Patients’ privacy and dignity was respected. We observed staff encouraging people to make decisions about what to eat and where. We observed that when patients wished to spend time resting in their room they could. Staff helped to facilitate this where required.

We saw staff giving guidance and reassurance to patients’. Patients’ were given information by staff relating to their medication and how it helped them. The staff we spoke with were able to tell us about the patients’ care needs and how they encouraged choice. They also told us about the risks patients took and how they worked with them to lessen these risks.

Patients’ were able to access all areas of the ward without any undue restrictions. They could go to their rooms to rest if they wished.

Patients and their relatives told us they were involved in decisions relating to their care and support.

The environment of the unit had improved but some of the décor undermined patient’s dignity because of poor maintenance. The trust had a plan in place to address this but the timescales for improvement were still under discussion at the time of the inspection.

The trust had carried out a compliance audit against the essential standards which had identified some shortfalls. To address these shortfalls an action plan was in place to ensure that patients’ needs were met.

While there had been improvements in record keeping further improvements were needed to ensure a consistent approach to patient care.

We used the SOFI (Short Observational Framework for Inspection) tool to help us see what people’s experiences were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff.

Patients told us that staff ensured their privacy was maintained during personal care. One patient told us that staff always knocked before they entered the room. They also told us that staff supported them with the things they found hard to do for themselves. We observed staff assisting patient’s and found that the interactions were empathetic and caring. Visiting relatives told us how much they had appreciated the efforts made by staff, one person commented how much calmer their relative was.

We found that the ward was experiencing long term staff sickness of key staff and had a period when there was no manager. The trust had taken steps to ensure that there was an acting manager to provide leadership and support to the staff group.

Patient’s care needs were not always assessed and risks were not always acknowledged in patient’s individual care records putting them at risk of harm. The records used by the ward did not have complete or accurate information.