Moseley Hall Hospital

During our inspection of Moseley Hall Hospital in January 2013 we found non-compliance with staffing. We identified that improvements were needed concerning staffing levels that were having a minor impact on the people using the service at that time. We carried out this inspection to find out if improvements had been made. We focussed on the two wards that we had assessed previously, wards five and six. We found that some new systems had been implemented concerning staffing levels and staffing issues, and some improvements had been made. However, we found that further improvements were needed, particularly on ward six, to ensure that people's needs could be met and to make sure that they were safe.

Information provided by the trust and senior staff from the trust told us that a recruitment drive was on-going. We were told that management had been disappointed with the outcome of the first recruitment drive, as the standard of many applicants had not been adequate. They told us that they were continuing to recruit. We spoke to a number of newly appointed staff and they confirmed that the recruitment process was on-going. This showed that action had been taken by the trust to improve staffing levels.

We found that systems had been put into place to make the admission processes more positive for people. Unlike our previous inspection, no one we asked told us that they had a poor experience at the time of their admission.

During our inspection we spoke with seven relatives, ten staff members, and twenty people who were using the service. As not everyone were able to tell us about their experiences, we used a number of different methods to help us understand the experiences of those people, which including observation.

During this inspection the majority of people we spoke with made positive comments about the attitude and behaviour of permanent staff. People who used the service and their relatives used words such as, 'Caring, 'Fabulous', and 'Kind' to describe the staff. One person said, 'The staff are all very pleasant'. Another person said, 'The staff are very kind. They look after me'. However, the majority of people using the service told us that there were not enough staff and that they had to wait at times to have their personal care needs met. Our observations on ward six confirmed that people did have to wait for the staff to deliver their personal care. One staff member told us, 'No way do we have enough time to meet people's full needs'.

We observed some care practices that were not positive. We saw staff standing over people when assisting them to eat. We also saw a staff member shaving a person without closing the curtain to promote their privacy and dignity. This meant that some staff practices did not give people assurance that their needs would be met in the way that they wanted them to be.

As our inspection was unannounced no one knew we would be inspecting that day. During our inspection we spoke with 13 people who were using the service, four relatives and ten staff. The majority of people we spoke with were complimentary about the care they received and the staff. One person told us, 'Excellent care and the staff are all very good'. Another person said, 'It is a wonderful place and the staff are all so kind'.

We found that staff practice promoted dignity and we saw that people were treated with respect.

People's needs had been assessed by a range of health professionals including dieticians, speech and language staff and the physiotherapist. This meant that people's health care needs had been monitored and met.

We found that systems were in place which encouraged people to eat and drink to prevent them suffering ill health from malnutrition and dehydration.

Staffing levels and staff mix had not always been adequate to provide people using this service with the explanations and reassurance that they required.

Records and staff both confirmed that systems had been used to monitor how the hospital had been run to benefit the people who used this service.