St Andrews Healthcare Northampton

Updated 13 March 2026

We assessed St Andrews Hospital Northampton between 10 October 2025 and 2025 5 November on site, and until 10 December (off site).

We assessed St Andrews Hospital Northampton between 10 October and 05 November (2025) onsite, and concluded our assessment on 10 December 2025 offsite.

This inspection was an unannounced focused inspection undertaken as a follow up to the previous inspections in July and August 2025, with 3 assessment service groups (forensic in-patient or secure wards, wards for older people with mental health problems and services for people with acquired brain injury) reviewed. The CQC had taken urgent action to impose a condition on the provider’s registration, to restrict new admissions across the entire site. We needed to assess if these restrictions remained fair and proportionate, and whether all were still needed to keep patients safe.

St Andrew’s Healthcare Northampton is part of St Andrew’s Healthcare, which is a registered charity. The charity provides specialist mental healthcare for patients who may have complex presentations, with challenging mental health needs. During our inspection we visited wards across the medium and low secure wards, to include learning disability / autism wards (LDA); wards for older people with mental health problems and wards for people with acquired brain injury.

During our inspection, we visited the following wards as part of the assessment:

• Cherry ward: a specialist older adult service for females with complex dementia and / or progressive neurological conditions, including Huntington's disease, who present with cognitive deficits (12 beds).
• Redwood ward: a specialist older adult service for males with complex dementia and / or progressive neurological conditions, who present with cognitive deficits (12 beds).
• Fairbairn ward: a medium secure service for deaf men with 17 beds
• Robinson ward: A secure admission ward for adult males with a mental health diagnosis with 17 beds
• Mackaness Ward: A secure admission ward for adult males with a mental health diagnosis with 15 beds
• Cranford Ward: a medium secure service for older men aged over 55 years old with 17 beds
• Meadow ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
• Sycamore ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
• Marsh ward: A specialist medium secure admission, stabilisation and treatment service for men with a forensic history with distressed behaviour
• Oak ward: a recovery-orientated medium secure service for women aged over 18 with 10 beds
• Fern ward: A stabilisation and treatment service for men who may also have a forensic history with distressed behaviour with 10 beds
• Allitsen ward: a long stay rehabilitation ward for males with 11 beds
• Tavener ward: a long stay rehabilitation ward for males with 11 beds
• Tallis ward: an admission, assessment and rehabilitation ward for males with 11 beds
• Elgar ward: an admission, assessment and rehabilitation ward for females with 12 beds
• Walton ward: an admission, assessment and rehabilitation ward for males living with Huntington’s disease with 14 beds

During this assessment we assessed the following service groups: Forensic inpatient or secure wards; wards for older people with mental health problems and services for people with acquired brain injury. We assessed 14 quality statements under 3 key questions: safe, caring and well led.

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The overall service rating was Inadequate

In the Forensic in-patient or secure wards (including LD/A), we found breaches of regulations in relation to dignity and respect (regulation 10), safe care and treatment (regulation 12); safeguarding (regulation 13); governance (regulation 17) and staffing (regulation 18). in wards for older people with mental health problems we identified breaches in relation to safe care and treatment (regulation 12); safeguarding (regulation 13); governance (regulation 17) and staffing (regulation 18). in services for people with acquired brain injury we identified breaches in relation to person centred care (regulation 9), dignity and respect (regulation 10), safeguarding (regulation 13), good governance (regulation 17) and staffing (regulation 18).

We have asked the provider for an action plan in response to the concerns found at this assessment.”

This service remains in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we user our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

Updated 21 September 2025

This assessment of forensic inpatient or secure wards at St Andrew’s Healthcare Northampton took place between 10 and 29 October 2025. This was an unannounced inspection due to the significant concerns raised by CQC and partner agencies during our previous inspection. The service was taking action to address concerns identified, which included an independent review of the culture of the hospital. Additionally, the service had undertaken individual patient safety interviews with all patients across the site. Further to our previous inspection, the service was required to undertake regular reviews of incidents involving restraint. This included a review of incidents via review of CCTV footage. The service had also focussed on staff training and awareness in relation to closed cultures.

