The Care Quality Commission
  • Mental Health
  • Independent mental health service

Archived: The Retreat Strensall

Overall: Good read more about inspection ratings

Charles Court Northfields, Strensall, York, North Yorkshire, YO32 5XP (01904) 499160

Provided and run by:
The Retreat York

All Inspections

1 December 2016

During a routine inspection

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.

21 to 22 March 2016

During an inspection looking at part of the service

We rated the Retreat Strensall as good because:

The feedback from people who used the services was generally very positive. We found the services were good and the provider was mindful of providing a safe environment and staffing levels that enabled it to provide additional support for patients who were more vulnerable.

Staff had access to training and supervision and there was a comprehensive mandatory training programme in place. The provider was working towards continually improving governance. Staff engagement and staff opportunities to provide feedback to the leadership team had improved.

Patients who could speak with us told us they had good relationships with staff who treated them with dignity and respect and that staff were always approachable.

We found that assessments and care planning was thorough and in collaboration with patients and their relatives and carers.

However

The provider used management of violence and aggression physical interventions during times when patients could present a risk to themselves and others. However, there was not always a full management of aggression and violence team available to respond. The provider had trained between 50% and 79% of staff in these techniques, meaning that not all staff had received this training.

Although there were nurse call alarms in place for patients, these were poorly positioned both in the bedroom and bathroom areas which meant patients may not be able to reach these when calling for assistance.

18 November 2013

During a routine inspection

During our visit we had the opportunity to speak with several people who use the service. People told us that they felt the staff were 'helpful' and 'friendly' and supported them to have a varied and inclusive life at Strensall. Comments included, "The staff are alright here, they are really supportive and talk to you.'

We looked at the records and talked with some of the staff. We confirmed that people were supported to give their consent to care and treatment. People also told us they were offered copies of their care programme and felt involved and included in decision making within the service. We confirmed that care records were person centred and that they included people's individual choices and aspirations.

We looked at the medication systems in the unit and confirmed that medication was stored administered and managed safely. This was important to make sure people's health needs were safely met.

We talked with the staff and they confirmed they felt well supported and confident in their role. They also said that there were good training and development plans in place.

We confirmed that there were good systems in place to listen to people's concerns and everyone was supported to access advocacy services and other help networks. We also saw there were effective systems in place to monitor the quality of the service complaints.

During a check to make sure that the improvements required had been made

When we visited this service in August 2012 and we found that the electronic systems used to manage care were not effective. We were concerned that important information was not being communicated effectively and that people may be at risk of not having their needs safely met.

Following our visit the provider continually kept us informed of the action they were taking to address this. They also showed us the improvements that had been made.

We confirmed therefore that the provider had made improvements to the electronic systems and that important information was being communicated effectively.

11 July 2012

During an inspection looking at part of the service

We spoke to six patients when we visited the service. Patients told us they felt that they were informed and were helped to make choices in their day to day lives. All told us they had made choices about their daily lives, such as when they wanted to rise or retire. One person also told us that they made their own decisions and had the opportunity to raise concerns by participating in the community meetings. This person also told us that that they had recently chaired the meeting.

All the patients we talked with told us the staff were, 'good' and 'helpful'.

Everyone we spoke to felt that they enjoyed the range of activities that were available at the hospital.

People also told us that the accommodation was comfortable, one person said, 'I like my room you can decorate it how you want and have your things around you' another person told us, 'I like the fact I have my own key and come and go as I please'.

21 November 2011

During a routine inspection

This service has recently moved from the area of Haxby to Strensall. Some of the patients have been resident on the unit for over five years and had developed links in the local community of Haxby. They had therefore found the move difficult and told us they did not feel settled at Strensall yet. This means many of the comments patients told us were prejudiced by the distress caused by the move.

Some patient's told us they had recently moved to Strensall and they 'Did not like it.' Another commented 'Staff don't make us do anything.'

Patient's told us they were unhappy about the move to Strensall, one patient said the new building was too far away from anywhere and ten minutes to walk to the bus stop; there are no crossings and the road is very dangerous.

Two patients's told us they had copies of care plans in their rooms but they did not know where to find them.

However, we observed patients were confident in when talking to staff to make their views known.

During our inspection we did evidence that improvements are needed, but some of the concerns we have found have been amplified by the move to Strensall.