The Farndon Unit

Updated 9 January 2023

The Farndon Unit is registered with the Care Quality Commission as an independent mental health hospital. The hospital, run by Elysium Healthcare Limited, accommodates up to 47 female patients over the age of 18 years. At the time of the inspection there were 35 patients, all of whom were detained under the Mental Health Act. The Farndon Unit offers assessment, care and treatment to meet the needs of individual patients with a diagnosis of mental illness, personality disorder and learning disability.

The Farndon Unit consists of a single building built around an internal garden area. There are five ward areas; Bolero, Courtland, Darcy, Ruby Frost and Aster. The Farndon Unit consist of two core services. All the services and wards were visited on this inspection:

Acute wards for adults of working age and psychiatric intensive care units:

Aster ward a nine-bed high dependency acute ward.

Forensic inpatient or secure wards:

Ruby Frost ward a 12-bed low secure rehabilitation/recovery ward

Darcy ward a 6-bed low secure rehabilitation ward

Bolero ward a 10-bed low secure ward.

Cortland ward 10-bed low secure ward

The hospital had a manager registered with the CQC in post at the time of the inspection.

The Farndon Unit is registered with the Care Quality Commission 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 last inspection was 11 January 2022. The service was rated as overall good with good ratings in all domains. There were no identified breaches.

The main service provided by this hospital was forensic inpatient or secure wards. Where our findings on acute wards for adults of working age and psychiatric intensive care units - for example management arrangements - also apply to other services, we do not repeat the information but cross-refer to the forensic inpatient or secure wards service.

Updated 9 January 2023

Updated 9 January 2023

We carried out this unannounced focused inspection, following on two serious incidents which had raised concerns about staff adherence to patients’ observations, record keeping and appropriately responding to patients. At this inspection we assessed if the remaining patients were safe and reviewed the quality of service.

We did not inspect all key questions in all domains because this inspection was undertaken specifically to assess Safe and Well led. The key questions inspected were in relation to the areas of concern. Effective, Caring and Responsive were not inspected.

Our rating of this location stayed the same. We rated it as good because:

• The service provided safe care. The ward environments were safe, clean and well maintained. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Substantive staff, regular agency and bank staff had received patient observation competency training. Temporary staff new to the service were provided with training before they commenced their shift or were not allowed to undertake patient observation until they had received the training.
• We saw staff undertook took daily close circuit television system checks. A ward manager would sample footage of patients who had high levels observation to check staff were observing the patient in line with the service observation policy.
• Patient risk assessments were comprehensive and included risk to self, including self-harm, suicide, self-neglect, risk to own health and degree of vulnerability to exploitation or victimisation.
• The psychology team provided patients a range of therapy for example compassion focused therapy, trauma model of cognitive behavioural therapy, eye movement desensitization and reprocessing therapy and 1:1 work with patients. An art therapist worked across wards.
• Staff feel valued and empowered. Staff told us they felt supported by their managers and the registered manager. Staff morale was good despite the recent serious incidents, it was still “raw” for some staff. Staff and patients told us there had been offered and continued to be offered strong support and wellbeing checks following on the recent incidents.

However:

• Healthcare vacancies rates across the hospital were high; with a high use of bank and agency staff to cover patients’ observations and core staffing.

Updated 9 January 2023

We carried out this unannounced focused inspection, following on two serious incidents which had raised concerns about staff adherence to patients’ observations, record keeping and appropriately responding to patients. At this inspection we assessed if the remaining patients were safe and reviewed the quality of service.

We did not inspect all key questions in all domains because this inspection was undertaken specifically to assess Safe and Well led. The key questions inspected were in relation to the areas of concern. Effective, Caring and Responsive were not inspected.

• The service provided safe care. The ward environments were safe, clean and well maintained. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Substantive staff, regular agency and bank staff had received patient observation competency training. Temporary staff new to the service were provided with training before they commenced their shift or were not allowed to undertake patient observation until they had received the training.
• We saw staff undertook took daily close circuit television system checks. A ward manager would sample footage of patients who had high levels observation to check staff were observing the patient in line with the service observation policy.
• Patient risk assessments were comprehensive and included risk to self, including self-harm, suicide, self-neglect, risk to own health and degree of vulnerability to exploitation or victimisation.
• The psychology team provided patients a range of therapy for example compassion focused therapy, trauma model of cognitive behavioural therapy, eye movement desensitization and reprocessing therapy and 1:1 work with patients. An art therapist worked across wards.
• Staff feel valued and empowered. Staff told us they felt supported by their managers and the registered manager. Staff morale was good despite the recent serious incidents, it was still “raw” for some staff. Staff and patients told us there had been offered and continued to be offered strong support and wellbeing checks following on the recent incidents.

However:

• Healthcare vacancies rates across the hospital were high; with a high use of bank and agency staff to cover patients’ observations and core staffing.
• The layout of Aster ward were cramped. Patients did not have access to a range of therapeutic rooms and quite areas.