St. Andrews Healthcare Northampton is an independent hospital, run by St Andrews Healthcare limited, which is a registered charity. The charity provides specialist mental healthcare for patients who may have complex presentations, with challenging mental health needs. During our inspection we visited medium secure wards and a learning disability and autism services (LDA) ward.

An assessment has been undertaken of a specialist service that is used by autistic people or people with a learning disability. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the service guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities.’

This inspection was undertaken to determine if there had been any improvements further to our last inspection (in July and August 2025) and to identify progress against the service’s action plan and the sustainability of improvements made.

We visited 5 medium secure wards in the medium secure division, plus 4 secure learning disability/autism (LDA) wards. The wards visited were as follows:

• Fairbairn ward: a medium secure service for deaf men with 17 beds
• Robinson ward: A secure admission ward for adult males with a mental health diagnosis with 17 beds
• Mackaness Ward: A secure admission ward for adult males with a mental health diagnosis with 15 beds
• Cranford Ward: a medium secure service for older men aged over 55 years old with 17 beds
• Meadow ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
• Sycamore ward: A medium secure admission, stabilisation and treatment service for men with a forensic history and distressed behaviour with 10 beds
• Marsh ward: A specialist medium secure admission, stabilisation and treatment service for men with a forensic history with distressed behaviour
• Oak ward: a recovery-orientated medium secure service for women aged over 18 with 10 beds
• Fern ward: A stabilisation and treatment secure service for men who may also have a forensic history with distressed behaviour with 10 beds

During this inspection we reviewed 14 quality statements under 3 key questions (safe, caring and well-led). We found ongoing breaches in relation to Regulation 12: Safe Care and Treatment; Regulation 13: Safeguarding service users from abuse and improper treatment; Regulation 10: Dignity and Respect ; Regulation 18 (staffing).

We will publish this information on our website after any representations and/ or appeals have been concluded.

In instances where CQC have decided to take civil or criminal enforcement action against a service, we will publish this information on our website after any representations and/ or appeals have been concluded.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

Staff were trained in and had a good understanding of the Mental Health Act (MHA), the Code of Practice and the guiding principles. As of September 2025, 95% of staff on medium secure wards, and 94% of staff on LDA wards were up to date with their Mental Health Act training.

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice. Patients had easy access to information about independent mental health advocacy. However, the service had changed their advocacy service. Staff told us that access to independent advocacy had decreased.

Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded they had done it. Due to available staffing, staff were not able to ensure that patients were always able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.

Staff requested an opinion from a second opinion appointed doctor when necessary. Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly and so they were available to all staff that needed access to them.

Staff did regular audits to ensure the Mental Health Act was being applied correctly and there was evidence of learning from those audits.

Mental Capacity Act

Ninety five percent of staff in the learning disability and autism (LDA) and medium secure wards were up to date with their training in the Mental Capacity Act. Staff generally had a good understanding of the Mental Capacity Act, particularly the five statutory principles.

The service had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it. Staff knew where to get advice from within the service regarding the Mental Capacity Act, including deprivation of liberty safeguards.

Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff had assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis regarding significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. The service had arrangements to monitor adherence to the Mental Capacity Act.

Updated 21 September 2025

This inspection of services for people with acquired brain injury at St Andrew’s Healthcare Northampton took place in October and November 2025. This inspection was undertaken to follow up on the findings from the inspection carried out in July and August 2025. The wards supporting people with acquired brain injury formed one of the 3 service groups reviewed during this assessment. At the time of the earlier inspection, the CQC had limited the service from accepting new admissions. During this follow-up inspection, we reviewed whether those limits were still justified, whether they remained appropriate to the level of risk, and whether they were still required to protect people from harm.

St Andrew’s Healthcare Northampton is part of St Andrew’s Healthcare, which is a registered charity. The charity provides specialist mental healthcare for patients who may have complex presentations, with challenging mental health needs.

