This was a focused inspection to check that the provider had complied with the requirement notice issued following our last inspection on 2-4 November 2015.

We found that the provider was compliant with the requirements because they had taken action to improve staff supervision at The Priory Hospital Sturt House since the last CQC inspection. Staff were receiving regular and appropriate supervision.

There was a robust process in place for the scheduling and recording of supervision sessions. All staff had an identified supervisor appropriate to their professional role. The supervisor provided monthly supervision which was recorded on a supervision template and signed by both parties.

Eighty one per cent of clinical staff had received at least one monthly supervision in the six months prior to our visit.

This was a joint inspection carried out with the Mental Health Act Commissioners. At this unannounced inspection we spoke with patients, staff and senior representatives of the Trust who attended for part of the inspection.

Patients were complimentary about the kindness of the staff, their involvement in their treatment and therapeutic activities. All of the patients told us that they felt safe at the hospital. We found that there was a mental health advocate service available to patients and that this service was used.

We found that there were processes in place that monitored patient’s nutrition and hydration. Where necessary we saw that patients were provided with nutritional advice that assisted them to make healthy choices. We saw that patient’s had access to fresh food and drink when they wanted.

We were told by staff that the hospital undertook appropriate checks before any member of staff commenced employment. The records that we looked at confirmed this.

We looked to see that staff had received all of the training appropriate to their roles and confirmed that this was the case. Staff that we spoke with told us that they always undertook training.

There were effective systems in place to monitor complaints. Patients told us that if they wanted to make a complaint they would know how to. We saw that the hospital recorded all complaints and resolved them where they could to the patient’s satisfaction.

We found during our inspection that most of the patients we spoke to felt respected by the staff and felt involved in their care. We saw several examples that the service involved patients in the decisions about the care they received for example with regular ‘community’ meetings.

We saw during our inspection that staff provided good care. Several patients spoke with us during our inspection and we spoke in detail with three patients. Most of them told us that they thought the staff were “good”. However we found that some patients felt there were not enough meaningful group activities for them.

The service had an effective safeguarding policy and we saw information around the building that reminded patients and staff of how to report any concerns they had. Patients we spoke with said that they felt safe there.

We looked to see that staff had received all of the training appropriate to their roles and confirmed that this was the case.

There were systems in place to assess and monitor the quality of the service. We were shown evidence of regular audits and action plans to address any issues raised.

We spoke to six people who use the service and received positive feedback overall. People using the service praised the staff for their helpfulness, willingness and friendly manner in providing support.

People using the service told us they felt involved in their care, had been supplied with copies of their care plan and had been involved in reviewing these.

All those using the service that we spoke to said they felt safe and knew who to speak to if they were worried or unhappy about anything. A person using the service told us they had been well supported when their health needs had changed.

We rated Sturt House as good because:

• The service provided safe care. The ward environments were safe and clean. There enough nurses and doctors to meet the needs of the patients. Staff assessed and managed risk well using recognised tools. Staff followed best practice in anticipating, de-escalating and managing challenging behaviour.
• Staff managed medicines safely and followed good practice with regard to safeguarding.
• All patients received a comprehensive assessment from a registered medical officer on admission. Patients’ physical health was assessed and monitored throughout their admission.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of patients cared for in a mental health rehabilitation service and in line with national best practice.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. Staff supported patients to be central in decisions about their care.
• Staff planned and managed discharge well. They liaised with services that would provide aftercare and maintained regular contact with community staff.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with the whole team.
• The senior team was visible on the ward and had a good knowledge of the patients. The service worked to a recognised model of mental health rehabilitation. Sturt House was working towards accreditation with the Royal College of Psychiatry network for mental health rehabilitation services in 2019.
• There were clear governance processes in place including a monthly governance meeting which looked at issues such as safety, security and risk, staffing, patient and carer experience.

However

• There was no open access to hot water for people to make drinks and patients had to request hot drinks from staff.
• The fabric and decoration of the ward communal areas was tired and in need of refurbishment.