Inspection Highlights Some Positive Changes but Ongoing Challenges in Ysbyty Gwynedd’s Mental Health Unit

Overall, inspectors noted that some progress had been made since HIW’s previous inspection in 2023. Inspectors observed strong teamwork and dedication, with staff working hard to meet patient needs even in challenging circumstances. Staff were providing compassionate and respectful care, with patients and families describing them as approachable, attentive, and supportive. The presence of bilingual staff, able to communicate in both Welsh and English, was highlighted as a particular strength, helping to ensure that patients feel comfortable and understood.

The inspection noted robust safeguarding procedures, effective infection prevention and control, and a clear commitment to patient safety. Staff were praised for their professionalism, with regular health and safety checks, comprehensive risk assessments, and prompt responses to incidents. Patients were able to access advocacy services and external support, though staff highlighted a desire for more structured and frequent advocacy presence. 

Several areas for improvement were also identified, including the lack of structured therapeutic activity programmes across all wards remained a concern, with no progress since the previous inspection in 2023. Patients and staff highlighted the lack of meaningful activities, which are vital for recovery. Although activity rooms and a gym were available, these were underused due to staffing constraints, and some equipment required repair. HIW recommended that the health board prioritise structured regular activity timetables and ensure sufficient staffing to support engagement.

Inspectors highlighted the unit’s challenges with paper-based records, including difficulties with document completion, storage, and accessibility. The health board should review the current system and consider implementing an electronic record system. We also noted some patient records and medication charts were incomplete, including missing legally required forms and inconsistent allergy information, which could impact patient safety.

The unit’s overall environment was concerning, despite being generally clean, some areas required attention to maintain a safe and therapeutic environment. Examples included limited seating in communal areas, maintenance needs in the garden, and shared bedrooms without en-suite facilities. Inspectors also highlighted the need for improved safety signage and repairs to certain facilities, such as water heaters, to maintain a recovery-supportive environment. 

Additional findings included issues with lack of medication storage, record-keeping, and inconsistencies in staff training, appraisals, and vacancy management. Staff feedback highlighted concerns around wellbeing, resource availability, and the need for greater visibility and support from senior management. The continued absence of a psychologist on the wards was highlighted as a significant gap in care, and persistent staff shortages have resulted in greater reliance on temporary agency staff. Inspectors asked the health board to review the night‑shift staffing model on Cynan Ward, where only one registered nurse was on duty, to ensure the skill mix reflects patient acuity and dependency.

Despite these challenges, the inspection found many positive aspects of care. Staff were praised for their resilience, teamwork, and commitment to patient wellbeing. The unit demonstrated ongoing quality improvement initiatives, including regular senior nurse walkarounds, committee meetings, and engagement with partner agencies to support patient care.

Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said:

The inspection of the Hergest Unit highlighted positive aspects of care, including strong teamwork, professionalism, and support for patients. However, areas for improvement have been identified, such as structured therapeutic activities, clearer patient information, record-keeping, and certain environmental and staffing challenges. HIW will continue to work with the health board to ensure these issues are addressed and support ongoing improvements in patient experience and safety.

September 2025 - NHS Mental Health Service Inspection – Hergest Unit, Ysbyty Gwynedd, Bangor