On the day of our inspection25 people lived at Raglan House. No one knew we would be visiting as our inspection was unannounced. We spoke to four people who lived at the hospital, two relatives, three staff, the head of care and the manager.

The people who lived at Raglan House had mental health care needs. People told us about their experiences, we looked at records and observed staff that cared for them. Staff we spoke to was able to tell us about people's needs so that they received care in a way that they preferred. One person said, “The staff are really knowledgeable and help me here.’’

We saw that systems were in place to keep people safe from harm. A relative told us, “I am sure they are safe there.’’ One person said, ‘’I like living here.’’

We found that staffing levels were adequate to ensure that people’s needs were met and that they were safe.

There were systems in place to monitor how Raglan House was run, to ensure people received a quality service.

We saw that complaints processes were in place for people or their relatives to use if they were not happy with the service provided.

On the day of our visit there were 22 people living at the hospital. No one knew we would be visiting. We spoke to four people who lived at the hospital, three relatives, three staff, and the head of care.

The people who lived at the hospital had mental health care needs. People told us about their experiences, we looked at records and observed staff caring for them. Staff we spoke to was able to tell us about people's needs so that they received care in a way that they preferred. One person said, ‘’Staff really know how to help me here.’’

Relatives told us they were kept informed about their relative's health so they felt involved in their care. One relative said, ‘Its’ absolutely fabulous care, I can sleep at nights now she is there.’’

We saw that systems were in place to keep people safe from harm. A relative told us, ‘They do seem to take a lot of care.’’ One person said, ‘’I feel comfortable living here.’’ Staff received a range of training to support the people who lived in the home. There were systems in place to monitor how the home was run, to ensure people received a quality service.

We spoke with the majority of people who used the service and were on the premises at the time of our visit. We spoke with staff of all grades and experience and the manager.

We spent the morning sitting with people in the communal areas, chatting with them and observing the interactions between people and staff. We looked at a selection of care records including risk assessments and support plans.

People told us that generally the staff were good and that they felt at ease and comfortable talking with the staff. People told us they have regular meetings and discussions with staff about the care and support they need. They told us that they have their own copy of their support plan. Staff told us of the support they offer to people each day. The information we saw recorded in the support plans was consistent with what staff and people had told us.

People told us the food was good and there was a choice available. Kitchen facilities are provided for people who wish to cook for themselves. We observed the lunchtime meal to be a lively and busy period.

Some people require one to one support from staff to help reduce the risk of harm to themselves and others. We saw staff providing this level of support in a calm and effective way. We did not see anyone waiting for help and support when it was needed.

The manager and staff told us they feel that the current staffing levels are sufficient to meet the needs of people. The manager told us of the contingency plans for other staff to be available if there are any changes to the level of support people need.

Staff told us of the training programme that is arranged for them. All staff we spoke with told us they felt the training was sufficient for them to do their job.

We rated Raglan House as Good because:

• Morale amongst staff at the service was excellent. The registered manager and head of care were described as providing consistent, effective and visible leadership and staff reported that working as part of the multi disciplinary team was like being part of a family.
• Staff at the service completed a range of environmental and individual risk assessments to ensure the safety of patients receiving care. Detailed contingency plans were in place in the case of emergencies and all patients received a review of their presenting risk on a daily basis.
• Care plans were detailed, holistic and recovery focussed. We found evidence that patients were assisted from the point of admission to identify and achieve their rehabilitation goals, and to work towards increasing independence and eventual discharge from the service.
• Sufficient numbers of skilled staff were available and patients were able to access nationally recognised therapeutic interventions, including psychology and occupational therapy. Professional development was encouraged by senior staff and monitored through the routine use of clinical and managerial supervision.
• A comprehensive audit programme was in place and completed by staff to ensure the delivery of a high quality service. Action plans were developed based on audit results and improvement was evident where previous results had not reached the required standard set by the provider.
• Patients and carers that we spoke with provided positive feedback in relation to the care and treatment provided by staff at the service. We were told that staff treated patients with kindness, dignity and respect, and that families and carers were routinely involved in the care planning process.
• Effective governance procedures were in place at a local and national level to monitor the quality of the service. The registered manager met routinely with the leaders of other hospitals to share good practice and to ensure lessons were learnt as an organisation when things did not go as planned.
• Staff and patients reported an open culture where they felt safe to raise concerns if necessary and were assured they would be supported by to do so. We found that where complaints or concerns had been raised, staff had responded promptly and duty of candour was evident where appropriate.