During our inspection we visited Aiden and Oswin wards and we spoke with eight members of staff and they were all open, honest and co-operative in their responses. We also spoke with six patients on the wards and their comments included; "There are good activities here, I enjoy doing woodwork." Another person said they were involved in music and the activities member of staff was helping with some recording." One person said " I am very happy with everything.” and went further to say that, “the staff couldn’t do enough for you.” He felt he was in receipt of a quality meaningful service for him and the staff were steering him “on the right path” to reduce the occurrence of future admissions.

We looked at four sets of care records and they contained care and treatment plans, assessments of need and risk assessments. They were very comprehensive and personalised including both mental and physical health components of care and welfare.

Staff spoken with told us that mandatory training was kept up to date for example, safeguarding, restraint, health and safety, fire safety and infection control and reminders were given when updates were due. There was also a range of client specific training available. The training information was viewed on the ward's computer and was found to be up to date.

There was a range of quality audits carried out on the wards. There was a report following each audit and where needed an action plan with follow up was in place.

As part of this inspection, the Care Quality Commission (CQC) liaised with other statutory bodies to identify an overall view of how the trust was performing and any areas of concern. Contact was made with Healthwatch England, NHS England and Monitor, and their views were taken into account in arriving at the judgements on compliance.

No specific areas of concern affecting this inspection were received from local Healthwatch England, the independent consumer champion for health and social care.

Monitor has the responsibility for ensuring foundation trusts, such as Northumberland, Tyne and Wear NHS Foundation Trust, are well led in terms of quality and finance. CQC received confirmation that apart from one recently received concern, Monitor had no other significant concerns regarding the trust. The issues raised by the specific concern were looked at during this inspection and are the subject of ongoing review by CQC.

NHS England has the responsibility for commissioning services and ensuring the provision of high quality services. The Cumbria, Northumberland and Tyne and Wear Area Team had the view that the trust is providing good care but had some questions about specific services and broader issues such as restraint policy. CQC was made aware that these, as well as quality and workforce issues, restraint and specific serious untoward incidents, will be discussed with the trust through a meeting of the Quality Review Group in September 2013. These issues are subject to ongoing monitoring by CQC and have been taken into account in the judgements made in this report.

The young people and staff expressed more confidence in these staff and the number of behavioural incidents had decreased. Staff said that they no longer felt “anxious”, “vulnerable” or “worried” as on the previous visit.

The young peoples advocate had recently completed a questionnaire with the service users and told us that the young people had responded that “they felt fairly safe” and that they feel they “will be listened to”. The advocate told us that any concerns that she had were listened to and responded to quickly.