Brooklands

Updated 17 April 2014

The Trust has a total of 21 active locations. There are three hospitals sites: Brooklands, St Michael’s Hospital and Caludon Centre.  Nine of these locations provide mental health services including Brooklands.

The Trust provides a wide range of mental health and learning disability services for children, young adults, adults and older adults as well as providing a range of community services for people in Coventry.

Coventry and Warwickshire Partnership NHS Trust has been inspected 21 times since registration.  Out of these, there have been 10 inspections covering five locations which are registered for mental health conditions. 

Brooklands has a forensic medium secure service for men called Janet Shaw, two specialist assessment and treatment services called Jade and Amber units, Malvern and Snowdon units for men who require a low secure environment and Eden unit for women who require a low secure environment. There are also two adolescent specialist assessment and treatment services in Brooklands called 1 and 3 Tuxford.

We inspected Amber Unit, Brooklands on 27 June 2013, following concerns raised by visitors to the unit. We found people’s views were not always taken into account in the way their treatment was delivered. We also found that people’s privacy and dignity was not always respected. We saw that people did not always experience care, treatment and support that met their needs and protected their rights.

Updated 17 April 2014

Janet Shaw

Core service provided: Medium secure forensic

Male/female/mixed:  male

Capacity:  15

Jade

Core service provided: Specialist assessment and treatment, 16–25 years

Male/female/mixed: male

Capacity: 15

Amber

Core service provided: Specialist assessment and treatment 18+

Male/female/mixed: male and female

Capacity: 12

Malvern

Core service provided: Low secure

Male/female/mixed: male

Capacity: 15

Snowden

Core service provided:  Low secure

Male/female/mixed: male

Capacity: 11

Eden

Core service provided:  Low secure

Male/female/mixed: female

Capacity: 15

1 Tuxford

Core service provided:  Adolescent Specialist Assessment and Treatment 12–19 years

Male/female/mixed: mixed

Capacity: 6

3 Tuxford

Core service provided:  Adolescent Specialist Assessment and Treatment 12–19 years

Male/female/mixed: mixed

Capacity: 6

We found at this inspection that Brooklands was not compliant with the safety and suitability of premises. This was because the security systems in place in Janet Shaw were not sufficient to protect the safety of people who used the service and staff. The gate lock had failed and whilst the perimeter was secure, the measures introduced limited people’s access to outside space.

People were at risk in the seclusion rooms in Malvern and Eden units of being cold and of harming themselves.

People’s privacy and dignity were not respected if they needed to use the seclusion room in Amber unit.

We saw that the medicine management systems were generally safe and ensured people had the medicines they were prescribed to promote their health and wellbeing. Staff did not have updated rapid tranquilisation training which could put people at risk of harm if they needed this.

Safeguarding processes were robust and all staff had received training to ensure they knew how to safeguard people from harm who used the service. However, for some staff this needed to be updated.

We saw that people received support from a team of professionals who worked together to ensure they had the care and treatment to meet all their needs effectively.

People’s physical health needs were monitored and met.

We found that each unit worked in isolation and did not share best practice which could mean that people’s care and treatment may not have been as effective as it could be.

People told us they did not like the food provided. We saw this was discussed at meetings held with people who used the service; however people were not aware of what they could do to make changes where possible.

Staff in Tuxford units were qualified and competent so that the treatment that children received was effective in meeting their needs and enabled them to move on to more suitable placements.

Some staff in other units required further training in how to meet individual needs to ensure they supported people to be safe.

People told us, and we saw, that they were supported to be involved in their care plans and to attend their reviews.

We saw that staff interacted well with people who used the service to promote their wellbeing and self-esteem.

We saw that some people did not participate in regular meaningful activities to ensure their treatment was effective and met their needs.

Generally we found that staff respected people’s privacy and dignity to promote their wellbeing.

We found that people knew why they had been detained under the Mental Health Act and what their rights to appeal to this were.

Updated 17 April 2014

We saw that the units were well staffed so that the individual needs of the children could be safely met.

Parents spoken with told us they had no concerns about the safety of their children when they were at the unit.

We found that some children displayed extreme behaviours of self - harm and violence towards others. However, this was managed by staff safely so as to promote children’s wellbeing.

Staff were qualified and competent so that the treatment that children received was effective in meeting their needs and enabled them to move on to more suitable placements.

