We found the trust could improve in the following areas:

• Not all ligature risks had not been identified by the trust’s ligature risk assessment. This could increase the likelihood of patient’s ligaturing in the service and impact on the safety of the patients.

• The patient kitchen was not clean.

• The training compliance at Parkside Lodge for the level 2 Mental Health Act inpatient training was 57%. The training compliance for the Mental Capacity Act, including Deprivation of Liberty Safeguards, level 2 was 69%. This training had been introduced into the trust's mandatory training schedule in July 2015. Staff had not received training on the updated Mental Health Act code of practice.

However we found the following areas of good practice:

• Staff had reviewed all patient prescription records had all been reviewed. Staff had followed the medication as required guidance. There was detailed recording of incidents on the trusts datix system.

• The seclusion room was in the process of being altered to comply with Mental Health Act guidance and to ensure patients’ privacy and dignity was not compromised.

• Multi-disciplinary team meetings took place twice a week; decisions and information gained during multi-disciplinary team meetings fed into the patients care plan.

• Patients had physical health checks on admission to Parkside Lodge and on a regular basis during their stay in hospital.

• Staff had regular supervisions and annual appraisals. Specialist training was available to staff.

There was evidence in patients records that staff explained to patients who used the service the care they were given and the reason for it.

Staff explained that they involved patients in their choices and that decisions were documented in their records. Staff signed and dated all records.

One patient said, “I know what my Care Programme Approach (CPA) is for and I feel included in my CPA meetings” Another patient said, “My Mum and Dad attend my meetings they always get invited” and “I think they do a great job and help build up my self-esteem.”

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. The needs of patients who used the service had been taken into account in ensuring there were suitable communal areas and the unit had an area of low stimuli should patients choose to use it

Patients we spoke with said they were very satisfied with their care. Patients said staff supported them in the way they liked to be helped. Patients’ needs were assessed and care and support was planned and delivered in line with their care plan.

The rotas we looked at showed that the staffing levels agreed within the unit were being complied with, and this included the skill mix of staff. They confirmed there were sufficient staff, of all designations, on shift at all times.

The provider had a policy on obtaining feedback from patients who used the service. This included information from sources such as patients meetings, complaints and survey questionnaires.

People using the service and visitors told us they are satisfied with the service they receive and they are respected. People said the environment is always clean and pleasant. People we spoke to said if they have any concerns they are happy to raise them with the staff or management team and are confident their concerns will be dealt with appropriately and promptly.

Staff told us that people receive a good service and they contribute to decisions about their care. Staff said they are confident that the management of the home would deal with safeguarding issues or concerns appropriately and systems are in place to ensure people are safe.