Archived: Eldertree Lodge

Updated 30 March 2020

Eldertree Lodge is an independent mental health hospital provided by Huntercombe (Granby One) Limited. It is a 41 bedded hospital providing specialist inpatient service for adults aged 18 years and over in locked rehabilitation wards specifically for patients with a learning disability or autism. Patients may present with a range of behaviours that are challenging, mental health problems, drug and alcohol abuse. Patients may be detained under the Mental Health Act 1983 or subject to Deprivation of Liberty Safeguards. All treatment programmes are delivered through a multidisciplinary team approach. The service is commissioned by clinical commissioning groups. Eldertree Lodge has a registered manager and is registered to provide the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983

• treatment of disease, disorder or injury.

• diagnostic and screening procedures.

Since the last inspection the hospital has decommissioned all secure beds and changed its name from Ashley House to Eldertree Lodge, also changing all the ward names. Eldertree Lodge is located in the outskirts of a rural village between Market Drayton and Newcastle-under-Lyme. The hospital has six wards that comprise of three admission and three discharge units:

Admission wards:

• Elm ward, seven beds, high functioning male only

• Chestnut ward, six beds low functioning male only

• Ash ward, six beds, complex care female only.

Discharge units are:

• Maple ward, seven beds, low functioning male only

• Birch ward, eight beds, high functioning male only

• Willow ward, seven beds, complex care female only.

The Care Quality Commission last carried out a comprehensive inspection for this hospital in September 2017, we rated it as good overall. We rated safe, effective, caring, and well-led as good. Responsive was rated as requires improvement and we issued the following requirement notice: Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Dignity and respect:

The hospital did not ensure that a patient was placed in an environment in which their privacy and dignity were always respected. There was no clear long term plan in place to ensure that the privacy and dignity needs of the patient would be appropriately met in the future.

At this inspection we found that the provider had taken actions to make improvements but we have identified breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for:

• Regulation 17 good governance
• Regulation 18 staffing

In the last two years all wards had been visited by our Mental Health Act Reviewers. There were 33 patients in the hospital when we inspected, all patients were detained under a section of the Mental Health Act. There were no informal patients, or patients subject to Deprivation of Liberty Safeguards (where a person’s freedom is restricted in their best interests to ensure they receive essential care and treatment).

Updated 30 March 2020

Eldertree Lodge is an independent mental health 41 bedded hospital. It provides specialist inpatient service for adults aged 18 years and over in rehabilitation units specifically for patients with a learning disability or autism.

Our rating of this service went down. We rated it as requires improvement because:

• The provider had not made sure that the environment was suitable for all patients it provided care to. Although it was providing care to adults with a learning disability and autism the wards were not ‘autism friendly’ in line with national recognised best practice. For example, managers had not considered the conflicting sensory needs of patients living on the same ward. Ward environments were not tailored to the sensory needs of individual patients.
• The provider had not ensured that staff received specialist training in caring for people with autism, including training in specialist communication skills.
• The provider did not ensure that the systems used to access information was well organised, staff were struggling to find essential information to support safe and effective care delivery, whether it was on electronic or within paper notes.
• Staff did not always follow best practice when storing and dispensing medication. Staff on Maple Ward did not routinely record the date of opening of new creams and bottles. They therefore could not be assureds the medications were still effective when given to patients. The providers own audits of medicines management had not identified the error we found on inspection.
• Staff supervision was not managed well; managers did not have robust systems to ensure they knew whether staff received regular supervision.

However:

• The service generally provided safe care. The ward environments were safe. The wards had enough nurses and doctors. Staff assessed and managed risk well, followed good practice with respect to safeguarding and minimised the use of restrictive practices.
• Staff implemented good positive behaviour support plans to enable them to work with patients who displayed behaviour that staff found challenging. The service had identified a local theme in self-harm through swallowing batteries and provided an individualised response to patient risk.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. The multidisciplinary team involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
• Patients led discussions of their experience of care in a programme of ‘noise, voice, choice’ meetings. Carers, families and external agencies were extremely positive about the service and believed the service always managed challenging behaviour well.
• Staff planned and managed discharge well and liaised with services that would provide aftercare. The provider had developed some local accommodation options that the hospital clinical team could continue to provide some support to patients as they settled in and got to know a new staff group. Staff helped patients with advocacy, cultural and spiritual support.

Updated 30 March 2020