The Billingham Grange Independent Hospital

Updated 10 January 2019

The Billingham Grange Independent Hospital is a 50-bed hospital that provides 24-hour support for people aged 18 or over. The hospital is a specialist service for people with mental health and physical health problems including progressive neurological illnesses or acquired brain injury that lead to cognitive impairment and complex and challenging behaviour’.

The hospital has three wards which are situated over two floors;

• Grange – an 18-bed male ward for working age adults
• Wynyard – a 16-bed female ward for working age adults
• Hart – a 16-bed male ward for older adults

At the time of our inspection the hospital was providing care and support for 47 patients.

The hospital 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 2007.
• Treatment of disease, disorder or injury.

The service aims to provide a safe environment with accessible gardens which provide a basis for therapy and leisure.

The hospital’s last comprehensive inspection was in September 2015 when the hospital was given an overall rating of good with requires improvement in the safe domain. A follow up inspection was carried out in May 2016 when the provider was found to have made improvements resulting in a rating of good in the safe domain.

A Mental Health Act Reviewer also carried out a visit to the service on 17 April 2018. At this visit the reviewer looked at three care plans. The reviewer raised concerns that patients were informed of their rights monthly not at the time their section was renewed or their treatment changed and that some care plans did not show clear evidence of patient involvement.

Updated 10 January 2019

We rated The Billingham Grange Independent Hospital as outstanding because;

• Staff displayed a caring and compassionate approach to patients. Staff knew patients they cared for well and ensured that the support they gave was in line with their personal preferences.
• There was a strong governance structure in place, which displayed joined up working from ward to board level. The service was very well-led at ward and regional level. Staff and patients told us the hospital director was approachable and supportive. The company had clear vision and values which were clearly embedded in the running of the service. Values were demonstrated by staff who cared for patients in a kind and compassionate manner.
• Staff went the extra mile to ensure that patients were involved in decisions about their care and treatment. Staff made multiple attempts to engage patients and used different methods to help patients make choices. Where appropriate there was evidence of families being involved in decisions about care.
• Patients, families and carers participated in the formulation of care plans. Where people were reluctant to participate, they were encouraged by staff. Patients were involved in planning for discharge. Discharge planning was embedded in care delivery and was discussed in multi-disciplinary meetings and ward rounds.
• Patients who lacked capacity were automatically referred to independent advocacy services. Contact details for advocacy services were displayed throughout the service. Patients were supported and encouraged to access services in line with the Mental Health Act Code of Practice
• Staff encouraged and supported patients to access health screening tests. There was a registered general nurse on each ward to monitor the physical health of patients. Staff used recognised screening tools to help them monitor various aspects of physical health.
• All patients had a named nurse and secondary nurse. Photographs of named nurses were in patient’s bedrooms to help them remember who the named nurse was. Patients had regular one to one time with their named nurse.
• There was minimal use of restraint and this was only used after verbal de-escalation had been attempted. Restraint was kept to low level holds and patients were given de-briefs following incidents.
• The provider kept staff, patients and visitors up to date with the running of the service and ratings from previous CQC inspections were posted in the hospital to ensure people could see them.
• Patients and carers were encouraged to give their feedback on the service and the care and treatment they received. The service had been proactive in capturing and responding to patients concerns and complaints.
• There was a good and varied activities programme which provided patients with activities seven days per week. There were a range of activities which helped with patients’ physical and mental health and fitness.
• Poor performance was identified and dealt with quickly and effectively. There was clear learning from incidents and lessons learned were shared both during clinical governance meetings and with staff from national Barchester Healthcare services. This helped to prevent recurrences of incidents.

Updated 10 January 2019

Updated 10 January 2019