Within the neuropsychiatry division, there were 4 wards for people with acquired brain injury at the time of the inspection. These consisted of; Tavener ward, Allitsen ward, Elgar ward and Tallis ward. The division also had Walton ward, a specialist ward for males living with Huntington’s disease. During this inspection, we focused upon all 5 wards:

• Tallis ward – an admission, assessment and rehabilitation ward for males (11 beds).
• Allitsen ward- an admission, assessment and rehabilitation ward for males (11 beds).
• Tavener ward- an admission, assessment and rehabilitation ward for males (11 beds).
• Elgar ward – an admission, assessment and rehabilitation ward for females (12 beds).
• Walton ward – an admission, assessment and rehabilitation ward for males living with Huntington’s disease (14 beds).

The service was registered to provide treatment of disease, disorder or injury and assessment or medical treatment for persons detained under the Mental Health Act 1983.

At the time of this inspection, the service did not have a registered manager in place.

This assessment service group was last inspected in July and August 2025, when it was rated Requires Improvement.

At this inspection, we reviewed 14 quality statements across 3 key questions: safe, caring and well led. We identified ongoing breaches related to person-centred care (Regulation 9); dignity and respect (Regulation 10); safe care and treatment (Regulation 12); safeguarding (Regulation 13); governance (Regulation 17); and staffing (Regulation 18). As a result of these findings, we rated the service Requires Improvement.

We found significant shortfalls in risk mitigation and safeguarding arrangements. Staff did not consistently protect people from abuse and improper treatment, and individual risks were not always effectively managed or reviewed. Staff did not consistently engage with people during enhanced observations, and some people experienced care that did not fully protect their privacy or dignity, particularly during incidents requiring restraint or transfer across wards. There were repeated incidents of unexplained injuries, prolonged restraint, inconsistent use of de-escalation, and gaps in documentation, including falls assessments and body mapping. Governance systems, audits and incident reviews had not always been effective in identifying, escalating or addressing risks in a timely way, which limited assurance that lessons were learnt and embedded across the service.

However, where possible, patients were supported to have choice and control and were able to give feedback on their care through regular community meetings. The service had undertaken some work to review and reduce blanket restrictions following the previous inspection, including changes to vaping arrangements and individual risk assessments. Patients were supported to maintain relationships that mattered to them through visits, telephone calls and virtual meetings, and some carers described staff as kind and committed to supporting their relatives.

Staff we spoke with were generally positive about working at the hospital and told us they felt supported by their immediate line managers. We met staff who were passionate about improving outcomes for people with acquired brain injury, despite ongoing staffing pressures and reliance on bank staff.

Mental Health Act and Mental Capacity Act Compliance

Most patients on the 5 wards were detained for treatment under the Mental Health Act 1983. Staff stored copies of detention papers and associated records within the electronic patient record, which could be accessed when required.

Staff received mandatory training on the Mental Health Act, with compliance above 90% at the time of inspection.

Staff were able to explain the Mental Health Act Code of Practice and clearly described the guiding principles that informed how they supported and treated people using the service.

Staff had access to advice and support through the provider’s Mental Health Act administration team. The service had clear policies and procedures in place that reflected the relevant legislation and were consistent with the Mental Health Act Code of Practice.

Staff explained patients’ rights under the Mental Health Act and repeated these as required, with records maintained in care notes.

Patients were provided with information leaflets in accessible formats where needed and had access to an Independent Mental Health Advocate (IMHA). Advocacy was provided through the Local Authority, on an individual referral basis.

Mental Capacity Act

Staff received training on the Mental Capacity Act and the five statutory principles. Training on the Mental Capacity Act and Deprivation of Liberty Safeguards formed part of mandatory training, with compliance above 90%.

Capacity to make decisions was monitored and discussed at multidisciplinary team meetings. Where people lacked capacity, staff completed decision-specific capacity assessments and best-interest decisions. However, records did not always show how people and their carers were involved in planning and reviewing their care.

