The child and adolescent mental health wards were rated Inadequate overall and for safe, responsive and well-led services, and Requires Improvement for caring and effective services. The concerns primarily focused on West Lane Hospital, it was not delivering safe care. There were substantial and frequent staff shortages and staff did not adequately assess, monitor or manage risks to patients. When patients demonstrated higher levels of risk, staff did not follow processes and procedures to mitigate these through appropriate observation and engagement.