Mental Health Services and Learning Disability Services

How we inspect

We assess whether services:

• Comply with healthcare regulations and key legislation such as:
  • Mental Health Act 1983
  • Mental Capacity Act 2005
  • Mental Health (Wales) Measure 2010
  • Deprivation of Liberty Safeguards
• Follow relevant professional standards and guidance
• Meet the Health and Care Quality Standards 2023
• Comply with Welsh Government strategy, policy and legislation.

Our NHS hospital inspections are usually unannounced to help achieve the following:

• Realistic view of day-to-day operations - Unannounced inspections provide a more reflective view of how services operate on a typical day, without the opportunity for staff to prepare or change routines. This helps HIW assess whether high standards are consistently maintained.
• Increased accountability - Knowing that inspections can happen at any time encourages hospitals to maintain continuous compliance with regulations and standards, rather than preparing only for scheduled visits.
• Improved patient safety - By observing services in their natural state, inspectors are more likely to identify genuine risks to patient safety or lapses in care that might otherwise not be seen during a planned inspection.
• Enhanced credibility and public trust - Unannounced inspections demonstrate HIW’s independence and impartiality, reinforcing public confidence that healthcare services are being held to account transparently and fairly.
• Opportunity to hear unfiltered patient and staff feedback - Patients and staff are more likely to provide authentic feedback during unannounced visits, as the environment is less staged and more reflective of their everyday experiences.
• Early Detection of Systemic Issues - These inspections can help uncover underlying problems in hospital culture, staffing, or leadership that may not be visible during a prepared inspection.

Each Mental health hospital inspection is carried out by a team comprising at least one HIW inspector (who leads and manages the process), an external peer reviewer with relevant professional expertise, and a patient experience reviewer. The external peer reviewer offers an independent clinical perspective, while the patient experience reviewer engages with individuals receiving care to gather first-hand accounts of their experiences. This collaborative approach ensures that inspections reflect both professional standards and the real-life experiences of patients.

After the Inspection

Following an inspection:

• We publish an inspection report on our website
• Services may be required to make improvements and submit an improvement plan to us
• We may take further action if serious concerns are identified
• We continue to monitor services using information from inspections, the public, engagement with healthcare staff, and other organisations.

If you would like a copy of our inspection workbooks please contact HIW.Inspections@gov.wales quoting which type of inspection workbook you require.

The findings from our inspections are published to our website.