Updated 21 September 2025

This inspection of services for people older people with mental health problems at St Andrew’s Healthcare Northampton took place in October and November 2025. This inspection was undertaken as a follow up to the previous inspections in July and August 2025, with the wards for older people with mental health problems being one of 3 assessment service groups reviewed. The CQC had placed restrictions upon new admissions to the service. We needed to assess if these restrictions remained fair and proportionate, and whether all were still needed to keep patients safe.

St Andrew’s Healthcare Northampton is part of St Andrew’s Healthcare, which is a registered charity. The charity provides specialist mental healthcare for patients who may have complex presentations, with challenging mental health needs.

In the neuropsychiatry division of the location, there were 2 wards open for older adults with mental health problems at the time of our assessment. One ward (Aspen ward) had been closed shortly after our last inspection. During this inspection, we visited both wards, Cherry and Redwood:

• Cherry ward - a specialist older adult service for females with complex dementia and / or progressive neurological conditions, including Huntington's disease, who present with cognitive deficits (12 beds).

• Redwood ward – a specialist older adult service for males with complex dementia and / or progressive neurological conditions, who present with cognitive deficits (12 beds).

The service was registered to provide treatment of disease, disorder or injury and assessment or medical treatment for persons detained under the Mental Health Act 1983.

There was no registered manager in post at the time of this inspection.

This assessment service group was most recently inspected in July and August 2025 and rated as Inadequate. At the time of this inspection, CQC were aware that the provider had plans in place to close the older peoples service in the future. CQC were not aware of any definitive dates for this planned closure at that time. As the assessment progressed, the provider confirmed closure of the 2 remaining wards would be at the end of November 2025.

During this inspection we reviewed 13 quality statements under 3 key questions (safe, caring and well led). We found ongoing breaches in Person centred care (Regulation 9); Safe care and treatment (Regulation 12); Safeguarding (Regulation 13); Governance (Regulation 17) and Staffing (Regulation 18). We rated the service Requires Improvement.

Systems to learn from incidents and embed lessons were not consistently applied, and governance arrangements required external oversight to maintain safety and drive improvement. Risk assessments were in place, but care plans often lacked sufficient detail. Daily progress notes were mostly task-oriented, which could compromise continuity of care.

Staffing continued to be a challenge, with a continued reliance upon bank staff, and occasional delays in meeting patients personal care needs. Raised concerns from staff about staffing were not always acted upon, and the service did not consistently foster a culture where staff felt confident their voice would be heard.

The provider’s chosen dementia care model was not consistently applied. Opportunities to promote independence and choice were sometimes missed, and dignity had not always been maintained.

However, some improvements had been made since the last inspection. We observed examples of compassionate care and staff spending quality time with patients. Staff tried to personalise care and engage people in activities they enjoyed. Documentation of injuries had improved across both wards. There had been some improvements with restrictive practices, with individual risk assessments replacing blanket restrictions, for example around the use of metal cutlery. Ward managers were visible and supportive, and staff described a positive team culture despite uncertainty about planned ward closures.

Mental Health Act and Mental Capacity Act Compliance

Patients on the 2 wards were detained for treatment under the Mental Health Act 1983.

Staff received training on the Mental Health Act and the Mental Health Act Code of Practice and could describe the Code of Practice guiding principles. Online training on the Mental Health Act was mandatory for all staff. Compliance was over 90% at time of inspection.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff could access support from the providers’ Mental Health Act administration department.

The service had the relevant policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice.

Staff explained to each patient their rights under the Mental Health Act. Rights were repeated to patients as required and this was recorded in patient records. Many patients had cognitive impairments which meant they had difficulties processing this information. Where possible, staff had involved and consulted relatives who were involved in their care.

Patients had access to an Independent Mental Health Advocate (IMHA). Posters were displayed on noticeboards on the wards with contact details to reach this service. Access to advocacy was through the Local Authority. Due to cognitive impairment of some patients, emphasis was on the staff to refer patients to the advocacy service if the patients themselves were unable to. Prior to the Local Authority arrangement, advocates would spend time on wards with patients. Advocacy was available, but at a reduced level to previously.

Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to, requested by the patient’s responsible clinician.

Staff stored copies of patients’ detention papers and associated records correctly and could access them when needed.

Managers and staff made sure the service applied the Mental Health Act 1983 correctly by completing audits and discussing the findings. The implementation of the policy was overseen by the Mental Health Act Steering Group comprising of the Mental Health Act lead, a clinical director, a solicitor, responsible clinicians, nurses and social workers.

Mental Capacity Act

Staff received training about the Mental Capacity Act and understood the key principles. Training on the Mental Capacity Act and Deprivation of Liberty Safeguards were incorporated into mandatory training on Mental Health Law. Compliance was over 90% at time of inspection.

Individuals’ capacity to make decisions was monitored and recorded at multidisciplinary team meetings.

Initial findings from a recent culture review (August 2025) highlighted a need for enhanced MCA /DoLS training for staff beyond e-learning, with focus upon practical application in a ward setting.

Updated 21 October 2025

St Andrew's Healthcare is a registered charity specialising in the assessment, treatment and rehabilitation of people with psychiatric disorders, including people with developmental disabilities and challenging behaviours. The providers' vision is to be the national leader in specialist mental health care.
St Andrews Hospital Northampton has five service divisions. These are:
• Child and Adolescent Mental Health Services (CAMHS),
• Autism Spectrum Disorder and Learning Disability Division (ASD/LD)
• Medium Secure Division,
• Low Secure and Specialist Rehabilitation Division, Acute and Psychiatric Intensive care units,
• Neuropsychiatry Division.

This assessment looked at services within the acute wards for adults of working age and psychiatric intensive care units. The wards included Naseby, a 15 bedded acute ward for males. Wards Heygete and Bayley, psychiatric intensive care unit for males, each offering 10 psychiatric intensive care unit for males. At the time of our assessment there was a low bed occupancy within all 3 of the locations. The two 10 bed psychiatric intensive care unit wards had 7 patients each and the 15 bed acute ward had 4 patients during our visit. Leaders stated that this was due to the service only accepting appropriate referrals while discharging patients at an appropriate rate.

The service provided mental health care to adult males across a spectrum of specialist mental disorders. Care is provided to those who need the relational, physical, and procedural security of a secure unit, in line with the National Medium Secure Specifications from NHS England.

The service was last rated as Requires Improvement (published September 2016). The report was published following Care Quality Commission's (CQC) old inspection approach using key lines of enquiry (KLOEs), prompts and ratings characteristics. This assessment has been completed following CQC's new approach to assessment; Single Assessment Framework (SAF).

This was an unannounced assessment, which means the service was not told an assessment was going to be taking place beforehand. During this assessment we looked at all quality statements across all 5 key questions. As we assessed all quality statements at this visit the current rating reflects the findings from this assessment.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

The organisation employed Mental Health Act caseworkers who all provided advice and support for staff. Caseworkers regularly visited the wards, and staff knew how to contact them for advice. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Staff explained to each patient their rights under the Mental Health Act in a way that they could understand, repeated as necessary and recorded it clearly in the patient's notes each time. Staff made sure patients could take section 17 leave (permission to leave the hospital) when this was agreed with the Responsible Clinician.

Patients had easy access to information about independent mental health advocacy and patients who lacked capacity were automatically referred to the service. Information about patients' rights under the Mental Health Act were displayed in an `easy-read' format on notice boards. Advocates visited the wards regularly. Advocates attended ward rounds and manager's hearings. Hospital managers requested advocates to be present at hearings where patients lacked capacity and were not represented by a solicitor.

Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to, and patients were able to request a SOAD by their responsible clinician. The Mental Health Act office reminded responsible clinicians of the need to contact a SOAD at least two weeks before their certification was required.

Managers and staff made sure the service applied the Mental Health Act correctly by completing audits and discussing the findings. The implementation of the policy was overseen by the Mental Health Act lead, a clinical director, a solicitor, responsible clinicians, nurses and social workers. The audit team conducted audits of specific matters relating to the Mental Health Act.

