This was a follow-up inspection because at our last inspection on 15th August 2013 we found the service provider was not fully meeting all of the regulations set out in the Health and Social Care act 2008. The service provider sent us an action plan dated 6th November 2013 telling us what actions they would take and when they would become fully compliant with the regulations.

We found that people who used the service could be confident that they would be supported by staff who understood how to deliver the service to them as individuals in a socially respectful way.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We spoke with three staff who confirmed that they were aware of the safeguarding policy and that they had been updating their training around the use of restraint.

There were enough qualified, skilled and experienced staff to meet people’s needs. We observed that there were enough staff to provided 1-1 support to people who used the service who had been assessed as requiring 1-1 staff time; staff we talked with told us that their 1-1 time was protected and that there were enough staff to ensure that they were not called away or so that they could be replaced if they needed a break. Staff told us that they were no longer short staffed and staffing levels were much better now.

We visited three units over two wards in the hospital.

We saw that patient's needs were assessed before they were admitted to the hospital. Each patient had a care plan based on their initial needs assessment. Some patients told us that they had been involved in their care planning and we saw that other patients did not have the mental capacity to contribute themselves. We also noted patients had a formal risk assessment that supported their care plan.

Patients told us they were well cared for and that staff were very caring and understanding. We observed some patients required more support than others and this was not always available because of the staffing levels provided.

We were told that activities were provided by the occupational therapy department, however patients were unoccupied on the day of our visit.

We looked at safeguarding procedures and made a referral to the local authority using the safeguarding multi disciplinary procedures.

We observed communal areas were comfortable and decorated and furnished to a reasonable standard. Individual accommodation was provided in single rooms and these varied in standard according to patient's wellbeing.

We observed the staffing levels on all three units we visited were insufficient to meet patient's assessed needs.