St Michael’s Hospital is a purpose built facility in Warwick, providing inpatient and outpatient adult mental health care.

Larches

Core service provided: Acute admission

Male/female/mixed: mixed

Capacity: 20

Willowvale

Core service provided: Acute admission

Male/female/mixed: mixed

Capacity: 20

The Rowans Ward

Core service provided: Psychiatric intensive care 

Male/female/mixed: mixed

Capacity: 11

Rosewood

Core service provided: Long stay/forensic/secure services

Male/female/mixed: mixed

Capacity: 15

Hazlewood

Core service provided: Long stay/forensic/secure services

Male/female/mixed: male

Capacity: 12

We found that the two acute admission wards at St Michael’s Hospital, Larches and Willowvale, had staff that wanted to deliver good-quality care, and this was confirmed by the people receiving care and treatment there. We saw some good examples of compassionate care that valued the individual needs of people on their roads to recovery. However, record keeping did not always reflect the personalised care that people told us they received.

Since CQC’s inspection Larches Ward is now for men only.

The psychiatric intensive care unit provided a safe and secure environment for people who needed an intensive and supportive environment during their stay in hospital. The unit is for both men and women. As an intensive care unit, Rowans is exempt from national guidance on mixed sex accommodation. The Trust told us that it tried as far as practicable to ensure that suitable arrangements were in place to offer men and women separate toilet areas. At the time of the inspection this was not clear as a sign had been removed from a toilet door.

The Crisis teams provided a combination of crisis assessment and home treatment to people experiencing mental illness. The service also acts as a ‘gatekeeper’ for all referrals to mental health services. We saw good examples of multi-disciplinary working between the crisis teams and the acute admission wards, therefore ensuring that people had a seamless journey of care. We saw that the service regularly checked the views of people and the results of surveys were used to improve the crisis service.

Rosewood Terrace and Hazelwood Unit staff used a ‘recovery’ approach to empower people to identify their needs and the support required. There were systems, including risk assessments, to keep people safe and for reporting any issues of concern. Improvements were needed to record keeping to ensure all records were accurate, accessible and showed people’s involvement. Systems were in place for people and staff to give feedback on the service, as were audits for measuring the quality and effectiveness of services. Staff helped people access community teams and services as part of their transition from hospital. Staff were given information and understood the trust’s governance framework, such as systems for feedback after incidents. Staff told us they were supported by their teams and line managers and could give feedback on the service. They said they had direct contact with their managers, but did not meet trust executive team members.

During our visit to Rosewood Terrace and Hazelwood Unit we found 16 people were detained under the Mental Health Act (MHA) 1983. Some paperwork relating to the MHA and code of practice was not easily accessible. We identified that community leave plans had set conditions for people not detained under the MHA. This indicated they could not always access community leave when they wanted.