Mental Capacity Act

Staff supported patients to make decisions on their care for themselves. They understood the policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity.

Staff assessed and recorded capacity to consent clearly each time a patient needed to make an important decision. Staff had assessed all patients' capacity to consent to treatment and to be in hospital. Assessments of capacity were routinely updated at multidisciplinary ward rounds. For patients detained under the Mental Health Act, responsible clinicians had completed the appropriate statutory certificates authorising treatment. Second opinion appointed doctors authorised treatment when patients lacked capacity to consent.

Staff received and kept up-to-date with training in the Mental Capacity Act and had a good understanding of the five principles. Training on the Mental Capacity Act and Deprivation of Liberty Safeguards were incorporated into mandatory training on Mental Health Law.

Staff gave patients all possible support to make specific decisions for themselves before deciding a patient did not have the capacity to do so. Staff sought to encourage patients to make decisions for themselves whenever possible. For example, when staff were supporting a patient to get dressed, they would lay out different clothes and help the patient to choose.

Updated 4 February 2025

We completed an assessment and inspection of St Andrews Healthcare Northampton on 12 and 13 March 2025.

This assessment was carried out following the CQC's new approach to assessment; Single Assessment Framework (SAF). We inspected the long stay rehabilitation mental health wards for adults of working age. We looked at all quality statements under each key question. We carried out a mix of onsite and offsite inspection and assessment activity between 12 March 2025 and 22 April 2025. This was an unannounced assessment, which means the provider was not told an assessment was going to be starting beforehand.

St Andrews Healthcare is a registered charity specialising in the assessment, treatment and rehabilitation of people with psychiatric disorders, including people with developmental disabilities and behaviours of distress.

The long stay or rehabilitation mental health wards for working age adults ASG (assessment service group) is made up of 5 wards/lodges. We assessed Silverstone, Watkins House and 37 Berkeley Close. We also assessed Berkeley Lodge and Sitwell Ward. At the time of the inspection there were 24 patients at the service in long-stay or rehabilitation mental health wards for working age adults.

We rated the service as Requires Improvement as we identified 6 breaches of the Health and Social Care Act 2012 regulations. Staff did not always record capacity and consent in relation to the clinical treatment model and support level framework on Silverstone ward. The service did not ensure to keep the clinic room clean and tidy and assess the risks to people's health and safety for safe care and treatment. Staff did not always use the least restrictive interventions. We found there were also blanket restrictions applied to patients on all wards.

The service did not ensure to manage and mitigate maintenance risks on premises in a timely manner. Governance systems and audits were not effective in identifying or addressing areas for improvement. The service did not always ensure that staff had the necessary specialist skills to support patients' needs and implement the proposed clinical treatment models.

However, the rehabilitative model was evident and there was good multi-disciplinary input into it. Care records including risk management were detailed and up to date. Many staff were compassionate caring and skilled.

During this assessment and inspection, we found 6 breaches of regulations.

The provider did not always:

• Ensure to obtain and record capacity and consent for care and treatment on Silverstone Ward
• Ensure care and treatment was provided in a safe way and to adhere to infection prevention and control processes.
• Ensure patients are safeguarded from abuse and improper treatment such as the application of blanket restrictions
• Ensure premises and equipment including maintenance risks are recorded and mitigated within a timely manner.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure there were sufficient, suitably competent, and experienced staff trained to apply and provide care within the clinical treatment model and dialectical behavioural approach for service users accessing specialist rehabilitation services

We have asked the provider for an action plan in response to the concerns found at this assessment.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

• Staff had received training in the Mental Health Act with a compliance of 95% and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
• Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
• The provider had relevant policies and procedures that reflected the most recent guidance.
• Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
• Patients had easy access to information about independent mental health advocacy.
• There was a lack of information relating to the care of informal patients within the clinical treatment model and consent policies. The leave section of the clinical treatment model and support framework did not include guidance or information around rights of informal patients. Staff and patients did not have sufficient understanding of informal patient's rights and management of risks in relation to time away from the ward, as there was a serious incident reported where one patient accessed leave without it being agreed.
• Staff did not always ensure patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted due to lack of staff.
• Staff requested an opinion from a second opinion appointed doctor when necessary.
• Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly and so that they were available to all staff that needed access to them.
• The service displayed a notice to tell informal patients that they could leave the ward freely.
• Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits.

