On our last inspection to the service on the 26th & 27th September 2013 we found that people who used services were not protected from the risk of abuse because the provider did not have a clear policy on the use of seclusion and time out. The provider was asked to take action on this.

We also found that the provider did not make suitable arrangements to ensure equipment was available in sufficient quantities in order to meet assessed needs and those repairs and maintenance issues were not completed in a timely manner.

We carried out this inspection to check whether improvements had been made. We visited Tarn, Avery and Shrewsbury wards.

We found that the provider had reviewed their policies and practices relating to the use of time out and seclusion. The staff had received training in the prevention and management of violence and aggression (PMVA) and were aware of how to care for people who were in crisis. People on each of the ward we visited said that they had discussed with them how to respond to their needs individually and care plans we saw reflected this. One person said this was helpful and felt that staff knew how to respond to him when necessary.

Policies and practices relating to equipment and repairs had also been reviewed and we saw that there were improved systems in place to respond to environmental issues on the ward. Equipment was managed safely and we saw that the ward teams had developed practices to support them.

During our inspection we visited Shrewsbury ward, Avery ward, Shepherdleas and Tarn ward. People we spoke with had mixed views about the service. Some people were very positive and told us how the staff were very friendly and supported them whilst other people did not always feel understood by staff. For example a person told us that staff are "nice and helpful” and someone else commented "staff are always friendly even when they’re stressed". However another person told us "they’re not very approachable" and someone else said that staff could be rude and abrupt.

We found that most people had access to information about the mental health act and advocacy, and there was evidence that some people were involved in their care planning. People received care that met their needs in most cases, however we found that a lack of clear policy on seclusion and the use of a time out procedure meant there was a risk that people's rights might not be upheld. Staff were trained and supported to deliver appropriate care and the provider had a system in place to ensure the quality of the service was monitored. Medicines were administered safely. However people and staff told us that there were difficulties caused by the procedure for obtaining new equipment.