We visited Auckland Park Hospital to follow up a previous inspection. In April 2013 we found that at that time the Trust was not meeting two of the Essential Standards of Quality and Safety.

During this inspection we found that the Trust had fully implemented their improvement plans, and had achieved compliance in both essential standards.

We found the improvements meant Auckland Park Hospital had in place appropriate opportunities, encouragement and support to people who used the service in relation to their autonomy and independence.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We also found that where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

The family members we spoke with were extremely complimentary about the service and staff. They all told us that this was the best service their relatives had used. They told us that all the staff were extremely skilled and competent. Comments from relatives included, “I have absolutely no complaints about the hospital and staff. All the staff are absolutely marvellous and the care is second to none. I don’t know why anyone would not consider the service to be first class.” and "The service is excellent. It really is marvellous."

People told us what it was like to be a patient in Auckland Park Hospital. They described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people in hospitals were treated with dignity and respect and whether their nutritional needs were met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by a practising professional and an Expert by Experience, who has personal experience of using or caring for someone who uses this type of service.

During the visit we spoke with five patients who were able to share their experiences with us. One person told us, “The food’s excellent, really nice. I like the people, the staff are nice”. Others told us, “They make an excellent meal here; best in town” and “I always find the meals are well presented and of good quality.”

One relative told us that staff used the preferred name for their husband. They also said “My husband’s speech is affected by his dementia, but the staff spend time talking to him and trying to understand what he is saying.” During the visit, we spoke with five patients and two relatives from across the three wards.

Some patients that used the service at Auckland Park Hospital were not able to tell us about their experiences due to their clinical condition. Therefore we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We saw that staff were respectful to patients, and throughout the visit tailored the way they spoke to individuals so they were supported to understand what was happening. We saw that patients were engaged in pleasant conversation during the serving of meals. Staff explained what was happening and, what foods were being offered. We saw that the process for serving lunch was calm and efficient. We saw that patients were asked what they wanted to eat.

In some units patients presented with behaviour that can challenge, putting both staff and patients at risk. We saw that this did not impact on staff practice, with all patients being offered food in a dignified manner.

We also looked at a report published by the Local Involvement Network. Local Involvement Networks (LINks) are made up of individuals and community groups, such as faith groups and residents' associations, working together to improve health and social care services. They published a report following a visit to Auckland Park Hospital on 20 January 2012. They found that there was a good choice of meals, with drinks offered to patients. They found that patients were offered choices of meals. They said that their observation of meal times demonstrated good standards relating to creating a pleasant relaxed environment for patients to enjoy their meal, and that no one appeared to be rushed and encouragement was given to those in need of it. They found that where wards were for both sexes, there were sensible arrangements in place to offer patients dignity and respect.

Most patients that used the service at Auckland Park Hospital were not able to tell us about their experiences due to their clinical condition. We therefore observed the care and treatment provided to help us understand the experience of people who could not talk with us. We found that staff took account where ever possible of the day to day decisions people made, such as what they wanted to eat or what they wanted to do with their time.

We also spoke with the relatives of five people who used the service. They told us that they thought the hospital was very good. Comments included, "The Hospital is absolutely brilliant. I can't fault the staff, the whole group of staff are brilliant." and "The staff are fantastic with him."

However, we found that that staff assumed that all people lacked capacity to make particular decisions, which impacted on their experience within the hospital. We found that staff acted in a way which conflicted with the key principles of the Mental Capacity Act (2005).

We found that aspects of the environment had not been adapted to meet the needs of people using the service. However, the provider had started work to investigate this further to address this.

We found that improvements had been made to the recording of information relating to the care and treatment of people using the service. We found that peoples' personal records including medical records were accurate and fit for purpose.