Mental Capacity Act

• Staff had had training in the Mental Capacity Act with a compliance of 95%.
• Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles, however not on Silverstone Ward.
• The provider had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff were aware of the policy and had access to it.
• Staff knew where to get advice from within the provider regarding the Mental Capacity Act, including deprivation of liberty safeguards.
• Staff took all practical steps to enable patients to make their own decisions
• For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions, however not on Silverstone Ward.
• The service had arrangements to monitor adherence to the Mental Capacity Act.
• Staff audited the application of the Mental Capacity Act and took action on any learning that resulted from it.

Updated 29 July 2025

St Andrew's Healthcare Northampton is an independent hospital for people with mental health needs, people with a learning disability and/or autistic people. This assessment looked at the wards for people with a learning disability and autistic people which we rated as requires improvement. When we have reported on St Andrew’s Northampton’s wards for people with a learning disability before, we have included our assessments of the forensic low and medium secure services for people with a learning disability and autistic people. For this assessment, we have changed our approach. Our findings about forensic low and medium secure services for people with a learning disability and autistic people are now included in the mental health forensic inpatient or secure wards assessment report. This assessment was a comprehensive unannounced assessment where we looked at all quality statements across the key questions.

The wards for people with a learning disability and autistic people assessment related to 3 services at St Andrew's Healthcare Northampton which provided individual bespoke services for people in hospital but not in forensic secure care. Each of these 3 wards provided care and treatment for one person. These services were Glendale, Billing Lodge and Lime Trees Cottage. This unannounced assessment took place from 11 to 13 March 2025. We visited Glendale and Billing Lodge. We have also used data about Lime Trees cottages to form our judgement. In this report, we may not give as much detail as we usually do. This is because the report relates to just 3 people that may be identifiable if we gave fuller details. As part of the wider inspection, we did some out-of-hour visits.

We have assessed the wards against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Right Support: People had complex needs and regular staff knew people well. However, people's care plans, positive behavioural support plans and risk assessments were not always clear and lacked the detail required to robustly guide staff on appropriate care and to help them to fully understand people’s distress. People were not always safeguarded from abuse. There were not enough suitably skilled staff to support people as staff had not received appropriate training to interact with people.

Right Care: People did not always receive person-centred care that promoted their dignity, privacy and human rights. Most staff were kind and caring but people reported that they were not always treated with respect and dignity, especially by staff who didn’t regularly work on the wards. People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible as staff had not looked at appropriate safeguards when caring for people away from others. Staff communicated with people in ways that met their needs.

Right Culture: Governance arrangements were not as effective or reliable as they should be. Some quality audits were in place; however, managers had not always ensured that the audits were relevant or specific to these wards. Managers recognised that improvements were needed (including the need for better, autism-informed care plans) but actions identified had not been followed through, and sustainability was not embedded into the service.

During this inspection we found regulatory breaches in regulations relating to person-centred care, safeguarding, safe care and treatment, good governance and staffing. We have asked the provider for an action plan in response to the concerns found at this assessment.

Updated 11 November 2024

The child and adolescent mental health service (CAMHS) at St Andrews hospital Northampton, has significantly reduced over time. The hospital has 2 CAMHS wards, but only one in use currently, which is Seacole ward. Stowe ward was closed at the time of assessment.

This onsite assessment of the CAMHS was undertaken on 27 November 2024. The off-site assessment concluded on 17 January 2024.

The assessment was prompted in part by notification of an incident to the CQC and feedback received from external agencies, including concerns about the menagement of risk. This assessment examined those risks.

The assessment examined 5 quality statements across 2 key questions; safe and well led. We found breaches of the regulations in relation to staffing. An action plan has been requested from the provider to address this.