Inspection identifies strong patient‑centred care alongside areas for improvement at a Mental Health Unit in Abergavenny

Inspectors found that the service prioritises patient independence, with a strong focus on supporting skill development and community reintegration. Staff-patient interactions were respectful and calm, and staff demonstrated a clear commitment to meaningful engagement. Patients were encouraged to take responsibility for daily tasks and were actively involved in their own care planning and treatment decisions. The multidisciplinary team worked collaboratively, and staff reported feeling heard and respected during ward rounds and multidisciplinary team forums.

The inspection identified several positive practices, including robust risk management processes, effective medicines management, and a calm, supportive ward environment. Patients benefited from tailored therapeutic input and a range of meaningful activities, and feedback from both patients and staff was generally positive.

While the overall findings were encouraging, inspectors identified areas for improvement. These included strengthening the structure and consistency of timetabled patient activities, improving aspects of the physical environment to support sleep and privacy, and addressing gaps in staff training. An immediate concern was resolved during the inspection when out-of-date medication was discovered. 

Inspectors emphasised the need for the service to strengthen aspects of record keeping arrangements by ensuring each patient’s legal status is accurately recorded on medication charts and implementing regular audits of care plan reviews and Mental Health Act documentation. The physical environment needs improvement to support patient wellbeing. This included bedroom doors without vision panels, meaning staff had to open doors during night-time checks, which disrupted patients’ sleep.

Mandatory training rates were generally well maintained; however, gaps were identified in key areas, particularly basic life support and Mental Health Act. Inspectors also recommended reviewing the proximity of the smoking area to the main unit building to ensure compliance with smoke-free legislation.

Governance and oversight processes were in place, and the unit maintained good working relationships with other mental health services and local authorities to support timely discharge planning. Inspectors noted that while the workforce is generally stable and staff feel supported, some concerns remain regarding nurse staffing levels at night.

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

"Our inspection of Ty Skirrid Unit found a dedicated team working to support patient independence and wellbeing. While there are clear strengths in patient engagement and multidisciplinary working, it is important that the health board addresses the areas identified for improvement to ensure the highest standards of care. We will continue to monitor progress as the health board implements its improvement plan."

October 2025 – NHS Mental Health Service Inspection – Maindiff Court Hospital, Abergavenny