At our previous inspection in February 2013 we identified concerns about how the care and welfare of people using the service was managed. These concerns focussed on how care plans and risk assessments were reviewed, particularly in relation to episodes of seclusion. In April 2013 the provider sent us an action plan that showed how they intended to make improvements to ensure that people received appropriate support, care and treatment. They told us that they expected to be compliant with this outcome by September 2013.

During this inspection we visited three of the five wards within the hospital. We spoke with staff working on these wards. We also spoke with people who were receiving care and treatment; and in detail with four people on one ward. We found that the provider’s planned improvements had been completed, or were in progress. People told us that they felt safe at Norvic and that staff were supportive and understood their needs. They also told us that they enjoyed the activities on offer and that they felt supported to achieve recovery.

Audit reports showed that senior nurses carried out monthly audits of people’s records to ensure that they were completed appropriately. Medical staff were also undertaking an audit of their response times to requests to attend people who had been secluded. This audit had not been completed at the time of our inspection but the provider undertook to forward the audit findings to the Care Quality Commission in due course.

Consent was sought from patients and recorded in accordance with best practice. Patients told us that they agreed with the decisions made about their care and treatment.

We found inconsistencies in how the care and treatment patients received were recorded, which meant that we could not be certain that what they received was appropriate. Care plans and risk assessments were not always completed or reviewed to ensure they were up to date.

The procedures to ensure the seclusion of patients was managed safely and consistently were not always followed in accordance with the trust's policy.

Patients told us they had access to a range of structured activities both on site and in the community, which they enjoyed. Some were particularly complimentary about some therapies and the support they received from the chaplaincy team. One person described the gym facilities as "More than adequate."

Risks associated with the hospital premises were managed effectively and most patients told us they were happy with, and felt safe in the ward environment.

There were effective recruitment and selection processes in place.

Patients had access to an effective complaints system that was responsive to their concerns.