We spoke with ward managers, staff and young people on all three units, including people detained under the Mental Health Act. We spent the majority of time on Ashfield and Heathland units, with a short visit to Irwin, the Eating Disorders Unit.

We found a very positive and good natured atmosphere throughout, particularly on Ashfield. Many young people were reluctant to talk with us at length, but those that did were generally very positive about the service. “I feel safe here,” “People are understanding” and “They help you” were some of the comments we had from young people who used the service.

Staff were all very positive, showed enthusiasm for their work and a good understanding of the needs of the young people they were working with. We saw much evidence of effective team working and good interactions between staff and young people who used the service.

We witnessed a daily group discussion taking place on Ashfield, which showed a positive and relaxed rapport in place between all at the unit.

We arrived at Parkview Clinic unannounced. The inspection team was led by one of four CQC inspectors and was joined by an expert by experience. This is a person who has experience of using services.

There were twenty nine people using the service on the day of our inspection. We spoke with twelve of these people. We spoke with four relatives and fourteen members of staff. We visited two of the three units (Ashfield Unit and Heathlands Unit). We did not visit Irwin Unit as two people were unwell with vomitting. We followed the care of eight people.

People told us that they were happy with the care and treatment they received. They told us that they and their families were fully involved in making decisions about the treatment they received. Comments included: “Young people are treated as individuals” and “I feel as if I know what’s going on”

People told us that staff were available at the times they needed them. They told us that staff had good understanding of their care needs and treated them with respect. Comments included: “Staff look after me well and are very supportive” and “Staff keep us motivated.” A relative told us “I visit the unit at least four times a week and have found that there is more than adequate staffing.”

People and their families told us that they felt confident that they could raise any concerns that they had, with any of the staff working there. People told us that they “Felt safe at the service."

We visited all of the three units within the service and followed the care of 13 young people. This included young people who had been detained under the Mental Health Act1983. The first day of our inspection was spent on the units and with people who used the service. The second date of the inspection was used to collect information we had requested at the feedback meeting with senior members of the trust. The information supplied helped to address some queries we had raised.

There were 35 young people using the service on the day of our inspection. We spoke with 16 young people, four parents of young people using the service and a variety of staff that supported them.

Young people made positive comments about the care and treatment they received. They told us that they and their families were fully involved in making decisions about the treatment they received and that their care needs were being met. One young person commented that ''I am given goals which are something to aim for.'' A parent told us ''The service has saved my daughter's life.''

Young people told us that, overall, staff were available at the times they needed them. They told us that staff had a good understanding of their care needs and they took the time to answer any questions they had. A young person commented “The staff have been very supportive, I can’t thank them enough. They have always been available to me and have given me my methods to cope.”

Young people and their families told us that they felt confident that they could raise any concerns that they had, with any of the staff working there. They told us that they were confident that their concerns would be taken seriously.

Young people were involved in monitoring the quality of service provided. They told us that action was taken in response to suggestions they made. However, young people told us that it may take a length of time for this to be done.

Plans are in place for a major redesign and refurbishment of the clinic. This is due to commence in January 2014. The trust told us that the aim is to ensure more space and better integration of wards and facilities throughout the clinic. Young people using the service have been involved in this project.

We have identified minor concerns about the management and safe storage of young people’s medicines. We have issued a compliance action to ensure the improvements required are made.

Young people told us that they often had to ask staff for permission to use the toilet facilities on the units. This was because toilet and bathroom doors were often kept locked. An agreed and written policy about this was not in place. This practice did not promote young people’s privacy, dignity and independence.