Steps must be taken to ensure that mental health services at Ysbyty Gwynedd meet the requirements of the local population, according to inspectors.

A recent surprise inspection at the hospital’s Hergest unit has generally praised staff for their levels of care, but has also recommended improvements in medicine management and arrangements for maintaining a safe and secure environment.

According to the Betsi Cadwaladr University Health Board, several of the recommendations have already been implemented since September’s inspection.

Among the concerns raised by Healthcare Inspectorate Wales was a lack of trained staff to facilitate gym sessions and that the strain of capacity demands meant that older dementia sufferers were being admitted to acute care admission wards, which impacted on their dignity of care for patients.

Inspectors also found that one toilet had no screen nor door and that full occupancy was a regular occurrence at the unit, with a number of patient records also described as “disorganised” with some information filled out incorrectly or not at all.

Despite reporting a high level of Restrictive Physical Intervention (RPI) training among the regular workforce, this was not always the case with bank staff, with inspectors also informed of one instance where a ward had been provided with sandwiches past their best before date.

The quality of leadership was generally praised, however, with the report outlining “clear management and leadership” with “a committed staff team who spoke of improved staff morale”.

The HIW report said: “We observed, and patients we spoke to confirmed, that on the whole staff interacted and engaged with patients appropriately and treated patients with dignity and respect.

“There are capacity pressures within the health board’s mental health provision that can restrict patients receiving the most appropriate care to meet their needs.

“The health board must review its model of care and in-patient capacity to ensure it meets the needs of its population in a timely manner.”

In response, Sam Watson, the health board’s head of mental health services in North West Wales, said: “We are pleased that Healthcare Inspectorate Wales found that patients were complimentary about the care they had received, and that the commitment of our staff to deliver safe and dignified care was noted.

“The findings reflect a number of significant improvements which have been made at the Hergest Unit since previous inspections in 2014 and 2016.

“There are still areas for improvement and we’ve put in place a comprehensive plan of action to address these. Many of Healthcare Inspectorate Wales’ recommendations have already been implemented.

“We continue to face a number of challenges to meet the needs of our population in an appropriate and timely way.

“Through our ambitious four year mental health strategy we are working with our partners to address these challenges by developing local alternatives to hospital admission, including crisis cafes and step down services.”