This unannounced inspection focused on concerns raised to CQC by a whistle-blower. We did not therefore inspect all activities of all CQC key questions.

We could not find any evidence that supported any of the whistleblowing allegations. We shared our findings with the trust at the end of the inspection and at a multi-agency meeting after the inspection.

The CQC had undertaken a comprehensive inspection of Black Country Partnership NHS foundation Trust in November 2015. The Macarthur centre had been inspected as part of the core service ‘Acute wards for adults of working age and psychiatric intensive care units’ and rated overall as good.

Following our inspection, we did not identify any actions that the trust must make to improve services. We did identify areas in which the trust should take action to improve.

We found the following areas of good practice:

• The ward environment was clean and well maintained.

• Risk assessments and management plans were in place. Staff regularly reviewed risks and handed over comprehensive clinical information between shifts.

• Seclusion records were complete and documented in line with the trust policy.

• The staff team had developed regular debriefings session and used supervision to reflect on how they managed challenging clients and stresses of working in the psychiatric intensive care environment.

• The ward had good links with the advocacy service that visited the ward regularly and staff supported patients to attend weekly community meetings.

However, we also found areas that the service provider could improve:

• Staff vacancies and high use of bank staff were affecting the consistency in the working approach for both patients and the permanent staff team.

• Staff did not always keep patient information confidential.

• Patients could only use the ward phone once a day and only in the presence of staff. This was a blanket restriction and it had not been individually care planned.

• Staff did not keep a log of informal complaints, which would mean staff did not have an overview of informal complaints and actions from them.

• Staff did not always record patient observations accurately.