We observed that staff engaged well with each child and ensured they received the care and support they needed.

The environment in Tuxford units should be improved to ensure that children benefit from a caring and supportive environment.

We saw that staff responded to children’s individual needs so that their religious and cultural needs were respected.

Some children placed there were a long way from their home. Staff responded to this by ensuring that children had regular contact with their family.

Staff spoken with told us that they were valued by the leaders of the Trust and felt their views were listened to.

Staff told us and we saw that there were plans to refurbish the building; however there were no firm dates and timescales set for this.

Updated 17 April 2014

All staff had received training in safeguarding vulnerable adults from abuse and processes were in place so that staff knew how to ensure that people were safe.

Systems for seclusion needed to be improved to ensure safety and wellbeing for the person needing seclusion and others.

In Amber unit we found that staff responded to people’s behaviours by placing restrictions on them and the response was not based on individual’s risks which could impact on people’s safety and wellbeing. All people who used the service could only access their mobile phones for one hour in the weekday evenings but could at all time at weekends. Staff could not explain to us the rationale for this.

There were enough staff to ensure people’s safety in Amber unit. However, in Jade unit there were sometimes insufficient staff with the appropriate skills to meet people’s complex needs and ensure their safety.

We saw that professionals worked together to meet people’s individual needs and ensure that their care and treatment were effective.

People did not participate in regular meaningful activities to ensure their treatment was effective and met their needs. Activities were not personalised to people’s Individual interests and needs. Several activities were record as ‘relaxing’ and so were passive which did not help to promote some people’s wellbeing.

We saw that people’s physical health care needs were monitored and met.

We observed that staff interacted well with people who used the service and knew how to support them to meet their needs.

Department of Health guidance that requires the provision of separate spaces for men and women to ensure they are cared for separately.  This standard was not always being met. This meant that people’s privacy and dignity was not always respected.

We saw that staff respected people’s religious and cultural needs to promote their wellbeing.

We found that some staff lacked awareness about the needs of people who have autism. The environment was not suitable in Amber unit for people who had autism which impacted on their wellbeing. However, plans were in place to improve this to benefit people who used the service.

It was unclear what the role of Jade unit was as it was for people from a wide age range and needs. Staff were not sure what the purpose of the unit as a whole was which meant that some people could be at risk of not having their needs met.

Staff told us they were well supported by their managers; however, they did not feel valued by senior managers in the Trust and told us they did not have contact with them. This could mean that they are not clear of their role within the Trust and how it impacts on the Trust as a whole to benefit people who use the service.

Updated 17 April 2014

We found that the security system in Janet Shaw was not safe and put people who used the service, staff at potential risk of harm.

The seclusion rooms in Malvern and Eden units were cold and unsafe which posed a risk to people who used the service.

We saw that the medicine management systems were generally safe and ensured people had the medicines they were prescribed to promote their health and wellbeing. Staff did not have updated rapid tranquilisation training which could put people at risk of harm if they needed this.

Safeguarding processes were robust and all staff had received training to ensure they knew how to safeguard people who used the service from harm. However, for some staff this needed to be updated.

We saw that people received support from a team of professionals who worked together to ensure that they had the care and treatment to meet all their needs effectively.

We found that each unit worked in isolation and did not share best practice which could have meant that people’s care and treatment may not have been effective as it could be.

People told us they did not like the food provided. We saw that this was discussed at meetings held with people who used the service; however, people were not aware of what they could do to make changes where possible.

We saw that in some units people were provided with appropriate activities and treatment programmes to promote their recovery and wellbeing. However, we saw that this varied in the evenings and at weekends which meant some people were bored and under-stimulated.

People told us that they were involved in their care planning and had agreed to their treatment.

We saw that the bathrooms in Janet Shaw needed to be refurbished to promote the privacy and dignity of people who used the service. One person told us that their privacy was not always respected by staff as they left their observation panels open in their bedroom door.

Two wards had been merged together into Malvern unit in October 2013. We saw that this had not been planned to meet people’s individual needs but as a response to refurbishing a building that had not been commissioned to be used as such. This impacted on how staff could respond to meet people’s individual needs.

We saw that people’s religious and cultural needs were respected and met.

We found that staff were unaware of the role of the directors within the Trust and did not feel led by them.

In Eden unit we saw that the role of the clinical lead and ward manager were confused which made it unclear as to who was accountable for the leadership of the unit.