Maister Lodge

Updated 29 July 2016

Humber NHS Foundation Trust provides wards for older people with mental health problems.

Maister Lodge is a 16 bed mixed gender ward for older people with organic illness leading to memory problems. It is a stand-alone unit located in east Hull. Only 13 of the beds were operational and on the day of the visit, there were 11 patients residing on the ward. All patients were detained under the Mental Health Act 1983 (MHA). The ward was closed to further admissions due to the complex and challenging behaviours of the patients currently on the ward.

Maister Lodge is registered to carry out two regulated activities: assessment or medical treatment for persons detained under the Mental Health Act 1983 and treatment of disease and disorder.

The CQC last inspected the trust in May 2014. There were no requirement notices issued in relation to Maister Lodge. A Mental Health Act reviewer inspected the service in May 2015. The trust lodged an action plan to deal with the issues raised in relation to the MHA.

Updated 29 July 2016

We found the following issues that need to improve:

• When we arrived at the ward, staff showed us into the nurses’ office. There were documents and drawers lying on the floor from an incident that occurred in the office earlier in the morning involving a patient. Staff were currently managing the patient through one to one observations.

• Staff told us they were often understaffed, which meant they struggled to meet the high level of observations their complex patient group required. Staffing rotas showed a high use of bank and agency staff and 26% of shifts not filled to the minimum establishment required. There were no senior nurses or managers on duty over the weekend.

• The staffing levels on the day of the inspection were three qualified nurses and three health care assistants on duty. This included the nurse in charge, as the ward manager was not on duty that day. Seven of the patients on the ward required high-level one to one observations and one patient had developed a physical health condition that required immediate attention from a doctor.

• Staff were confused by the introduction of zonal observations to support one to one patient observations. The ward introduced this practice when they implemented the trust’s supportive engagement policy. The manager had plans to review how staff were implementing the policy.

• Staff did not routinely report patient restraint as an incident. They documented the use of restraint in individual patient records. This meant there was no way of monitoring the number of restraints occurring daily or identifying any themes arising.