We visited three wards on the Bradgate mental health unit. These were Beaumont, Bosworth and Aston wards. We also visited the Belvoir Psychiatric Intensive Care Unit. We spoke with nine patients and fifteen members of staff. In addition we spoke with some senior managers. All the wards we inspected had different purposes, functions and resources. We observed positive interactions between staff members and patients throughout our visit. Many of the patients we spoke to were very satisfied with how they were cared for by staff. Most patients on the wards told us staff were respectful and polite. The majority of people told us they were satisfied with their care, treatment and support. However we were repeatedly told patients were bored particularly when they were restrictions around their care and they were unable to leave the ward.

We received a range of comments from patients, “I feel safe here, there is a vision window at night to check on me” “Staff are nice, helpful and considerate. They are polite to my relatives, and when we went to the family room I had a good time with my kids.” “ Activities have become less because the member of staff has left.” Patients told us they were not asked to provide feedback or give comments or complaints. They said ward meetings were no longer provided to gather patient’s views.

During this inspection visit we followed up on areas of concern that had been highlighted at the previous inspection. This had taken place at the Bradgate Mental Health Unit in April 2011.

During our most recent inspection in October 2011 we visited four wards. These were Aston, Ashby and Heather. We also visited the Belvoir Psychiatric Intensive care unit.

The majority of patients we were able to speak with were satisfied with how they were cared for by staff. Some of the comments we heard were very positive, whereas some were more neutral. None of the people we spoke to highlight any specific concerns in relation to how their privacy and dignity was respected. Patients told us that staff were effective in explaining care and treatment and they felt that their views were taken into account.

Patients we spoke to said they were involved in on-going discussions with nursing and medical staff in relation to the care, treatment and support they received.

During the inspection the issue of patients being moved within the service wasn't raised as a significant concern by any patients. Some patients said they would prefer to be admitted on to the same ward when they need treatment. In some cases this was possible and in other cases this was not possible due to bed availability at any given time and the assessed need of the patient.

We talked to patients on Aston ward from the general psychiatric group and also patients on the ward for detoxification for substance misuse. Opinions were expressed by all patients that it 'might' be better that they were placed in specific dedicated areas for treatment. However, none of the patients that we spoke to expressed concerns in relation to the care they received on the ward.

The conversations we had with patients on the ward provided a wide range of opinion in relation to the provision of food. Some patients were satisfied with the food whilst others gave the view that the food was boring and repetitive. We saw that snacks were available when required on each of the wards visited. This was managed differently on each ward and reflected the individual care needs of patients with varying presenting illness. At the time of the visit the patients on Belvoir had chosen to fund takeaway meals on two evenings of the week. This was as a result of comments from patients during community meetings. On another ward we were told by two patients that they were pleased with the quality and quantity of the food and were able to get a second helping of food when they wanted it.

During our conversations with patients on the wards no one indicated that they felt vulnerable because of the male/female mix.

Patients on all wards were satisfied with the care and treatment received by staff and no concerns were mentioned to us during the visit.

We inspected the Bradgate Mental Health Unit (the unit) to make sure the trust had taken action to meet the requirements of the two warning notices we had served.

The trust had failed to take proper steps to ensure that care records contained appropriate information to meet the needs of the patients. The trust had also failed to plan and deliver care that met the physical health needs of patients in their care.

The trust had also failed to take proper steps to make sure suitable arrangements had been made in respect of patients’ discharges.

We found improvements had been made. We spoke with staff who understood the needs of the patients they were caring for. We looked at patients records and found improvements had been made and information about patients care was now recorded. We spent time talking with patients about their care they received.

Staff told us that planning for patients discharge had improved but there was still work to do to get this right. Patients told us they felt more involved in their care but they were concerned about arrangements in place for their leave and potential loss of bed upon their return.

We looked at how the trust deployed its staff to meet the needs of patients in their care. We found that improvements were needed. There is still work for the trust to do to make sure that there are appropriate numbers of suitably skilled and knowledgeable staff on duty.