Caludon Centre

Updated 22 July 2014

The Caludon Centre is a purpose built facility, based on the University Hospital Coventry and Warwickshire (UHCW) site, providing inpatient and outpatient adult mental health care and learning disability inpatient and outpatient services.

Services

• A Place of Safety
• Psychiatric Intensive Care Unit
• Older Adult Mental Health Inpatient Service
• Older Adult Mental Health Outpatient Service
• Adult Mental Health Inpatient Service
• Adult Mental Health Outpatient Service
• Learning Disabilities Inpatient Service
• Learning Disabilities Outpatient Service
• Community based crisis services
• Assessment and Treatment Service

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.

Coventry and Warwickshire Partnership Trust was formed in 2006 and integrated with community services from NHS Coventry in April 2011. The organisation now provides services from more than 80 locations with an income of about £200 million, and employs more than 4,200 staff.

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.

The trust also provides inpatient, community and day clinics as well as specialist services to a population of about 850,000 living within Coventry and Warwickshire, and also to a wider geographical area in some of their specialist services.

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. The Caludon Centre is a location which has previously been inspected by the Care Quality Commission.

Updated 22 July 2014

The Caludon Centre in Coventry is a purpose built facility providing inpatient mental health and learning disability services for adults of working age and mental health services for older people.

Sherbourne

Core service provided: Psychiatric Intensive Care Unit

Male/female/mixed: mixed

Capacity: 11

Spencer

Core service provided: Acute Admission

Male/female/mixed: female

Capacity: 14

Beechwood

Core service provided: Acute Admission

Male/female/mixed: mixed

Capacity: 20

Hearsall

Core service provided: Acute Admission

Male/female/mixed: mixed

Capacity: 20

Swanswell

Core service provided: Older People

Male/female/mixed: mixed

Capacity: 22

Quinton

Core service provided: Older People

Male/female/mixed: mixed

Capacity: 16

Gosford

Core service provided: Services for people with learning disabilities and autism

Male/female/mixed: mixed

Capacity: 9

We found a number of inconsistencies across the different services and good practice within wards had not been shared with other wards.

Some wards were regularly short of substantive staff and there was a heavy reliance on bank or agency workers. Some staff did not know the ward routines and as a result, people did not always receive the care they required. There was little continuity of care for individuals. Some staff did not know about the person they were caring for and had not had an opportunity to read the person’s care plan records.

On some wards, staff were not trained specifically to meet people’s needs and this increased risks to both staff and people using the service. Some staff told us that they had direct contact with their managers while others had little face-to-face contact and had not received supervision or attended team meetings.

There was a system for staff to report incidents that were then reviewed and acted on by managers. However, we found that regular incidents had taken place on Quinton ward, but there was nothing to show that learning from these incidents had taken place to prevent them happening again.

We found the Caludon Centre did not always adhere to the Mental Health Act’s Codes of Practice. Some records did not show that people had been told about their rights under the Mental Health Act which could have impacted on their understanding of how to appeal against their detention and how to obtain the services of an independent Mental Health Advocate to support them.

Some wards were better managed than others and on those wards, there was a lack of support for ward staff.

A risk assessment process was in place; however much of the documentation seen in people’s personal files was incomplete to demonstrate personal risk and been considered. We were told that the doors in place were specially commissioned doors to be ‘anti- ligature’ but the closure was visible when the door was open.

On some wards, people had detailed care plans that showed staff how they should be supported and we saw they were involved in these. Other records were unclear and had not been updated regularly. This meant that staff might not know how to support people to reduce risk and meet their needs.

On some wards, staff worked with the team of professionals involved in each person’s care to ensure that all their needs were met. Staff worked with other providers so that when the person was discharged they received the support they needed.

In outpatients, doctors talked with people and gave them, and others involved in their care, opportunities to raise and discuss issues. The doctors responded to these issues, such as side effects relating to medication.

There was the potential of a risk of harm for the people on Quinton Ward which had a number of breaches in regulations. We had sufficient serious concerns regarding Quinton Ward to issue a Warning Notice regarding this ward. The trust sent us an action plan following the inspection to detail how they were planning to implement improvements. We undertook a follow up inspection in July 2014 and found the trust had taken action to improve the outcomes for people on this ward. We found that the trust had responded and that the ward was much improved with sufficient improvement to remove the warning notice. Details of this visit and our findings can be found within the Older People section of this report.

Updated 22 July 2014

This service was responsive to the needs of the people using it. People were seen up to four times each day for both medication management and psychological support while at home. The team planned in detail the type of intervention needed during each visit and fed back to the team at the next handover.

Updated 22 July 2014

Staff confidently raised concerns about the practice of other staff and action was taken as a result of this. This meant that people were safeguarded from harm and abuse.

Staff received the training they needed to meet people’s individual needs, ensuring their wellbeing.

Some records were unclear and had not been updated regularly. This meant staff might not know how to support people to reduce their current risks and meet their needs.

There were six staff vacancies, which were being covered by bank and agency staff. Regular staff covered most shifts, but sometimes new staff did not know the person they were caring for or how to meet their needs.

People had detailed care plans that included their involvement, and showed staff how they would like to be supported. We saw that people had regular physical health checks to ensure their wellbeing.

Staff worked with the team of professionals involved in each person’s care so that their needs were met. Staff worked with other providers so that when a person was discharged they received the support they needed.

Some records did not show that people had their rights under the Mental Health Act explained to them. This could have an impact on their health and wellbeing.

Staff had an understanding of what they needed to do to make improvements to benefit people.

Updated 22 July 2014

The unit was airy with a good amount of open space. There were facilities for women to ensure they had access to private space. People we spoke with told us that they felt safe and there were a variety of activities for them to participate in.

The unit was well staffed but used high levels of bank and agency staff due to the number of close observations needed. Staff were well supported and regularly received supervision and support.