During our visit all nine patients were detained under the Mental Health Act. This meant to ensure the safety and wellbeing of themselves, and others, there were certain restrictions on what they could do and the decisions they could make. We spoke with four patients. They told us they enjoyed the meals and there was a good choice of food and drink available to them.

Patients were happy with the care and support they received. One patient said “I would give 10 out of 10 for the staff, my care, the food, the surroundings and other the residents”. Patients said staff regularly spoke with them about their care and treatment. One patient told us, “if you have any queries you just ask staff and discuss it with them, they always listen to our points of view”.

Patients told us they felt safe and said staff were kind and treated them with respect. One patient said “the staff are respectful to me and are helping me get better”.

We found there were effective systems in place to protect people from the risk of the spread of infection. We saw there were enough staff to meet patients’s needs.

Patients and their representatives were regularly asked for their views about the quality of the service and any recommendations they made were acted upon.

We rated Woodside as requires improvement because:

Woodside’s systems and processes were not established or operating effectively to assess monitor and improve quality and safety and mitigate risks in a number of areas.

The service had undertaken a number of audits. However, these failed to highlight key issues, for example with documentation and the compliance of the Mental Capacity Act. The service had not recognised and reviewed, or individually risk assessed, the use of some blanket restrictions in line with the Mental Health Act Code of Practice including access to the kitchen and outside space.

Staff were not fully supported in their roles. They did not receive regular clinical and management supervision nor were they up to date with mandatory training despite this being part of the weekly key performance indicator recording and monitoring for the organisation.

Staff were unsure of their roles and responsibilities under the Mental Capacity Act 2005 despite the high staff training compliance rate for this course. Patient records showed very few capacity assessments for patients regarding decisions around care plans and activity plans.

Not all staff could access the electronic records or contemporaneous patient information at all times. We found the records were not always complete or reflected the patients’ care and treatment, including family involvement, physical health observations and investigations, and the rationale for administering as required medicines. Care plans reviewed were not specific to patients’ communication needs; just one of the eight patients in the service had an easy read care plan.

The staffing establishment levels were not appropriate to support shifts as required without additional bank and agency staff. Staff patients’ and carers told us that at times escorted leave was rearranged or cancelled because there were too few staff to either accompany or drive patients. Therefore, the service was not consistently ensuring that sufficient staff were deployed to deliver activities relating to patient treatment and care. Doctors on the on call rota lived some distance away from the hospital therefore were not immediately available following an incident of restraint.

Whilst there were a range of policies which were regularly reviewed and supported good medicines management, we found some issues relating to medicines administration, storage and management.

However:

Woodside provides recovery focused care to its patients from a multi-disciplinary team. Staff clearly understood patient needs. We saw they worked and interacted with patients in a very positive and caring manner. Patients and carers spoke highly about the staff and provision of care.

The manager was approachable and supported staff. Regional managers visited Woodside regularly and all staff knew the senior management. The multidisciplinary team meetings were effective as patients were reviewed regularly including changing presentations; risks and the level of support required facilitating recovery and discharge.

The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers and the multidisciplinary team investigated incidents and made changes to patient care where necessary.

Woodside was a clean environment, with clear signs and well displayed information. Posters and leaflets described key information and processes for patients in different forms including easy read and pictorial. Patients were encouraged to personalise their bedrooms and have input into the food choices for the menu, which was changed frequently. Staff made healthy, quality food on site for patients.