We spoke to several patients during our visit about their views on the care and treatment they received. They told us they felt well cared for and that the staff were kind and supportive. We saw many examples of positive interactions between patients and staff and we observed patients were relaxed and at ease.

Two Mental Health Commissioners spoke privately with five patients. The expert by experience spoke with several patients and concluded that patients generally felt satisfied with the care and treatment they received. They also felt that staff treated them kindly and were respectful.

Patients told us that they liked the food and that the chef listened to their views and suggestions. They told us that the food was good and that healthy options were available if they requested this.

Patients told us they knew their rights and they felt safe. They told us that if they had a problem or concern they knew who to talk to. Staff told us they had undertaken their safeguarding training and they would not hesitate to report any concerns or issues to their line manager.

People were supported by staff who received appropriate professional development.

The provider had systems in place to monitor the quality and safety of the hospital.

People we spoke to told us that they were happy with all aspects of their care and treatment at Pelham Wood. They told us that the staff were caring and kind and helped them with their rehabilitation programme.

They had good comments regarding the quality and variety of food offered. They said that the chef provided a healthy option if they requested this and that they had an input with the menu planning.

People told us that they had been involved it their treatment plan and were able to discuss this with their primary nurse and at meetings.

People told us that there was always some activity taking place that kept them occupied.

We were told that staff were polite and always treated people with respect.

We rated Pelham Woods as good because:

• Both wards were safe and clean and received daily cleaning from domestic staff. Furnishings were well maintained and this included a recently renovated patient lounge area which was bright and welcoming. Convex mirrors had been installed in areas of the ward that had been identified as blind spots. Extra closed-circuit television cameras had been installed to cover areas of the garden which had been identified as difficult to observe continuously.
• The service had carried out significant work to identify restrictive practices on the wards and the reason they may have been in place. Those restrictions that were necessary to maintain the safety of the wards were kept under regular review. This meant that the breach in regulation identified in the previous report had now been addressed.

• The service had brought the staff and patients together to try to look at the way the wards were working and used the “Safewards” model which gives methods for reducing risk and coercion in inpatient wards. There were creative attempts to involve patients in all aspects of the service.

• Patients had care plans which were up to date, personalised, holistic and recovery focused. The multidisciplinary team actively involved patients and their families or carers in all aspects of their care and treatment during weekly reviews. Staff undertook comprehensive physical health assessments for all patients. Patients were having dental and optician appointments and regular blood pressure and weight checks.
• Patients had regular one-to-one time with staff and had access to groups such as walking, current affairs, gardening, goal setting and fitness with the support of technical instructors. They also provided recreational activities such as smoothie making and pampering sessions. Staff treated patients with dignity and respect and understood the needs of individual patients. Staff were proud of their work and the progress patients were making.
• Patients had clear discharge plans and progress towards discharge was discussed during handovers, multidisciplinary meetings and patients’ reviews. There were no delayed discharges across the two wards.
• There were sufficient staff to ensure that patients received the right care for them at the right time. The service considered the fluctuating needs of the patient group and ensured that ‘floating’ staff could dedicate their time where it was most required. During the time leading up to the inspection, the service had recruited a number of permanent staff so reducing its reliance on agency and bank staff. Nearly all staff (98%) had completed statutory and mandatory training. Staff were receiving regular supervision and all staff had received an appraisal.
• The service demonstrated a commitment to achieving best practice and this was reflected in its performance and risk management systems and processes. Managers and staff worked in a systematic way to continually improve the quality of the services and to create an environment in which staff could provide high quality care. Managers reviewed governance arrangements in a proactive way to ensure that they reflected current best practice. The service was well led at ward level and by the hospital director with an inspiring shared purpose. The managers were striving to deliver and motivate staff to succeed with a great commitment towards continual improvement and innovation.
• Managers and staff took a systematic approach to working with other organisations to improve care outcomes.
• The staff were achieving consistently high levels of creative and constructive engagement with the patients, across all equality groups. Rigorous and constructive challenge from patients, the public and stakeholders was welcomed and seen as a vital way of holding the service to account.

• Staff knew how to handle complaints appropriately and there were different options available to patients should they choose to make a complaint either informally or formally.

• There was clear learning from incidents which was fed back to the staff and the patients. Learning was fed back from the managers to the staff when things went well which promoted training, research and innovation. Staff were open and honest to patients and carers when something went wrong.