to manage risk to all patients in the hospital. The staff team were using blanket restrictions rather than undertaking individual risk assessments, managing risks in accordance with those risk assessments and only using blanket restriction where absolutely necessary.
• Not all bedroom doors had observation panels that staff could lock to ensure individuals privacy could be maintained.
• The staff did not provide patients with care plans in an easy to understand format. Staff did not agree advanced directives with patients about their care.