Inspection finds improvements had been made at a secure mental health hospital in Monmouthshire

Inspectors found staff were committed to providing safe and effective care and were treating patients with dignity and respect. Assurance work found patients were receiving good quality care and there were suitable protocols in place to manage risk, health and safety and infection control. There were some areas for improvement including ensuring resuscitation and emergency equipment is stored in a clear and accessible place for staff in an emergency. However, no immediate concerns about patient safety were identified during the inspection.

HIW completed an unannounced inspection at the hospital on three consecutive days in February 2023. During this period, a number of assessment areas were inspected within the hospital which provides 97 beds for males and females with mental illnesses and/or personality disorders including for males with intellectual/learning disabilities.

Inspectors found patients were receiving tailored care that reflected their individual needs and risks. Good facilities were available onsite such as a social club and café which gave opportunities for patients to engage and relax outside of their immediate environment of care. Patients could engage and provide feedback about their care and had weekly access to a mental health advocate who provided further information and support.

The clinical rooms had been reconfigured since our previous inspection to improve the privacy and dignity of patients receiving their medication. Robust procedures were in place for the safe management of medicines on each ward. Patient care plans were being maintained to a good standard, and statutory documentation was in place for patients who were required to be appropriately and legally detained.

The medicines management procedures on the hospital’s Treowen Ward were of a particularly high standard and demonstrated excellent initiatives and best practice. However, inspectors did note that fridge and room temperature checks within other wards needed to be regularly monitored and documented. Sharps bins should also be stored safely and removed in a timely way. The service must ensure resuscitation and emergency equipment is stored separately and in a clear and accessible place for staff to identify quickly in an emergency. Inspectors also noted mental capacity assessments need to be documented and stored within patient records to be accessible by staff.

There were established and effective governance arrangements in place to provide oversight of clinical and operational issues. It was concerning that when asked, members of hospital staff reported that they had faced discrimination at work from patients within the last 12 months. We have asked the service to outline the actions that will be taken to try and eliminate this discrimination and describe the support that is available to staff following such incidents.

Chief Executive of HIW, Alun Jones said:

It is positive to see the quality of patient care being delivered by the dedicated staff at Llanarth Court Hospital. It is reassuring to see improvements have been made since our previous visit to ensure patients are receiving safe and effective care. The Priory Group has produced a plan which sets out improvement actions as a result of this inspection work. HIW will monitor the health boards’ progress against this plan.

• February 2023 - Inspection Summary Report- Llanarth Court Hospital, Usk
• February 2023 - Independent Mental Health Service Inspection Report - Llanarth Court Hospital, Usk