We rated The Huntercombe Centre Birmingham as good because:

• Ward areas were well maintained, including furnishings and decoration.
• There was an appropriate skill set of professionals available on the ward including doctors, occupational therapists, support workers, psychologists and psychiatrists to support patients in their recovery.
• Staff comprehensively assessed all patients on admission to the ward and this included comprehensive physical and mental health assessments. All patients had up-to-date care plans and risk assessments.
• Staff had access to medications and medical equipment required to care for patients.
• There were appropriate policies and procedures in place and staff attended daily meetings as part of a multidisciplinary team to discuss patients’ care.
• Staff recorded capacity to consent to treatment and there was evidence of informed consent and assessment of capacity present in the files of all patients who required it. Patients had access to a mental health advocate. We saw staff interacting and engaging well with patients and allowing them to express their views.
• The Huntercombe Group had recruited a new registered manager and deputy manager. Both demonstrated the skills and experience needed to drive forward further improvements to the service.
• Staff were supervised by the registered manager and had received regular supervision and yearly appraisals. Staff told us they worked in a supportive and approachable staff team. Staff we spoke with were aware of who their senior managers were. The regional director and company director visited the ward regularly. The Huntercombe Group had given staff opportunities for training and development. Staff told us the company had a good attitude to continuing professional development.

However

• There were three doctors authorisation signatures missing from two patients prescription charts which meant medication may have been issued without a doctors authorisation.

There were 10 people who used the service on the day of our inspection. Seven people were detained under the Mental Health Act 1983. Two people lived in separate flats that were within the building. One person was semi-independent in their flat and was soon to be discharged. The other person had staff who worked with them on a one to one basis to help meet their needs.

We spoke with seven people who used the service, an advocate who visited during our inspection, six members of staff and the registered manager.

People told us that staff supported them. One person said, “It’s better than my last place as it is not so secure. I have a mobile phone here. I have got a lot of leave and staff have sorted it for me.”

Staff had the information they needed to know how to support people who used the service to meet their individual needs.

We saw that people were encouraged to eat a healthy and balanced diet to ensure their health and wellbeing. One person said, “The food is good, we have a choice.”

People told us that staff gave them their medicines when they needed them. Medicine managements systems in place were safe so that people received their medicines as prescribed to ensure their safety and wellbeing.

Staff were supported to ensure they had the appropriate skills and knowledge to safely meet people’s needs.

People, their relatives and staff were asked for their views about the hospital and we saw that these were listened to.

This report is based on a visit that was carried out as part of a co-ordinated responsive inspection. Our inspection was unannounced. There were six patients there when we visited. We spoke with five patients, five staff and the regional manager.

All patients spoken with told us and we saw that they could make choices about their lives. One patient said there were less restrictions placed on them now than where they lived previously.

We saw that patients were encouraged to do things for themselves. One patient was being supported to move into their own flat within the hospital so promoting their independence skills.

We saw that patients were supported to have regular checks of their physical and mental health to ensure their well being. Staff supported patients when needed to attend health appointments. Some patients told us they could see their GP when they needed to.

Systems were in place to ensure that patients were safeguarded from harm. We saw that patients were comfortable in the company of staff who spent time talking with and listening to them. One patient said, ” I have no hassle from staff or the other people living here.”

Staff received the training they needed so they knew how to support the patients. There were enough staff to support patients to meet their needs.

Patients were asked for their views about the hospital and these were listened to. Where risks to patient's safety and welfare were identified, action was taken to make improvements.

We spoke with four people who used the service, three members of staff and the manager.

People told us that they had regular discussions with staff about their care and treatment. Staff told us of the monthly formal meetings that are held to discuss any issues or changes that may occur within the month. We saw pictorial as well as printed written documents were used to assist people with understanding and consenting to their care and treatment.

People told us they were generally happy and satisfied with staying at Rose Lodge. One person told us of their plans for moving to alternative accommodation and how much they looked forward to this.

People told us they liked the food that was provided for them, and we saw people and staff sitting together enjoying the midday meal. People looked relaxed and at ease in the company of staff.

People told us of the weekly timetable of activity that had been discussed and agreed with them. They said it was good to know what they were doing each day and when they would be doing it. Many people were out of the building at the time of our visit but we observed a variety of activity happening with the people who were in.

Three people we spoke with told us they felt safe at the home. One person confirmed that they had participated in a group session where they discussed keeping safe, concerns and how to make a complaint. The manager explained that this training had been arranged for all staff and people who used the service. Thus ensuring everyone is aware of how to report any concerns or suspicions they may have.

We rated The Huntercombe Centre - Birmingham as good because:

• Feedback we received about the service from patients, families and carers and stakeholders was excellent. The service was described as open, transparent and responsive to patients needs and we saw a clear focus on patient rehabilitation and discharge planning.
• We found a wide range of risk assessments and care plans that had been completed by the multidisciplinary team which evidenced the voice of patients using the service. Care and treatment records were comprehensive, holistic and recovery focussed, were in date and showed evidence of frequent reviews which reflected patient progress.

• Morale amongst staff at the service was excellent. The leadership culture was described as open and accessible and staff felt valued and listened to by the registered manager. All staff that we spoke with reported an environment that promoted mutual support and teamwork.

• Patients were able to provide feedback on the service, be involved in the running of the service and were supported to undertake voluntary jobs. Initiatives were in place to recognise and celebrate patient contribution and we saw this was promoted through regular community meetings between patients and staff.

• Attendance at mandatory training was high and was monitored by the registered manager. All staff eligible for an annual appraisal had received one and clinical and managerial supervision arrangements were in place for all staff. 

  All staff were suitably skilled and qualified to perform their role and disclosure barring service and professional registration checks were complete.

• Safeguarding referrals had been made to the local authority where appropriate and statutory notifications completed by senior staff and the registered manager. Mental Health Act and Mental Capacity Act requirements were being met and paperwork relating to the detention of patients was complete and showed evidence of patient consultation and documentation of their views.

• A range of audits and key indicators were in place to monitor the service's performance. Outcome measures and rating scales were used to check on the effectiveness of clinical intervention and patients were able to access psychology and occupational therapy based interventions.

• All incidents that should be reported had been. We saw that investigations had been commenced immediately following an incident, learning had been identified and changes made to mitigate against future occurrences.

• Environmental and health and safety checks were routinely completed including bi annual ligature risk audits, fire safety checks and portable appliance testing. All staff had access to a personal alarm and the system was serviced annually and checked monthly by the service's maintenance department.