31.08.16
Stafford children’s mental health hospital placed in special measures
The CQC has rated Huntercombe Hospital in Stafford as inadequate in all areas – for providing safe, effective, caring, responsive and well-led services.
Huntercombe provides mental health inpatient services for up to 39 patients aged eight to 18.
The CQC last inspected the hospital in 2014, when it found it was failing standards around environmental safety but otherwise raised no concerns.
It launched unannounced inspections on 29 and 30 April and 3 May 2016 after a member of staff blew the whistle.
Dr Paul Lelliott, CQC’s deputy chief inspector for hospitals and lead for mental health, said: “We were concerned that the safety of young people using the service was compromised due to insufficient staffing levels, restrictive interventions, poor physical health monitoring and a poorly trained and supervised workforce.”
The CQC found that staffing levels for registered nurses did not meet the local minimum standard for a majority of night shifts on Wedgewood and Hartley wards and a quarter of day shifts, and that staff often used restraint as a first instead of a last resort.
The CQC inspectors said that patients showed them bruises on their arms which were caused by staff’s use of restraint.
They said that after they were restrained, they did not receive medical attention and there was no follow-up to explore why the incident had happened. They also said they did not have enough activities and were stopped when they tried to organise them.
Patients said because of lack of staffing they could not always go out or access their care plans, appointments with consultants were infrequent and as little as 10 minutes long, and patients had smuggled in contraband items such as mobile phones and razor blades without being discovered.
Young people also told the CQC inspectors that they saw unfamiliar agency staff on the wards who made them feel uncomfortable and reported “inappropriate behaviour” from staff.
One patient reported having called Childline from inside the hospital. Carers for patients reported “punitive” behaviour from staff and “restrictions” on visits to wards.
The CQC said that there was no consistent system for maintaining safe access to the site and no safeguarding system for abuse allegations.
It also found that the hospital’s multi-disciplinary team was “not supporting the psychological needs of young people”.
Staff did not receive regular clinical supervision or annual appraisals or specialist training to support decisions such as naso-gastric tube feeding. They used the wrong legal framework to assess the ability of patients under 16 to make a decision, and were not aware of safeguards on physical interventions in the 2016 Mental Health Code of Practice.
The report also said that morale among staff was very low, and concerns raised by staff had not led to action by the management teams.
A spokesperson for the Huntercombe Group, which operates the hospital, said: “We have been carrying out an improvement programme at The Huntercombe Hospital Stafford, over the past few months, to address the requirements of the CQC inspection report from their visit in May.
“For a short period of time, we stopped taking new admissions but as a result of rapid improvements that were made, it was agreed that the hospital should accept new admissions, on a phased basis five weeks later. A further CQC inspection took place in June and although we are awaiting the written report, the inspectors’ verbal feedback acknowledged that improvements had been made and that the hospital had addressed the concerns raised in the warning notice.
“We deeply regret that some aspects of the service had fallen below the high standards that we are committed to provide. We are confident that the centre has been turned around by the strengthened management team and it has made good progress towards in returning to the standards that we expect of it.”
The CQC will now inspect the hospital again in six months, with the potential to remove the Huntercombe Group’s ability to operate the hospital or cancel its registration if it does not see improvements.
There have been widespread concerns raised recently about the quality of children and young people’s mental health services, with 28% of patients being turned away from services and delays of 10 years before they received treatment.
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