Archived: The Retreat Strensall

Updated 8 March 2017

The Retreat Strensall was a 20 bed ward for male and female patients situated in the village of Strensall on the outskirts of York in North Yorkshire. The Retreat York is the registered provider for The Retreat Strensall and provides the following specialisms and services;

• caring for people whose rights are restricted under the Mental Health Act
• caring for adults over 65 year
• dementia
• mental health conditions.

The Retreat Strensall provided a community rehabilitation unit which promotes recovery, independence and social inclusion, supports patients to regain and develop new skills, and aims to discharge people into a community placement.

The Retreat Strensall has been registered with the Care Quality Commission since October 2011. It is registered to provide the following regulated activities:

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

• diagnostic and screening procedures

• treatment of disease, disorder or injury.

The hospital has a registered manager and a controlled drug accountable officer. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is run. A controlled drugs accountable officer is a senior person within the organisation with the responsibility of monitoring the management of controlled drugs to prevent mishandling or misuse as required by law.

Accommodation for patients comprised:

• 15 bed ward in the main building for male and female patients.
• Two bed bungalow for male patients.
• Three bed bungalow for female patient

At the time of our inspection, the ward had 15 patients. This included patients who were detained under the Mental Health Act, informal patients, and patients with Deprivation of Liberty Safeguards in place.

There have been five inspections carried out at The Retreat Strensall. The most recent comprehensive inspection took place on 21 to 22 March 2016. Following that inspection, we rated The Retreat Strensall as good.

The Retreat Strensall has been subject to two Mental Health Act monitoring visits. The most recent visit took place on 23 August 2016. The ward provided an action plan based on a range of issues found at that inspection. This included:

• A lack of information on display for detained and informal patients advising them of their rights in the bungalows
• old copies of section 17 leave forms on the patient’s records
• lack of involvement and completed capacity assessments about patients’ understanding of their care plans and financial arrangements
• staff were not clear about patients who had authorised Deprivation of Liberty Safeguards in place
• lack of privacy screen on bedroom windows and the clinic
• no lockable storage in patients bedrooms for patients to keep their possessions secure
• no privacy hood on the ward payphone.

We took the findings and actions the ward said they had completed into account during this inspection.

Updated 8 March 2017

We rated The Retreat Strensall as good because:

• Staff protected patients from avoidable harm and abuse. They ensured the environment was safe and clean and provided adequate staffing levels to enable staff to support patients who were more vulnerable. Staff took a proactive approach to safeguard patients who were vulnerable and effectively managed risks on a daily basis.
• Staff planned patients’ care and treatment in line with current evidence based guidelines and used outcome measures to monitor patients’ progress. The arrangements for assessing and monitoring physical health meant patients had good outcomes. Staff considered the range and complexity of patients’ needs and worked collaboratively with other services to support patients’ recovery. Staff were mindful of least restrictive practice and ensured they protected the rights of all patients with regard to the Mental Health Act Code of Practice and the Mental Capacity Act and Deprivation of Liberty Safeguards.
• The feedback from people who used the services and their relatives or carers was very positive. Staff demonstrated a strong person-centred culture and an ethos of mutual respect. Staff treated patients with kindness, dignity, and understood individual patient behaviours. Staff supported patients in ways which promoted patients’ rights, and preferences. Staff routinely sought feedback from people who used the service including patients and relatives and responded appropriately to their feedback.
• Staff ensured that the needs of all patients who used the service at The Retreat Strensall were met. The facilities promoted comfort and confidentiality and staff provided a wide range of information for patients and their relatives or carers. Patients had access to a variety of meaningful individual and group activities seven days per week. Staff supported patients to make choices about things that were important to them such as food and spiritual support. Staff used care pathways and the care programme approach to plan patients’ discharges. Where staff identified delays in patients’ discharges, they worked in a proactive way to reduce the delays for patients.
• Local managers led their team well. Managers at The Retreat Strensall were involved in the governance arrangements for the provider and ensured they kept staff informed. Local managers were always available and accessible to staff and staff spoke highly about the local management arrangements. There was always sufficient staff and staff morale was generally good. The service had good systems in place to monitor and audit the quality of care and was committed to making improvements.

However;

• The Retreat Strensall did not have an emergency back-up generator or lighting that meant the safety of the service was placed at risk when lighting systems failed
• The Retreat Strensall shared the one available electrocardiogram machine with the provider. This meant that the machine was not always immediately available for use at The Retreat Strensall.
• Appraisal and supervision compliance rates at The Retreat Strensall did not meet the requirements of the provider’s policies.
• Some staff were unhappy about the way senior managers at the provider had engaged with staff at The Retreat Strensall in the past.

Updated 8 March 2017

Updated 22 June 2016

The Retreat Strensall services comprised of two bungalows attached to a 21-bed hospital unit residing in a residential community setting. There was a 4-bedroom bungalow for female patients and a 2-bedroom bungalow for male patients.

Overall, we found the services were good, the environment was clean and tidy, staff were respectful and patient’s care was person centred.