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Older people’s Kent ward needs ‘urgent’ improvement

A team of CQC inspectors issued two warning notices to Kent & Medway NHS and Social Care Partnership Trust after identifying ‘urgent’ problems with the older persons’ continuing care ward.

Joined by a specialist team of doctors, nurses, managers and experts, CQC examiners demanded that the trust make immediate improvements in the ward at Littlestone Lodge at Dartford.

They said the trust had been failing to assess and monitor the service or look after the welfare and safety needs of patients.

Inspectors identified ‘poor practice and unsafe care’ including unsafe and covert administration of medicine. People in care were not being effectively assessed and their physical health, mobility needs and pain management were not catered for.

All patients were wearing incontinence pads despite not necessarily requiring one.

Experts present also required that staff made immediate improvements to address the physical health needs of two patients.

They later returned for a second check and determined that they had made enough improvements to the service to meet the warning notice requirements.

Dr Paul Lelliott, CQC’s deputy chief inspector of hospitals and lead for mental health, said: “We were particularly concerned about what we found at Littlestone Lodge. We believe that the managers of the trust should have taken more decisive action sooner to tackle the problems.”

Addressing the remaining wards of the trust, which was found to require overall improvement, he said: “Some of the care environments were not safe enough. We found seclusion rooms that were too small, and designated health-based places of safety that were not fit for the purpose for which they were being used.

“Bed occupancy levels of the wards that admitted people of working age who have mental health problems were very high. There were delays in finding beds in a psychiatric intensive care unit for patients who needed that level of care. There had been at least three occasions where patients were nursed in the section 136 suite or in a quiet room, with one patient having to sleep on a beanbag because no bed was available.”

He added that the dignity and privacy of patients were not always respected as they infringed same-sex accommodation guidance, especially in acute inpatient, rehabilitation and older people’s wards.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. We will return in due course to check that the improvements that we have identified have been made,” he said.

Despite several areas requiring improvement the trust still received ‘outstanding’ ratings for its psychology department, ‘carer support worker’ service and transitional living ward, amongst others.

Angela McNab, chief executive of the trust, said: “Safety, dignity and nothing less than excellent patient care is what motivates us. As the CQC recognised in very many areas we are ‘good’ and ‘outstanding’, so we have the skillsets. The report is important in making sure we apply those standards across the board. That is why we have either already addressed or are in the process of addressing with our partners the issues raised.”

She added that the areas requiring improvement were already in the trust’s plans at the time of the inspection and they have now “moved with speed to accelerate change”.