All inspections: Brighton & Hove Clinic

We rated The Brighton and Hove Clinic as good because :

The service provided safe care for children and young people. The ward environment was safe and clean. The ward had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding. Activities within the service and out in the local area were geared towards children and young people .
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments which were suitable to the needs of the young people, in a format and language that reflected young people and their family’s involvement and in line with national guidance about best practice.
The ward team had access to the full range of specialists and education opportunities required to meet the needs of the young people on the ward. Managers ensured that these staff received relevant training, group clinical supervision and appraisal. The ward staff worked well together as a multidisciplinary team alongside staff from the education team and with those outside the ward who would have a role in providing aftercare.
Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005 including Gillick competency and Fraser guidelines. They followed good practice with respect to young people’s competency and capacity to consent to or refuse treatment.
Staff treated young people with compassion and kindness, respected their privacy and dignity, and understood the individual needs of young people. They actively involved young people and families and carers in care decisions.
Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. Staff felt respected, supported and valued. They reported that the provider promoted equality and diversity in its day-to-day work and in providing opportunities for career progression. They felt able to raise concerns without fear of retribution.

However:

At the time of the inspection the hospital did not have a permanent registered manager as the previous registered manager had just left. A permanent manager had been appointed but had not yet started at the time of the inspection. The hospital also did not have a permanent hospital director although interim arrangements had been put into place to cover both posts.
The young people had restricted access to an outdoor space in the hospital and due to the layout of the unit were not able to access the outdoor space freely and had to wait until staff were available, this had an impact on young people’s access to fresh air.
Staff stated and records indicated they were not receiving any formal individual 1:1 supervision.
There were a few areas where medicines management needed to improve, medication no longer being used was found not to be properly disposed of by the pharmacist, medication errors were found where incident reports had not been recorded. This was resolved at the time of the inspection.

We rated The Brighton and Hove Clinic as good because:

The service was compliant with same sex accommodation guidance and separated male and female bedrooms and grouped these to achieve as much separation as possible. Staff told us that risk would outweigh gender separation and if a patient was assessed as high risk they would be put in a bedroom nearest to the nursing office. Additional staff could be arranged to nurse a patient in their own room if required, and all bedrooms were en-suite so patients did not have to pass other patients to use bathroom or toilet facilities.
Staff completed thorough patient risk assessments at point of admission and reviewed these frequently throughout admission.
The ward had a comprehensive safeguarding policy. Staff training rates for safeguarding were 97% for safeguarding adults training and 99% for safeguarding children training.
Staff completed comprehensive and timely assessments of all patients when they were admitted. Patient care plans were holistic, recovery focused and personalised. Patients all had a copy of their care plan.
Staff had regular supervision and annual appraisals were up to date. All staff had current disclosure and barring service checks. Staff whose check was due for renewal had all applied for their renewal in advance so there was no time that the service had staff working without full checks in place.
Patients were very complimentary about the care they received and said they felt safe on the ward. Patients reported that staff always had time for them and activities or leave were rarely cancelled. Staff were responsive to individual patient needs.
The ward had a full range of rooms suitable for patient use. All patient bedrooms had a safe for patients to store items, and patients were able to personalise their own bedroom. The communal lounge had a drinks machine which patients could use to get a hot drink at any time of day or night. Patients had access to an outside space on the ground floor and a first floor outside terrace.
Staff reported that senior managers were a visible presence on the ward and they felt able to approach them if they had any issues. Staff reported a high degree of job satisfaction and motivation. We observed a supportive staff culture and a real sense of team working. Staff were passionate about their job and spoke highly of the management structure in place.
The hospital had good governance systems in place. This was reflected in the high rates of mandatory training, supervision and staff appraisals.

However:

The ward did not have paper copies of incident forms to use in the event of the electronic system not being available for use.
Patients told us there was little in the way of structured activities at weekends, and no access to activities providing physical exercise.

Brighton & Hove Clinic

All Inspections

22-23 May 2019

During a routine inspection

7-8 March 2017

During a routine inspection