The Dales

We saw evidence of staff treating patients with both dignity and respect. The care which we saw taking place appeared to have compassion, and we saw staff being both polite and professional when dealing with those in their care. We observed choices being offered to patients; this helped patients have an important say, and influence, the care which they received.

Patients gave us mixed views in relation to the activities which were available to them on the ward. Some patients felt there was enough to do, whereas others felt there was not enough to do.

We had concern that occasions had arisen when some patients had been admitted to some wards when there were no beds immediately available for them. Staff told us this did not happen frequently and only happened if it was felt unsafe to leave a person in the community.

The Care Quality Commission does not find the practice of admitting patients to a ward, when there is no bed for them, to be acceptable but equally recognises the difficulties which the trust is faced with when a patient is in desperate need of help, potentially life-saving help, but there is no bed available. Prior to this inspection, the Commission was already aware of this issue sometimes arising and discussions had already taken place between the Commission and the trust's management. The trust themselves recognise that admitting patients when there is no bed is not acceptable and they had already started to put in place a range of measures to try to rectify the issue. The Care Quality Commission continues to work with the trust in monitoring this and the Commission's use of regulatory powers will be considered should it be deemed necessary.

We noted some concern that it can sometimes be difficult for patients, who require escorted leave, to be given such leave when there are demands on staff and staffing numbers.

The majority of patients we spoke with were happy with the care and treatment they received. All patients spoken with felt supported by staff.

We saw a range of assessments and care plans had been carried out to help ensure the needs, and risks, of individual patients were being addressed. We saw care plans were in place to also ensure patients' physical health needs were not overlooked.

All staff we spoke with told us that they had received safeguarding training. We saw there were both systems and processes in place to ensure patients were safeguarded from harm. We saw that if a patient needed to be restrained, this was documented and reflected upon to ensure that any learning could be gained from the incident.