Cheswold Park Hospital

Updated 15 December 2023

Cheswold Park Hospital is a purpose-built hospital in Doncaster. Riverside Healthcare Limited is the provider. The hospital is an independent mental health hospital that provides 9 low and medium secure accommodation for male and female patients over 18, with mental disorder, learning disabilities and autism spectrum disorder with an offending background, who require assessment treatment and rehabilitation within a secure environment. At the time of our inspection there were 86 patients at the hospital.

The hospital is registered with the Care Quality Commission to provide the following regulated activities:

• Treatment of disease, disorder, or injury
• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Diagnostic and screening procedures.

The hospital did not have a registered manager at the time of inspection. The provider was served a fixed penalty notice for failing to ensure this registration requirement was met. Following the inspection, a registered manager was appointed in October 2023. The registered manager, along with the registered provider, is legally responsible and accountable for compliance with the requirements of the Health and Social Care Act 2008 and associated regulations. The hospital had a controlled drugs accountable officer on site. Controlled drugs accountable officers are responsible for all aspects of controlled drugs management within their organisation.

The hospital has 3 medium secure wards and 6 low secure wards:

• Esk is a 12-bed low secure male ward.
• Aire is a 12-bed low secure male acute admissions ward.
• Foss is a 12-bed low secure male pre-discharge ward.
• Calder is a 16-bed low secure male personality disorder ward.
• Wentbridge is a 7-bed low secure ward for males with a diagnosis of autism.
• Hamilton is a 12-bed medium secure pre-stepdown male ward.
• Brook is a 16-bed medium secure male ward.
• Bronte is a 12-bed medium secure female ward.
• Don is a 12-bed low secure ward for males with a personality disorder.

We last inspected the hospital in July 2021. We rated this service as ‘requires improvement’ overall with ratings of ‘good’ in the caring and responsive key questions and ‘requires improvement’ in the safe, effective, and well led key questions. The hospital was in breach of the following regulation:

• Regulation 18 Health and social Care Act 2008 Staffing

We also suggested some actions which the provider could take to improve the service, including ensuring all incidents were reported consistently, that all clinic rooms and equipment were organised, and that systems in relation to staffing and supervision were monitored to ensure effectiveness.

What people who use the service say

We spoke to 34 patients across the hospital. Most patients told us that most permanent staff on the wards were doing a great job in a difficult situation due to the lack of staff available, however, they did not always feel safe on the wards and that they did not make complaints as previous concerns were not listened to or acted upon when they had been referred to senior management. Patients across the hospital told us their ward was overly restrictive for the security designation it had been given and a significant reduction on access to external leave had a negative impact on their care pathway. Patients also told us that staff did not always treat them with respect, as some staff made fun of them, did not always knock before entering their bedrooms and bathrooms, and they could also be vindictive and act inappropriately towards patients. Patients were unhappy they had not been involved in the provider’s new policy on leave or the upcoming ban on electronic cigarettes throughout the service.

Patients told us that when our inspection team were on site there were more staff on the wards and the food provided was better than usual.

Updated 15 December 2023

Our rating of this location went down. We rated it as inadequate because:

• The service did not provide safe care. The wards did not have enough nurses and support staff. Staff did not assess and manage risk well or manage medicines safely or follow good practice with respect to safeguarding.
• The service placed people at risk of harm by not ensuring that all staff were up to date on their physical intervention training, intermediate life support training and basic life support training.
• Staff did not develop holistic, recovery-oriented care plans informed by a comprehensive assessment. Care plans, risk assessments and positive behaviour plans were not updated including after any incident. The electronic records system was not fit for purpose.
• Managers did not ensure that all patients had suitable access to Section 17 leave or activities on and off the ward. Patients were restricted to the ward for extended periods of time.
• Managers did not ensure that staff had received appropriate training, supervision, or appraisal. Staff and patients did not receive appropriate debriefs following incidents.
• Not all staff understood or discharged their roles and responsibilities under the Mental Health Act 1983 or the Mental Capacity Act 2005. The service did not appropriately audit the use of the Mental Capacity Act 2005.
• Staff did not always treat patients with compassion and kindness, respect their privacy and dignity, or understand the individual needs of patients. They did not actively involve patients and families and carers in care decisions.
• The service was not well led, and the governance processes did not ensure that ward procedures ran smoothly.

Letter from the Chief Inspector of Hospitals, Dr Sean O’Kelly:

"I am placing the service into special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration."

Updated 15 December 2023

Our rating of this service went down. We rated it as inadequate.

See the summary above for details.