Women's rehabilitation centre Spring Wood Lodge in Leeds drops in rating to 'requires improvement'

Spring Wood Lodge on Town Gate Close, Guiseley, supports women over the age of 18 who have complex emotional and mental health problems associated with significant risk behaviours.

The service currently provides care to a maximum of 21 female patients.

The Care Quality Commission last carried out a focused inspection of the service on November 18, 2020.

At that inspection the service was rated as ‘good’ overall.

A spokesperson for Elysium Healthcare told the Yorkshire Evening Post "the safety and wellbeing" of their patients is their "priority".

However, the rating has now dropped to 'requires improvement' after a November 2021 inspection found a number of issues at the home.

The service had previously been subject to a large scale safeguarding enquiry implemented by the local authority due to agency staff sleeping whilst on duty, high incidents of self-harm and a high amount of complaints, the report stated.

Due to improvements made by the service, the enquiry was closed in April 2021.

The Care Quality Commission monitored the service through regular engagement and completed a full inspection to enable a review of the whole service.

At the latest inspection, the CQC rated the hospital as requires improvement overall with good in the caring and responsive domains.

Inspectors issued the provider with three requirement notices under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

These related to person centred care, safe care and treatment, and good governance.

"Although we found the service largely performed well, it did not meet legal requirements relating to safe, effective, and well led, meaning we could not give it a rating higher than requires improvement", inspectors said in the latest report from November 9, 2021.

"There was no formal psychological provision in place for patients.

"Medicine charts did not match the appropriate Mental Health Act documentation and were not routinely updated as soon as reasonably practicable.

"Not all patient areas were well maintained and cleaned regularly.

"Cleaning records and clinic room records were not regularly completed and audited.

"Patient outcomes for occupational therapy were not routinely measured and reviewed."

However, inspectors did find that "the service had enough nursing and medical staff, who knew the patients and received basic training to keep people safe from avoidable harm".

"Staff participated in the provider’s restrictive interventions reduction programme, which met best practice standards", the report stated.

"Staff made every attempt to avoid using restraint by using de-escalation techniques and restrained patients only when these failed and when necessary to keep the patient or others safe.

"Staff also assessed the physical and mental health of all patients on admission.

"They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed.

"Care plans reflected patients’ assessed needs, and were personalised, holistic and recovery oriented.

"Staff supported patients to make decisions on their care for themselves."

What did inspectors find?

Ward areas were not always clean, well maintained, and fit for purpose, inspectors found.

The report continued: "Staff did not make sure cleaning records were up-to-date and the premises were clean.

"The cleaning records did not have all the information required and had multiple gaps where cleaning should have been recorded."

In contrast, the service had a COVID lead who ensured infection control policy was followed.

The staff were well trained and knowledgeable, inspectors found.

Patient notes were also comprehensive, and all staff could access them easily.

What did people who used the service say?

Inspectors spoke to eight patents and nine carers of patients.

"Three patients told us there was a delay in getting prescriptions following a change in medicines at ward round and five patients told us there was not enough cleaning provision", inspectors said.

"Seven patients told us that mealtimes were too early, and four patients said the service regularly ran out of snack options such as bread and milk.

"Following the inspection, the service changed mealtimes to a later time and ensured there was always a range of snacks available for the patients.

"All patients said the new menu at the service was good and that staff were respectful and interested in their wellbeing."

One carer told inspectors that the lack of a psychologist had impeded their relative's progress.

Four carers also said they were not routinely updated on their relative's care, whilst four carers said that communication from the service was good, and they were kept updated.

All carers’ said staff were supportive, respectful, and interested in the patient’s wellbeing.

Staff treated patients with compassion and kindness.

They respected patients’ privacy and dignity, inspectors found.

They understood the individual needs of patients and supported patients to understand and manage their care, treatment, or condition.

What do the company say?

A spokesperson for Elysium Healthcare said: "The safety and wellbeing of our patients is our priority and so we welcome the scrutiny that comes from the Care Quality Commission (CQC).

"We were pleased to see that the inspectors highlighted the fact that our staff treated patients with compassion and kindness and that they understood the individual needs of patients and supported patients to understand and manage their care, treatment, or condition.

"However, it is true, like many healthcare providers across the UK, we have faced recruitment challenges during the pandemic.

"We are pleased to confirm that we will shortly announce the appointment of a lead for our psychology team.

"Finally, we have conducted a comprehensive audit and review of our housekeeping protocols and we look forward to evidencing these improvements to our partners at the CQC in the coming months."

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