Patients at the older adult mental health care ward at Bronglais Hospital are “cared for in a compassionate and supportive environment” but “significant gaps” were found in safety-critical training which “present a potential risk to patient and staff safety”, inspectors have found.

Healthcare Inspectorate Wales visited Enlli Ward at Bronglais hospital in Aberystwyth over three days in June.

A report released last week inspectors found that “patients on Enlli Ward were cared for in a compassionate and supportive environment, where staff treated patients with kindness, dignity, and respect.”

However, inspectors said that they found “significant gaps in compliance with safety-critical training, including Physical Intervention, Immediate Life Support (ILS), and Basic Life Support (BLS)”, which “present a potential risk to patient and staff safety.”

“Similar concerns have been raised by HIW during previous inspections within the health board,” the report said.

“While actions have been taken to improve training compliance, the findings from this inspection demonstrate that the required level of sustained improvement has not been achieved,” inspectors said.

“This raised concerns that learning from previous inspections has not been fully embedded and that governance arrangements have not been sufficiently effective in securing compliance with mandatory and safety-critical training requirements.”

Inspectors also found “gaps in temperature monitoring records for the medicines fridge and clinical room, along with a small number of missed checks of emergency equipment, including the resuscitation bag.”

“In addition, some gaps were identified in observation records, indicating that documentation was not always completed consistently,” inspectors found.

“While staff advised that observations were taking place, incomplete recording reduced assurance that patient monitoring requirements were fully evidenced.

“We also identified weaknesses in medicines governance, including, temperature monitoring, and the availability of consent to treatment documentation.”

Despite the concerns identified, the report praised the care from staff towards patients.

“Patients spoke positively about their care and described staff as attentive, responsive, and aware of their emotional needs,” the report said.

“There was strong evidence of person-centred care in practice, with patients supported to engage in a range of meaningful activities and maintain independence wherever possible.”

The ward “provided a clean and well-maintained environment, with access to therapeutic spaces, including outdoor areas, and activities designed to support patients’ wellbeing,” inspectors found.

Inspectors also found that patients on Enlli Ward “received care within a generally safe and well-maintained environment, supported by established systems for risk management, safeguarding, and oversight of care.”

“The ward was clean, organised, and fit for purpose, and staff demonstrated a good understanding of patient needs, risk management processes, and safeguarding responsibilities,” a report said.

The reported concluded: “Overall, while systems were in place to support the delivery of safe and effective care, improvements are required to strengthen monitoring processes, governance arrangements, and compliance with safety-critical training requirements.”

Inspectors said Hywel Dda University Health Board “must ensure that governance arrangements are strengthened, including keeping policies up to date and ensuring consistent delivery of staff supervision.”

An improvement plan will be put in place and published on the HIW website.