We spoke to six out of 13 patients at St Matthews hospital. We also spoke to the registered manager and five staff who were supporting them and we observed how support was provided.

The patients told us that the staff were very kind and caring and that they were given support to be independent and learn new skills. One patient told us “The staff are good at their jobs” and “It’s the best clean hospital I've been in and the shops are very easy to get to from here". Another person said "I do cooking and buy my own food from the shops with support from staff”. They told us that they enjoyed this activity.

Patients also told us that they were generally satisfied and involved with the care, treatment and support they received from staff. They said that there were plenty of activities to do in the unit and in the community. One person told us “I am never bored here because there are lots of good activities to do” and “I help out by doing charity work”. Patients also told us that they knew how to make a complaint if they were not happy with the quality of service received. They told us that they were encouraged to express their views at their monthly “community” meetings and felt they were listened to by staff and the manager.

On the day of the visit there were 11 patients. We spoke with four patients and three staff on duty. All the patients in the hospital were able to communicate verbally.

We observed that there was good interaction between staff and the patients. The patients told us that the staff were “nice” and spoke to them in a dignified manner. They also told us that they were informed about their rights when they were admitted to the hospital and also afterwards at the ward meetings with professionals.

The patients told us that they did lots of activities in the hospital and out in the community. One patient told us that they liked St Mathews hospital because they helped with gardening, did voluntary work, went to the gym, and played football. All the patients we spoke with told us that they did their own laundry, kept their rooms tidy and cooked a meal with support from staff. Most of the patients told us that the food was good and that they had a choice of what to eat. Two people told us that they had to have special food and their needs were being met.

All the patients told us that they felt safe living at the hospital. They told us that if they had any concerns; they would talk to staff on duty or to the manager. They told us that all staff listened to them and took action when they had concerns and were not happy.

We rated St Matthews Hospital as requires improvement because:

• The service had blind spots, which were not addressed by any mitigating actions.
• Ligature assessments were not robust and did not cover all areas of the building.
• The process for ensuring that staff received feedback from incidents and complaints was not robust. Staff did not understand what lessons had been learned from, or how they were shared.
• Training compliance was below the providers’ target of 90% at 75% and there was a discrepancy over data. Compliance to the Mental Capacity Act training was low at 68%.
• Blanket restrictions were in place for patients to have access fresh air.
• Pat down searches were being conducted in the entrance to the service. This practice compromised patients dignity and privacy and was a blanket restriction.
• Relevant checks that are required under the regulation of fit and proper person had not been undertaken.

However:

• The service was clean, presentable and well maintained.
• Data supplied by the provider showed compliance with supervision of 87%.
• Data supplied by the provider showed compliance with appraisal of 84%.
• Staff were aware of the provider’s visions and values and demonstrated these in their behaviours.
• We observed staff to be passionate and motivated to meets the patients’ care needs.
• Staff demonstrated a good understanding of patients’ individual needs
• All patients had received a timely risk assessment on admission. There was evidence that risks assessments are updated after incidents.
• The Mental Health Act administrators had good oversight of the service, they provided support to the services and staff were aware of how to contact them.
• Shift to shift handovers were taking place daily.
• Senior managers had good oversight of the services and clinical governance.