We inspected Whorlton Hall due to concerns raised by the Panorama programme into alleged abuse of patients at this hospital.
We have taken enforcement action against the registered provider in relation to our concerns about this location. This limits our rating of safe, effective and well-led to inadequate, and the rating overall for Whorlton Hall to inadequate.
At the time of inspection, there was an ongoing police investigation which meant we were not able to review all documentation, or speak to patients, so whilst we inspected these domains, we were unable to rate the caring and responsive.
- The service did not have effective systems in place for ensuring that staff adhered to the provider’s policies and procedures. This included adherence to safe practice in administering ‘as required medication’ and monitoring patients after rapid tranquilisation, keeping records that demonstrated that staff were suitable to work at the hospital and undertaking the daily environmental risk checks.
- Staff used physical restraint on 1348 occasions in the year leading up to the inspection. They also used rapid tranquilisation on three occasions. The Resuscitation Council (UK) recommends that staff using restraint or rapid tranquilisation should receive training in immediate life support as a minimum standard. Staff at Whorlton hall had not received this training.
- The provider’s restrictive interventions reduction programme had not been effective. Staff continued to use physical restraint frequently and the number of times it was used had increased.
- Staff did not follow best practice with respect to mental capacity and best interests. Rather than undertake mental capacity assessments on a decision-specific basis, staff made over-arching assessments which covered a number of different areas. Staff made decisions in patients’ best interests for patients assessed as lacking capacity. However, a number of the best interest documents failed to record how the patient, family, carer or advocate had been involved in the best interest decision making process.
- We found a number of instances where staff were not following the care plan. These included decisions about the gender of staff carrying out observations on patients and the importance of using Makaton and other communication aids.
- Recruitment procedures established to ensure staff employed in the service were of good character or had the necessary qualifications, competence, skills and experience required to carry out their role were not operated effectively.
- Care plans were personalised, holistic and recovery orientated.
- Staff ensured that patients had access to physical health care services.
- There was access to a well-equipped activity hub at the hospital which enabled a range of educational and social activities to be facilitated.