On the day we inspected there were 25 people living at Uplands some people were there informally and some were detained under the Mental Health Act 1983.

We observed staff being respectful, asking if people if they needed support and only assisting when asked.

We carried out an inspection in February 2013 when we identified concerns with consent, care and welfare and medicine records. We made compliance actions asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care. The provider wrote to us and told us what action they were going to take and they sent us an update on their actions in May 2013.

We inspected on 6 June 2013 to review the progress the provider had made. We found that the provider had taken steps to improve consent, care planning and medicine records. Individualised care plans detailed the support and care each person required. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We spoke with six staff and the registered manager.

There were effective arrangements in place to ensure the home was clean and free from infection. The quality of the service provided was monitored by an effective quality assurance processes.

Uplands is an independent hospital for people with a mental health diagnosis, some of whom are detained under the Mental Health Act 1983. The service whilst offering treatment also aims to assist people with a mental health diagnosis to enhance their skills to be able to live in the community or at least more independently.

On the day of our visit there were 27 people living at the service we spoke with seven of them and they described their experiences of care. One person described their experience as “It’s generally okay, not the place for me. Staff are caring but I can’t do anything without them. I want to go out but need staff with me so I don’t always bother”. Another commented, “Staff care, I get on well with most of them. They try and help. I do lots of things like watching TV or DVD’s and I go out sometimes”.

We spoke with six staff and the registered manager. Staff told us about working at Uplands and the support they receive from senior managers. “The management are really approachable, easy to talk to and will point them in the right direction”. One person told us about their induction and said, “It was the most comprehensive induction I have had”. The staff we met also told us about the training they had attended and that they were able to speak openly with senior staff and the manager about any concerns.

We found areas of concern with consent to treatment, care plans and medicine records. All of these areas were discussed with the manager.

Most people told us that they were happy at Uplands; some people do not have a choice at the moment but to be there as they are detained under the Mental Health Act.

They liked the interaction with the staff and were very fond of some of them. They said they are able to give their opinion, for example about the food and they feel respected and heard. They are able to have visitors at any time. Observation of staff and patient interaction seemed to be good with staff offering choice and time for people to express in their own way what they wanted.

We rated Uplands Independent Hospital as good because:

• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national best practice guidance. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multi-disciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
• Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
• The service worked to a recognised model of mental health rehabilitation. It was well led and the governance processes ensured that ward procedures ran smoothly.

However:

• The service did not maintain comprehensive ligature risk assessments.
• The service did not ensure all staff were up to date with mandatory training, and up to date training records were not readily available.
• The furniture and decor in the complex care ward appeared worn and in need of replacement. Although, work was underway to address this, and new furniture had been ordered.
• The service did not proactively engage carers.
• The service was not using standardised outcome measure for all patients.