• There had been six locum psychiatrists in the last six months, which created a level of uncertainty and instability on the ward as staff accommodated different medical styles.
• Some staff lacked assurance in verbal de-escalation techniques.
• Records relating to the seclusion of patients were not timely
• There had been two serious incidents in the last six months.
• The ward filled the beds of those patients taking ward leave when there were no other beds available. Potentially, this meant that if patients did not want to extend their leave the trust would have to transfer them to another ward for non clinical reasons.
• Staff morale was low.

However:

• The unit previously had minimal ligature risks. The bedrooms in the new build had blind spots, where staff could not observe patients. The trust managed these risks by installing mirrors opposite the bedroom doors. This meant staff could observe if patients were safe.
• Staffing levels were reviewed and increased to accommodate the increase in beds.
• The seclusion policy was under review to ensure it adhered to the changes in the MHA Code of Practice.
• The new conversion was clean and bright and increased the facilities available to patients.
• Activities were meaningful and well led. Patients had access to activities at the weekend.
• The provider had made changes to the ward in response to staff concerns that were slowly being recognised. The local managers were actively working towards improved staff morale.

The Care Quality Commission (CQC) had met with members of Humber NHS Foundation Trust (FT) Committee and with the Board of Governors to share information. We had looked at information obtained from the CQC Mental Health visits to speak with detained patients over the last year. We had also consulted ‘Monitor’, the independent regulator of NHS Foundation Trusts who told us they had no concerns about Humber NHS FT.

When we visited Newbridges we spoke with three patients, three staff and the unit manager. We looked round the premises and we looked at documentary evidence for five ‘Essential Standards for Safety and Equality’ outcomes. We also received copies of the provider’s organisation ‘Provider Compliance Assessments’ and those specific to the unit.

Patients told us they were satisfied with the support they received and that they had signed consent to treatment forms where necessary. They said they were happy with the cleanliness of their accommodation, had opportunities to visit places in the community and that they felt safe during their stay.

One patient said, “I want to get into my own flat but it’s taking time to get everything sorted. Oh it’s okay here but it is a bit boring, just waiting around.”

We found that Newbridges staff were confident, conscientious and committed to their roles. They knew about patients’ needs and wishes and they ensured good infection control practices were followed. The premises were suitable for their stated purpose.