We rated Hazelwood House as outstanding because:

• The service provided safe care. The environment was safe and clean. There were sufficient nurses and doctors. Staff assessed and managed risk well, managed medicines safely, followed good practice with respect to safeguarding and minimised the use of restrictive practices. Staff had the skills required to develop and implement good positive behaviour support plans to enable them to work with patients who displayed behaviour that staff found challenging.

• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment of each patient. They provided a range of treatments suitable to the needs of the patients cared for in a ward for people with a learning disability (and/or autism) and in line with national guidance and best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.

• Staff communicated with patients and presented information to them in a way they could understand.

• The staff team included or had access to the full range of specialists required to meet the needs of patients. Managers ensured that staff received training, supervision and appraisal. Staff worked well together as a multi-disciplinary team and with those outside the ward who would have a role in providing aftercare.

• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. They actively involved patients and families and carers in care decisions. Patients and carers spoke positively about the staff and one carer said the care for their relative had been exceptional.

• Staff used innovative ideas to help support patients and improve their experience.

• Staff were responsive to the needs of the patients and supported them to access educational, training and work opportunities.

• Staff planned and managed discharge well and liaised well with services that would provide aftercare. They did this by completing an effective handover with referring and receiving hospitals and external services to ensure an effective care pathway.

• The service worked to the transforming care model. The hospital was well led, and the governance processes ensured that hospital procedures ran smoothly.

• The service was part of the Royal College of Psychiatrists’ peer review quality network.

• The hospital director and the clinical director had successfully implemented a number of changes in a short space of time in order to reduce restrictive practice and improve patient experience. They did this by communicating well with staff and considered their wellbeing throughout the process,

• The hospital director and clinical director had been selected as one of five finalists for the award in the Care Team category of the Great British Care awards.

There were 13 people using the service at the time of this inspection. We spoke with six people and also with staff and the acting manager.

People told us they were involved in planning and reviewing their care and treatment. We saw that people’s needs were assessed and their care and treatment was planned and delivered to ensure their welfare and safety.

We saw that people were offered suitable choices of food and drink. People told us they enjoyed the food provided, though some people wanted larger portions. We saw that people’s views about the meals provided were noted and action was planned to address issues found.

People told us they felt safe at Hazelwood House. We saw that people were protected from abuse by the policies and procedures in place and by staff awareness. People told us, “Staff are brilliant here and will do anything to support you.”, and, “Staff are always there if I want to speak to them.”

We found there were sufficient staff available to ensure people’s needs were met. People using the service had ready access to staff with a range of qualifications, skills and experience. We found that staff were appropriately supported with training, supervision, and opportunities for personal and professional development.

This visit to the service was a joint one with a Commissioner from the Mental Health Act Commission, which is part of the Care Quality Commission. The role of the commissioner is to provide a safeguard for individual patients whose rights are restricted under the Mental Health Act 1983.

An Expert by Experience accompanied us and spoke with people who used the service. Experts by Experience are people who have used services or have cared for someone who have used services.

As part of our visit we spoke with five people using the service, the manager and five staff in different roles.

We found there were a range of community meetings held where people could share their views and put ideas forward on how to improve the service. People valued these opportunities.

We observed positive and respectful interactions between staff and people. Some activities were happening during our visit and staff and people were laughing together during these. The staff we spoke with could tell us clearly about people and their preferences.

The staff team at Hazelwood House is a multi disciplinary one who worked together to provide care for people. The home was staffed to a consistent level apart from some night shifts where we found lower levels of staff for some nights. People in the home were aware of this and expressed that they did not feel safe on these occasions.

Of the fourteen patients at Hazelwood House we spoke with nine patients throughout our two day inspection visit.

The majority of these patients were positive about the support and treatment they received.

One patient told us that they took part in meetings that were mostly about patients points of views about being at Hazelwood House. This patient told us that staff supported them with their risk assessments and explained why they were in place. This person said the staff ensured they were safe and talked to them about their care plans.

Another patient said “staff talk with me and treat me with respect”.

Some of the patients that we spoke with told us about the things they liked to do during the day. Some people had their own laptop, others liked listening to music, cooking or exercising in the gym.

We asked patients if they were provided with information in a way that they could understand and they confirmed that they were. One person told us that pictures were used to explain things to them.

We asked patients if they felt safe at Hazelwood House and they told us they did. One patient said” I would talk to any member of staff, if I was hurt I would go to the nursing staff”.

We rated Hazelwood House as good because:

• Patients were able to participate and make a difference to their care by being actively involved. They had a wide range of activities and therapies to aid recovery, were encouraged to give feedback into the service, and attended meetings with staff and peers from other units. They help develop information for other patients in easy read formats.

• Staff used a positive behavioural system that encouraged good behaviours amongst the peer group, which both staff and patients thought worked really well. Staff knew their patients well and were able to engage them, deflecting potential aggressive behaviours well

• The unit had a good structure to ensure that staff were up to date with training and supervision. A system was in place that encouraged learning within the staff group, and staff had awareness of when to report incidents and deal with complaints.

• Staff were aware of patients’ needs and risks as thorough up to date information was available, including personalised care plans and activity plans.

• We found the unit to be safe, secure, clean, spacious and comfortable with a good quality of furnishings and decoration throughout, including a large garden area for fresh air.

• A wide range of skilled staff participated in the multi-disciplinary team, who used specialist tools to assess and monitor their patients, to ensure progress was on track.