A private mental health hospital in Greater Manchester has made enough improvements to be taken out of the special measures regime for failing healthcare organisations, the regulator has said.
Arbour Lodge Independent Hospital in Stockport was previously deemed “inadequate” following an inspection by the Care Quality Commission in July 2016.
“Importantly there have been improvements in patient safety. A new manager and governance structure have helped to address staffing concerns”
Inspectors found the hospital was short of staff, which meant observations were failing to be carried out safely and that patients were not cared for properly at the 13-bed unit for older men.
They also witnessed unsafe moving and handling practice during this inspection, which put patients at risk of harm.
Among the other problems at the hospital, run by Barchester Healthcare Homes Limited, were medicines being given without legal authority or safe monitoring, and poor medicines management by nurses.
But at its latest visit to the hospital in March 2017, the CQC found a series of “substantial” changes had been made, including staffing improvements.
Staffing levels had been reviewed since the last inspection and a new process had been introduced for prescribing and reviewing observations, said the CQC in its latest report on the hospital.
In the day there were five support workers and one nurse, while at night there was one nurse with two support workers, to care for the nine patients currently living at the hospital.
A regular agency nurse was contracted to cover night shifts while other temporary staff familiar to patients were used to cover up to two shifts a week.
“An agency staff checklist had recently been introduced to ensure staff were aware of medication, moving and handling, care plans”
CQC report on Arbour Lodge
“An agency staff checklist had recently been introduced to ensure staff were aware of medication, moving and handling, care plans and emergency procedures,” noted the report.
Meanwhile, the hospital had vacancies for three full-time nurses, the same number for support workers and was also looking to recruit an occupational therapy assistant and Mental Health Act administrator
In addition, nurses had completed medicines competency assessments in the last 12 months, while over 70% of all staff had received additional training on rapid tranquillisation.
”There was effective medicines management practice, in terms of regular stock checks of medicines and clinic room audits. The hospital had arrangements with the GP and local chemist for prescribing and supplying medicines,” said the CQC.
Contrary to the previous visit, inspectors said they also observed safe moving and handling practice, “including staff intervening when an agency nurse attempted to move an individual unsafely”.
“There is still work to be done, and we have made it clear to Arbour Lodge Independent Hospital where they must improve further”
The organisation has now been assessed as “requires improvement”. The CQC said further changes were needed to ensure staff were not allocated to carry out observations for longer than two hours – as per the hospital’s policy – and to improve care planning so that more details and guidance were recorded.
Nicholas Smith, the CQC’s head of mental health inspections for the North West, said it was clear from the latest inspection that staff had worked hard to make improvements.
“Importantly there have been improvements in patient safety. A new manager and governance structure have helped to address the staffing concerns we had, and services are much more responsive to the needs of people using them,” he said.
“There is still work to be done, and we have made it clear to Arbour Lodge Independent Hospital where they must improve further,” he added.
A spokeswoman for Arbour Lodge reiterated the hospital had made “significant improvements” since the inspection in July 2016.
”We are glad to see that this has been reflected in the latest inspection report in which the service was rated as ‘good’ under [the] ‘caring’ and ’well-led’ [assessments],” she said.
”We take the findings of the Care Quality Commission seriously and we have implemented a comprehensive plan clearly outlining the steps being taken to ensure these improvements in our services continue to be achieved.
”Extra training for staff is being provided to address issues raised in the report, and we would like to reassure everyone of our commitment to providing the highest quality of care to those residing at Arbour Lodge Independent Hospital,” she added.