On the day we inspected there were 27 patients, with one patient being admitted from another unit on the day. All patients accommodated at Southfield were detained under the Mental Health Act 1983.

We spoke with seven patients and ten staff. This included nurses, health care support workers and senior staff. We visited all three wards at Southfield and the flat, where two patients at a time can move into when they need support to be able to return to the community. The wards were Cedar ward, a nine bedded female ward, Oak ward for nine men, and Beech ward which could accommodate up to ten men. The two bedroom flat is used to accommodate either two men or two women at any one time.

Patients described the staff as “great”, “fine” and “good”. They felt involved in their care and most felt respected by staff. Patients were aware of their rights and knew what their care plan consisted of and their plans for their future.

Staff felt supported and were motivated in their work and were complimentary about the management support and the teams. One person described their job as “very nice” and the staff “look after each other”. All staff felt they had enough staff to carry out their roles.

Most patients felt safe and staff had a good understanding of their responsibilities in relation to safeguarding.

The environment was clean and in good decorative order but there was limited access to outside areas, which was a particular concern for non-smokers as the only outside space was the designated smoking area. Patients were able to personalise their bedrooms.

Patients were able to access a range of therapeutic and social activities both on the unit and in the local community. Care plans were personalised and detailed but some documentation was difficult to navigate due to the limitations of the electronic system.

Patients had mixed views about the food with some people describing it as “lovely” and others describing it as poor.

The quality of the service provided was monitored by an effective quality assurance processes.

Trust Headquarters provides a number of services. However, this inspection only looked at the Ashford Unit.

All people using the service at the time of our visit were detained under the Mental Health Act. However, we found that people were supported in promoting their independence and community involvement within the constraints of the Act.

We spoke with two people using the service and one family member. They told us staff treated them with dignity and respect. One said, “They’re friendly and polite. You can have a bit of banter with them”.

People’s needs were assessed and treatment was delivered in line with their individual care plan. We looked at two care plans and related records. We saw that people had access to specialist treatments and their needs were met. One family member told us, “The place is run really well. The specialists are brilliant”.

We spoke with the manager and two members of staff. They demonstrated a good understanding of safeguarding principles and the mechanisms for reporting abuse. There were arrangements were in place to ensure people were not subjected to unnecessary restraint.

We looked at duty rotas for the service. We saw there were enough qualified, skilled and experienced staff to meet people’s needs. The provider had an effective system in place to assess and manage risks to the health, safety and welfare of people using the service. We saw records of monthly audits used to monitor the quality of service provided.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The young people we spoke with were generally positive about the care and treatment they received.

The provider was taking action to minimise the use of restraint and there were systems in place to safeguard people against the risk of abuse. However, training was not sufficiently detailed and staff did not demonstrate that they understood their role and responsibilities in relation to safeguarding. This increased the risk that allegations of abuse would not be responded to appropriately.

There were effective systems in place to reduce the risk and spread of infection. People were cared for in a clean, hygienic environment. However, the maintenance and décor of the building did not provide an environment that was suitable for the wellbeing of young people who used the service.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had systems to assess and monitor the quality of service provided, however, they were not always effectively implemented at ward level. The failure to check whether the ward had suitable equipment available and take action to address identified shortfalls increased the risk that the service would not be able to safely meet people’s needs .