St Andrews Healthcare Northampton

Ratings - Wards for people with learning disabilities or autism

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Requires improvement

• Responsive

  Requires improvement

• Well-led

  Requires improvement

Our view of the service

St Andrew's Healthcare Northampton is an independent hospital for people with mental health needs, people with a learning disability and/or autistic people. This assessment looked at the wards for people with a learning disability and autistic people which we rated as requires improvement. When we have reported on St Andrew’s Northampton’s wards for people with a learning disability before, we have included our assessments of the forensic low and medium secure services for people with a learning disability and autistic people. For this assessment, we have changed our approach. Our findings about forensic low and medium secure services for people with a learning disability and autistic people are now included in the mental health forensic inpatient or secure wards assessment report. This assessment was a comprehensive unannounced assessment where we looked at all quality statements across the key questions.

The wards for people with a learning disability and autistic people assessment related to 3 services at St Andrew's Healthcare Northampton which provided individual bespoke services for people in hospital but not in forensic secure care. Each of these 3 wards provided care and treatment for one person. These services were Glendale, Billing Lodge and Lime Trees Cottage. This unannounced assessment took place from 11 to 13 March 2025. We visited Glendale and Billing Lodge. We have also used data about Lime Trees cottages to form our judgement. In this report, we may not give as much detail as we usually do. This is because the report relates to just 3 people that may be identifiable if we gave fuller details. As part of the wider inspection, we did some out-of-hour visits.

We have assessed the wards against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Right Support: People had complex needs and regular staff knew people well. However, people's care plans, positive behavioural support plans and risk assessments were not always clear and lacked the detail required to robustly guide staff on appropriate care and to help them to fully understand people’s distress. People were not always safeguarded from abuse. There were not enough suitably skilled staff to support people as staff had not received appropriate training to interact with people.

Right Care: People did not always receive person-centred care that promoted their dignity, privacy and human rights. Most staff were kind and caring but people reported that they were not always treated with respect and dignity, especially by staff who didn’t regularly work on the wards. People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible as staff had not looked at appropriate safeguards when caring for people away from others. Staff communicated with people in ways that met their needs.

Right Culture: Governance arrangements were not as effective or reliable as they should be. Some quality audits were in place; however, managers had not always ensured that the audits were relevant or specific to these wards. Managers recognised that improvements were needed (including the need for better, autism-informed care plans) but actions identified had not been followed through, and sustainability was not embedded into the service.

During this inspection we found regulatory breaches in regulations relating to person-centred care, safeguarding, safe care and treatment, good governance and staffing. We have asked the provider for an action plan in response to the concerns found at this assessment.

People's experience of this service

People were not very positive about their care and progress at St Andrew’s Hospital. 

One person commented on the environment stating ’This place is a shithole, the environment here is shit and old.‘

People reported a small number of incidents where they alleged physical abuse or inappropriate restraint by staff. One person felt staff had moved their belongings deliberately and this caused them distress. Ward staff were already aware of these incidents and told us they were being looked into. However not all these incidents were included on the hospital's systems to provide assurance that senior leaders were aware of all safeguarding incidents or complaints.

People felt there was not enough activities and staff did not fully engage with them other than observe them. People reported that some staff were nice but they were regularly cared for by staff that did not know them well. One person was complimentary about the care they received from the doctor.

People did not understand why they were subject to so many restrictions and why they did not have access to some of their belongings.