Due to the complex needs of the patients currently being supported we spent limited time with them. We asked the service to facilitate arrangements for us to contact the relatives of patients being supported. On this occasion due to a delay in receiving contact details we were unable to seek their views.

We spoke with one patient who used the service they told us they felt the service was okay and that they liked members of staff team. We observed both patients being relaxed and comfortable in the company of the staff team.

We looked at two care records they provided detailed person centred information about patients needs.

Discussions with members of the staff team and records held by the service showed staff had been supported to undertake training to enable them to support patients safely and to promote their wellbeing. The training matrix for the staff team showed specialised training was now being provided.

Discussions with members of the staff team, managers and information held in records showed the service operated a culture that allowed and supported learning from incident and accidents.

Records showed that unannounced visits to services including Eastway were undertaken by members of the executive team, board members and specialist advisors.These visits formed part of the quality assurance systems in place to monitor the quality and safety of the service being provided.

Records were held securely to maintain patients right to confidentiality.

We previously inspected Eastway in November 2012 following information received from the local authority and relatives of a patient, which indicated that people were at risk of receiving inadequate and inappropriate treatment and care. Before we carried out our inspection in November we were aware that the provider had responded to the concerns raised and had implemented an action plan designed to improve standards of treatment and care provided. However, when we carried out our inspection we found that Eastway was not meeting five of the seven essential standards of quality and safety we inspected. Patients were not always experiencing care, treatment and support that met their needs and protected their rights or safeguarded them from abuse.

We carried out this inspection because we received further information which indicated that a patient was still at risk of receiving inadequate and inappropriate care and treatment.

We found that the Trust had made some improvements in care planning since our previous visit. However, we identified other deficiencies in care planning and delivery, inadequate planning for the patients discharge and inadequate safeguards to protect the patient from potential abuse.

We are unable to discuss the details of our findings in this open report because we would identify the patient and breach their rights of privacy. We will continue to monitor this service as part of our ongoing inspection programme.

When we visited Eastway on the 23 and 26 November we met all four patients staying on the unit but we only spoke with one of them. Other than saying hello and exchanging greetings we were unable to communicate with some of the people due to complex communication needs.

The patient we spoke with presented as relaxed and at ease in the environment of the ward and in the company of staff. They spoke with insight about the reason they came to stay on the ward and how they had been helped to regain skills and independence. They told us that staff treated them nicely and how they enjoyed going to work each day and doing activities such as swimming or relaxing with staff on the unit.

We spoke with the families of the three other patients, either during the course of our visit or on the telephone. Their views and experiences of the standard of care and treatment provided varied. Two of the families spoken with told us that their relatives had positive experiences at Eastway. They told us that their relative’s mental and physical heath care needs where being met and that they were kept informed of developments. One of the patients’ relatives praised managers and staff for their dedication to duty describing them as wonderful and brilliant.

Another family described how their relative had deteriorated in mental and physical heath since their admission to Eastway. They told us that there was a lack of understanding of their relatives needs brought about by ineffective assessment and care planning and a failure to learn from experience. They told us that this had a detrimental affect on their relative’s health and well being. They told the change in management at the beginning of October had brought some improvements with greater opportunities for collaborative working but they remained concerned for their health and welfare of their relative.