We visited the Eden Unit which includes Eden Psychiatric Intensive Care Unit (PICU), Eden and George wards, Endeavour Court, Endeavour House, Ford House and Resevoir Court and is part of Birmingham and Solihull Mental Health Foundation Trust, as we had received some information of concern regarding a shortage of staff there.

We spoke with the managers of Eden (PICU), Eden Ward, and George Ward. We also spoke with two staff from each unit. We spoke to six patients across the three wards.

There was a clear structure in place for the planning and review of patients' care, treatment and recovery. The content of care plans provided staff with enough information to make day to day decisions around patients' care needs and choices.

There were a number of staff vacancies across the three units, particularly on Eden PICU. We identified times where minimum staffing levels were not complied with. This meant that patients' needs may not have always been met safely and appropriately. There were often difficulties in covering staff shortages with bank staff or agency staff.

The trusts recruitment process itself often took a long time. We were told of one instance where it had taken 5 months from a person being offered the post to starting work on the ward.

Staff received supervision, but this was mostly informal supervision given during the day. Staff on each ward told us they felt very supported by their manager and by the team they worked with.

We visited the PICU ward. There were nine patients there on the day of our visit. We spoke briefly with two patients, and at length with a further three patients. Some people were too unwell for us to speak with.

Patients on the unit on the day of our visit were being assessed and / or treated within the provisions of current mental health legislation. They were not there on a voluntary basis. The average stay of patients, we were told by the manager and staff, is six to eight weeks. One person had been at the unit for over six months.

Patients we spoke with were not happy at being at the unit. Three people were anticipating imminent moves to more open environments. Those who were about to move elsewhere were unhappy at restrictions in place, such as limited access to facilities. Staff advised us that restrictions, such as limited access to bedrooms and bathroom facilities, were necessary safety precautions for the well-being of all. They advised that, as individuals showed that they no longer needed these restrictions, they were ready to move on. This was what was happening in the case of three people we spoke with.

We spoke with the manager, and with nine people working at the unit; six of them at length. Staff showed a commitment and motivation to the well-being of patients on the ward. We heard positive comments about the unit working as a team; “we all help each other” “work as a team” and “get things done”.

Whatever their views about having to be on the Eden Unit, patients were positive about the staff. One person told us “the staff help”. Another said that the staff were “good”, that there were always enough staff around to help them and that they clearly explained things to them.

Patients told us they were satisfied with the care they received on the unit. They said the staff team were good, but they were not happy with the lack of activities available.

Patients told us they felt safe on the unit.