- NHS mental health service
Whipton Hospital
All Inspections
4-5 February 2014
During a routine inspection
Whipton Hospital is located on the outskirts of Exeter. Devon Partnership Trust has a specialist service on this site called the Additional Support Unit which is an inpatient assessment and treatment service for up to five patients who have a learning disability. When we visited, there were five patients on the unit and four patients were detained under the Mental Health Act 1983.
We found many good areas of practice at Whipton Hospital. Staff felt confident to raise concerns about the practice of other staff and that action would be taken as a result. This meant that patients were safeguarded from harm and abuse. Staff had an understanding of what they needed to do to make improvements to benefit patients.
Staff received the training and support they needed to meet patients’ individual needs to ensure their wellbeing. There were just below two whole time equivalent band five staff vacancies out of a total resource of nearly 37 staff working at the hospital. In addition, the service had significant numbers of staff on maternity and long-term sick leave. Established and consistent agency personnel were used to cover these vacancies.
Patients had detailed and comprehensive care plans that showed staff how to support them and patients were involved in these. We saw that patients were supported to have regular health checks to ensure their wellbeing. Overall, records where well-maintained, comprehensive, up to date and regularly reviewed. We looked at records which showed that patients had their rights under the Mental Health Act 1983 respected and that access to Independent Mental Health Advocates was supported and encouraged.
Staff worked with the team of professionals involved in each patient’s care to ensure that all the patients’ needs were met. Staff worked with other providers so that when each patient was discharged they received the support they needed.
The environment was well maintained and the majority of procedures and processes in place ensured that patients were kept safe from risk and hazards.
We spoke with three relatives and three patients who were very pleased with the service. Staff were described as “absolutely magnificent”, “extremely caring, understanding and are sensitive to patients’ needs”. One person said that that the short notice cancellation of some meetings was frustrating and inconvenient but that the staff were brilliant. One patient told us, “The staff get me all the meals and drinks I need”.
There were three areas for improvement identified. These were to ensure that blanket restrictions such preventing people from accessing the kitchen are reviewed to check they are still needed. Supporting people to promote their independence through the development of daily living skills should be explored. Fridge and freezer temperatures should be monitored at the appropriate frequency to ensure food is safely stored.
24 April 2012
During an inspection looking at part of the service
This inspection was carried out by two inspectors who visited the locations on 26 April 2012 to check on compliance with the above outcomes. We also checked on the actions taken to improve the outcomes for people identified at the previous inspection of the service in February 2011. These related to an improvement action for outcome 1: Respecting and involving people who use services, and a compliance action for outcome 21: Records. On the day of our inspection there were four people accommodated in Knightshayes and five people accommodated in the Additional Support Unit.
We chose four people (two who were staying at the Adult Support Unit and two who were staying at Knightshayes) to look at the care and treatment they had received since they were admitted. We looked at the records of care held in each location, talked to staff who were on duty at the time of our visit, and talked to the Modern Matron who was responsible for managing the services. We either talked to each person, or, if they had limited verbal communication skills, we observed the support they received. We found out how they spent their time and whether this was a positive experience for them.
People told us they were happy with the services they were receiving. They felt safe, and said they would talk to one of the staff if they were worried or unhappy about anything.
We talked to each person about their care plans. They told us they had been consulted, and they had agreed the support and treatment set out in the plans. Each person had a care plan that had been drawn up in a format they understood, and they held their own copy. People told us that they were confident that their care plans were being followed, and the treatment and support was helping them to work towards either returning successfully to their previous homes, or to work towards finding suitable new homes. A person who was nearing discharge told us 'my psychiatrist comes every Thursday, we talk about medicines and stuff'. The person commented 'I think they listened to me', so felt respected and in charge of their life when speaking about what they had wanted to do regarding having an overnight stay away from the unit.
One person had drawn up their own Wellness and Recovery Plan, and other people had worked with a member of the staff team to draw up and agree their plan. They all had a Health Action Plan in place. We saw evidence to show that the plans had resulted in improvements in people's health.
People had been involved in improving the quality of the service. For example, one person told us 'we have a meeting with staff about once or twice a week'. We saw a 'learning log' displayed on the notice board in an easy read/picture format that documented issues people had raised and the actions taken to resolve these.
Since our last inspection significant improvements had been made to the way the staff team used the computerised care planning system. Care plans contained greater detailed information on every aspect of each person's health and personal care need. The systems for monitoring and reviewing the care plans had improved and this had resulted in staff having a greater awareness of how problems in one area of a person's needs might affect them in other areas.
Staff told us that the morale of the staff team had improved significantly in recent months. They said the level of training on topics relevant to people's care needs had increased, and they had regular staff meetings where they were able to discuss issues and felt they were listened to and respected for their ideas and opinions. They said the improvements to the care planning systems had resulted in better outcomes for people, and this made their jobs more rewarding.
1, 2 November 2011
During a themed inspection looking at Learning Disability Services
All four of the patients we spoke with were happy with the service they were receiving and felt safe. All said they would speak to staff if they were unhappy.
Team members made the following comments about the services over the two days of the inspection: 'There was a relaxed atmosphere when we entered both of the units', 'Patients were still in bed on arrival at 9.15am and were seen to get up when they wished', 'Patients had free access to a comfortable lounge area, kitchens and dining areas', 'Male and female accommodation was separate'.
A member of the team met with two relatives, they made the following comments;
The unit keeps them informed and they are consulted and involved in their welfare decisions.
They are able to meet their relative in private or in the lounge when they visit.
They are sure their relative would say if they were ill treated and they haven't.
Two of the staff we spoke with were asked about the training available to them. Both commented there was a good range of training available to them, one member of staff said that E learning (web based learning) has been introduced and they find this format more difficult.
We asked five staff what it was like to work at the Whipton Hospital (including a member of agency staff). They all agreed that it was a good place to work, it was well managed and that patients receive a good service.
It is important that patients using the service have the opportunity to comment about the service they receive and are able to change how the service operates. Speaking with the modern matron they explained that they had identified this and as a result have had a business plan approved to employ an Expert by Experience (a person with a learning disability who has used services) to act as a quality assurance monitor. Part of their role will be to visit the units and speak to the patients using them. In addition to this in future patients using these units will be asked to complete a patient questionnaire about the service they received that has been written in plain English and is supported with pictures.
13 December 2010
During a routine inspection
People told us that they are invited to attend meetings where their care, treatment and support are discussed. If they choose not to attend staff spend time explaining to them what happened at the meeting. People are involved in their own care as much as they are able and information is available to them in formats suitable to their needs. Where a person is unable to weigh up information and make sound decisions best interest decisions are made on their behalf. Consent to care and treatment is sought and recorded.
We saw that staff treat people respectfully. However, observation windows into people's bedrooms were left open and any person could look in. One person told us that staff are 'OK'. People appeared relaxed around the staff. Staff spoke of their commitment to improving people's health. There is a genuine desire by staff to ensure safe and seamless care for people. People are protected from abuse through staff knowledge, training and supervision, the ethos of the unit and a commitment to ensuring people's human rights are respected and upheld.
People appeared comfortable on the units, which were warm, fresh and very clean. The environment was safe and well maintained. One person told us the food was nice.
Records did not provide sufficient information of people's individual needs. Staff we met knew people's needs well but the inadequacy of record keeping might affect the outcome for people should staff on duty be less knowledgeable.