Updated 11 October 2019
Castle Lodge independent hospital is a specialist independent mental health service based in Kingston- Upon-Hull. It is part of the Barchester hospital and complex care services division. Providing services for men with an organic diagnosis, a type of illness usually caused by disease affecting the brain, and women with a functional diagnosis, a type of illness that has a mainly psychological cause, on an informal and a detained basis. The hospital accommodates up to 15 patients.
The hospital is registered with the Care Quality Commission to carry out two regulated activities:
• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder or injury
At the time of our inspection, there was a registered manager who was also the controlled drugs accountable officer for the hospital in post.
The Care Quality Commission has inspected Castle Lodge independent hospital seven times; the last inspection was an unannounced follow up inspection that took place in January 2017.
At the last inspection, we rated the hospital overall as ‘good’. We rated the service as ‘requires improvement’ for Safe, ‘good’ for Effective, ‘good’ for Caring, ‘good’ for Responsive and ‘good’ for Well-led.
Following that inspection, we told the provider that it must take the following actions to improve Castle Lodge Independent Hospital:
- The provider must ensure safe systems in the management of medicines.
- All staff involved in dispensing medication must be familiar with and work to hospital protocols. Pharmacy systems must be robust, and the provider must ensure that medication audits are effective with learning from these shared.
- Hospital staff must ensure the correct quantities of all medications are available, so each patient has sufficient to meet their needs.
- The provider must ensure that the administration of covert medication is only agreed following consultation with a pharmacist and regularly reviewed in multidisciplinary team meetings.
- The provider must ensure that medicines for disposal are appropriately stored and disposed of in a timely way.
- New medication and device safety alerts must be cascaded to nursing staff in a timely manner.
We also told the provider that it should take the following actions to improve Castle Lodge Independent Hospital:
- The provider should ensure enough qualified, competent and skilled staff to meet the needs of the patients. This includes sufficient qualified nurses on duty to complete the professional oversight required, a consultant psychiatrist is able to attend the hospital in the event of a psychiatric emergency within 30 minutes and gaps in the appointment of key staff are kept to a minimum.
- The provider should ensure that following assessment of a patient’s capacity to consent the documentation available to record this is fully completed and that the opinions of a patient’s family or advocate are recorded in best interest meeting notes within patient files.
- The provider should ensure that patients maintain as much independence as is possible. This includes having everything they need to participate fully in an activity, for example reading glasses, to be able to access all areas of the ward and gardens independently and when possible being able to make their own drinks and snacks.
- The provider should ensure that dirty linen trollies remain stored away from patient areas.
We issued the provider with one requirement notice, this related to:
Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
The provider submitted an action statement setting out the steps they would take to meet the legal requirements of the regulations. We reviewed the requirement notices at this inspection and found that the hospital had addressed the actions agreed in relation to the breach and the should.