Antelope House

Updated 16 April 2019

Southern Health NHS Foundation Trust provides acute mental health care inpatient units for adults of working age from four sites, Antelope House (in Southampton), Elmleigh (in Havant), Melbury Lodge (in Winchester), and Parklands Hospital (In Basingstoke). It also provides psychiatric intensive care (PICU) from Antelope House and Parklands Hospital.

We visited one of these sites (Antelope House) because the concerns were specifically about the this service.

Antelope House has two acute mental health inpatient wards. These are Trinity, a 21-bed female ward, and Saxon, a 21-bed male ward. It also has a 10-bedded mixed sex psychiatric intensive care unit (PICU) (Hamtun). Hamtun Ward has three beds for female patients, and seven beds for male patients. We visited both Saxon ward and Hamtun ward but did not visit Trinity ward because we had not received any concerns about that ward.

Following the inspection in June 2018, we served a Requirement Notice and told the trust to make the following improvements in relation to staffing levels:

• The trust must ensure that the safer staffing levels are met on all the wards s to ensure safe care and treatment of patients. This includes consistent medical cover across the wards. (Regulation 18).

We reviewed the outstanding requirement notice relating to safer staffing levels from the previous inspection in June 2018 which following this inspection in February 2019, remains in place.

Updated 16 April 2019

Prior to the inspection, in response to concerns raised by patients, staff and the local leadership team regarding the safety and quality of care at Antelope House the trust had made a number of key changes to the staffing structure including new leadership and additional checks on safety and support for staff. The trust introduced these key changes on 11 February 2019 so had only been in place nine days prior to our inspection.

Prior to the new staffing arrangements being implemented the senior management team spent time talking with staff, visiting the wards to ensure they understood the issues facing staff and consider what changes needed to be made to make improvements to the quality and safety of patient care.

Changes had been made to managerial and nursing roles and additional medical support was put in place to support staff. Daily safety huddles were also set up to discuss risks and concerns within Antelope House. Changes were communicated to staff in writing and in person. However, these were new and not fully embedded.

During the inspection, we found:

• Staff had not ensured that risks concerning a patient’s physical health had been fully addressed.

• Staffing levels were not always sufficient and fell below the trust ‘safer staffing levels’ on both wards approximately once per week. There were a number of vacant posts on both wards and a high level of staff sickness. The wards were heavily reliant on bank and agency staff and some shifts were left short by one or two staff members once or twice per week.

• Staff morale on Hamtun ward was low, three staff were off sick and the remaining staff team were feeling under pressure. Staff said that prior to the changes they had felt undermined by senior management regarding admissions to the wards and felt that communication had been poor.

However:

• The trust had recognised that staff morale was low on Hamtun ward and had put in place arrangements to bring about improvements. During the inspection staff told us told us that they felt there had been more support from senior management recently.

• The trust had implemented daily safety huddles to discuss any concerns on the wards and provide additional support to staff and monitor patient safety.

• Staff on Saxon ward felt that morale was good.