03 - 05 March 2020
During an inspection looking at part of the service
Our rating of the service stayed the same. We rated The Dallingtons as Good because:
- The service had enough nursing and medical staff, who knew the patients and received basic training to keep people safe from avoidable harm.
- Staff assessed and managed risks to patients and themselves well and followed best practice in anticipating, de-escalating and managing challenging behaviour. Staff used restraint only after attempts as de-escalation had failed.
- Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.
- Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Care plans reflected patients’ assessed needs, and were personalised, holistic and recovery orientated.
- Staff provided a range of treatment and care for patients based on national guidance and best practice. They ensured that patients had good access to physical healthcare and supported them to live healthier lives.
- Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.
- Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition.
- Staff involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. They ensured that patients had easy access to independent advocates.
- The design, layout and furnishings of the wards supported patients’ treatment, privacy and dignity. Each patient had their own bedroom with an ensuite bathroom. Patients could keep their belongings safe. There were quiet areas for privacy.
- The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support.
- The service treated concerns and complaints seriously, investigated them and learned lessons from the results. These were shared with the whole team and the wider service.
- Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed and were visible in the service and approachable for patients and staff.
- Teams had access to the information they needed to provide safe and effective care and used that information to good effect.
- Managers engaged actively with other health and social care providers to ensure that an integrated health and care system was commissioned and provided to meet the needs of the local population.
However:
- We found out of date bandages, saline, dressings, tape and sterile gloves in the first aid kits and emergency fire grab bag. Staff immediately rectified this when it was bought to their attention.
- Two patients who were on high dose medications did not have an appropriate monitoring tool in place. Staff put these in place immediately when this was bought to their attention.
- Not all staff were up to date with their Mental Health Act training.
- Not all staff were able to articulate the organisations vision and values.
- Staff sickness and turnover was above the national average.