Kneesworth House

Updated 15 December 2025

We assessed Kneesworth Hospital on 12-14 August 2025.

We assessed the service due to emerging risk. The service was last inspected in September 2021 as a focused inspection.

At this assessment we assessed 3 assessment service groups; Long stay or rehabilitation mental health wards for working age adults, Forensic inpatient or secure wards and Acute wards for adults of working age and psychiatric intensive care units. We assessed 33 quality statements in each assessment service group.

We rated the service as good.

Updated 17 June 2025

The assessment of acute wards for adults of working age and psychiatric intensive care units took place on 12 August to 14 August 2025. This assessment service group was made up of 1 psychiatric intensive care unit (PICU) and 2 acute wards. The PICU ward was called Wimpole and admitted female patients. It had capacity for up to 10 patients and had 6 patients admitted at the time of the inspection. One of the acute wards was called Bourn. Male and female patients were admitted to Bourn with a split of 10 females and 5 males, giving the ward capacity for 15 patients. The ward was full at the time of the inspection. The other acute ward was called Nightingale and admitted male patients. It had capacity for 14 patients. The ward was full at the time of the inspection.

We rated the service as good. The service had made improvements and is no longer in breach of regulations. Staff now ensured that patients’ access to bedrooms, mobile phone chargers and outdoor space were only restricted where this was required through individual risk assessment. Staff now ensured patients were secluded in line with the Mental Health Act Code of Practice and the provider’s policy. Staff now ensured essential learning and information was passed between the hospital’s senior management team and the ward managers and this was shared with all staff and recorded appropriately.

Mental Health Act and Mental Capacity Act Compliance Summary

The service admitted patients under the Mental Health Act 1983. Staff received and kept up-to-date with training on the Mental Health Act and the Mental Health Act Code of Practice and could describe the Code of Practice guiding principles. Training on the Mental Health Act was mandatory for staff and the compliance rate was 94.7%.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff received assistance from designated Mental Health Act staff, based at the hospital.

The service had clear, accessible, relevant and up-to-date policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice. For example, there was a process in place to monitor patient’s legal status and renewal dates, which meant staff were able to ensure reviews took place in a timely manner.

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 record each time. Discussions in patients’ ward rounds included information about the right to appeal against detention.

Staff made sure patients could take section 17 leave (permission to leave the ward or hospital) when this was agreed with the responsible clinician and ministry of justice where applicable. The use of leave from the ward was agreed by the multidisciplinary team. Arrangements for leave were made at daily planning meetings and nurses carried out an assessment of each patient’s mental state before each occasion of leave was utilised.

Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to.

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

Mental Capacity Act

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 was mandatory for staff and compliance figures across the hospital were 95.5%. Training on the Mental Capacity Act was provided as part of the induction process.

Staff assessed and recorded capacity to consent clearly each time staff had reason to doubt whether a patient had capacity to make a particular decision. Staff completed an assessment of each patient’s capacity to consent to admission and treatment on admission. Further assessments took place during reviews by the multidisciplinary team.

Updated 17 June 2025

The assessment of forensic inpatient or secure wards took place on 12 August to 14 August 2025. This assessment service group was made up of 2 medium secure wards and 1 low secure ward.

Clopton ward was a medium secure ward admitting male patients. It had capacity for 12 patients; the ward was at full occupancy at the time of the inspection.

Ermine ward was a medium secure ward admitting male patients. It had capacity for 18 patients and had 16 patients admitted at the time of inspection.

Orwell ward was a low secure ward, admitting male patients. It had capacity for 16 patients and had 10 patients admitted at the time of inspection.

We rated the service as good. The service had made improvements and is no longer in breach of regulation. Staff now ensure patients were secluded in the right environment and seclusion was recorded in line with the Mental Health Act Code of Practice and the provider’s policy.

Mental Health Act and Mental Capacity Act Compliance Summary

The service admitted patients under the Mental Health Act 1983. Staff received and kept up to date with training on the Mental Health Act and the Mental Health Act Code of Practice and could describe the Code of Practice guiding principles. Training on the Mental Health Act was mandatory for staff, and the compliance rate was 94.7%.

Staff had access to support and advice on implementing the Mental Health Act and its Code of Practice. Staff received assistance from designated Mental Health Act staff, based at the hospital.

The service had clear, accessible, relevant and up-to-date policies and procedures that reflected all relevant legislation and the Mental Health Act Code of Practice. For example, there was a process in place to monitor patient’s legal status and renewal dates, which meant staff were able to ensure reviews took place in a timely manner.

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 record each time. Discussions in patients’ ward rounds included information about the right to appeal against detention.

Staff made sure patients could take section 17 leave (permission to leave the ward or hospital) when this was agreed with the responsible clinician and ministry of justice where applicable. The use of leave from the ward was agreed by the multidisciplinary team. Arrangements for leave were made at daily planning meetings and nurses carried out an assessment of each patient’s mental state before each occasion of leave was utilised.

Staff requested an opinion from a Second Opinion Appointed Doctor (SOAD) when they needed to.

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

Mental Capacity Act

Staff received and kept up to date with training in the Mental Capacity Act. Staff had a good understanding of the Mental Capacity Act. The training was initially provided as part of the induction process and thereafter staff had regular refreshers.

Staff assessed and recorded capacity to consent clearly each time a person needed to make an important decision. Staff took all practical steps to enable people to make their own decisions. Staff completed an assessment on admission of each person’s capacity to consent to admission and treatment. Further assessments took place during reviews by the multidisciplinary team.

Staff knew where to get advice regarding the Mental Capacity Act, including deprivation of liberty safeguards.

Updated 17 June 2025

The assessment of long stay or rehabilitation mental health wards for working age adults took place on 12 August to 14 August 2025. This assessment service group was made up of 1 rehabilitation ward called Wortham and 4 rehabilitation bungalows Pelican, Herron, Falcon and Phoenix wards. Autistic people and people with learning disabilities lived in some of the bungalows, so we assessed the service against ‘Right support, right care, right culture’ guidance. This supports us 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.

Wortham ward had a capacity of 17 patients and had 11 male patients on the ward at the time of inspection. Each of the bungalows had 1 patient, all patients were male.

We rated the service as good. The service had made improvements and is no longer in breach of regulations. All emergency equipment was properly stored, and easily accessible and all staff knew where to locate it.

Mental Health Act and Mental Capacity Act Compliance Summary

Ninety five percent of staff had received training in the Mental Health Act

Staff were trained 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 their Mental Health Act administrators.

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.

Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.

Staff ensured patients took their Section 17 leave (permission for patients to leave hospital) when this has 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 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.

Care plans referred to identified Section 117 aftercare services to be provided for those who had been subject to section 3 or equivalent Part 3 powers authorising admission to hospital for treatment.

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. Training compliance figures across the hospital were 95.5%.

Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles.
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 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. 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.