An independent children’s mental health hospital has been placed in “special measures”, after an inspection sparked by a whistleblower found safety concerns including staff shortages and overuse of restraint on patients.
Care Quality Commission inspectors visited Huntercombe Hospital in Stafford after a member of staff raised “serious concerns” about patient safety.
“We were concerned that the safety of young people using the service was compromised”
Following a series of day and night inspections in April and May, the CQC rated the hospital overall “inadequate” and announced today that it had been placed in the special measures regime for struggling healthcare providers.
The hospital, run by the Huntercombe Group, was judged inadequate in all five categories assessed by the CQC: safe, effective, caring, responsive, and well led.
The 39-bed hospital runs a psychiatric intensive care unit, children and adolescent mental health acute assessment unit and a specialist eating disorders service for children aged eight to 18.
The CQC inspection report, which was published today, found:
- Patients felt staff overused restraint as a first rather than last response, and showed inspectors bruising on their arms
- Staff shortages meant wards were not operating with minimum staffing levels, with some ward shifts run with just one qualified nurse
- Medication was not always securely stored
- Personal searches failed to stop patients from obtaining banned items they could self-harm with
- The multidisciplinary team was not meeting the needs of young patients
- Patients said staff were uncaring and carers described their behaviour as “punitive”
- Governance systems were not operating with sufficient authority to be effective
The hospital provides child and adolescent mental health services (CAMHS) services and takes children and young people detained under the mental health act, as part of NHS England’s specialised mental health services.
Following the inspections, the CQC served the hospital with a warning notice to urgently improve. The report outlines 24 areas where the hospital must improve, and five areas it should improve on before inspectors return in six months.
If the hospital fails to improve the CQC could take enforcement action including closing part or all of its services. The site, which is the fourth independent mental health hospital to be put in special measures in England, has been told to ensure:
- Staffing levels are sufficient
- Mandatory staff training levels are reached
- Care plans and risk assessments are completed and regularly reviewed
- Management of aggression and use of restrictive practices are in line with the “least restrictive” principle and subject to a reduction strategy
The CQC’s deputy chief inspector of hospitals, Paul Lelliott, said that despite the Huntercombe Group’s executive team being aware of safety concerns it did not address them in time.
He added: “We found a number of serious problems when we inspected the services run by Huntercombe Hospital, Stafford, and have subsequently placed the service into special measures.
“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,” he said.
“Staff often used physical restraint as a first, rather than last, response to a patient’s distress,” said Mr Lelliott.
Dr Paul Lelliott
“Despite being aware of the safety concerns at the hospital, the executive team within the wider Huntercombe Group did not act or respond at the pace required to address the issues in a timely or decisive manner,” he said.
A spokesman for Huntercombe Group said an improvement programme had been in place at the hospital for the past few months to address the CQC’s concerns, and that “rapid improvements” had resulted.
He said: “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,” he said.
He added: “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 [hospital] has been turned around by the strengthened management team and it has made good progress towards returning to the standards we expect of it.”
The Huntercombe Group is a division of Four Seasons Health Care, one of the UK’s largest independent care providers. It runs six CAMHS hospitals in total along with a range of other services around the country.