The Care Quality Commission (CQC) has taken action to keep people safe following an inspection of the men’s and women’s services at St Andrew’s Healthcare in Northampton.
The inspection was carried out in July and August at the following areas of each service: acute wards for adults of working age and psychiatric intensive care units (PICU), long stay/rehabilitation mental health wards for working age adults, forensic/inpatient secure wards and wards for people with learning disabilities or autistic people.
Following the inspection, conditions were placed on the provider’s registration. The conditions demand that the provider must not admit any new patients to the forensic, long stay rehabilitation wards and the wards for people with a learning disability at the women’s service and to the wards for people with a learning disability at the men’s service, without consent from CQC.
It must also ensure there are adequate staffing levels so observations can be carried out safely, that staff receive appropriate training for their roles and that audits of incident reporting are completed. An action plan detailing improvement must be sent to CQC on a fortnightly basis.
Following the inspection, the overall rating for the men’s service remains requires improvement and the overall rating for the women’s service remains inadequate.
Stuart Dunn, CQC head of inspection for mental health and community services, said:
“When people with mental health needs receive care, all possible steps must be taken to ensure they get appropriate care in a safe environment. Our inspectors found that this wasn’t always happening at the men’s and women’s services at St Andrew’s Healthcare.
“People who needed these services told us that they didn’t always feel safe, and inspectors evidenced practice that reflected this. For example, people told us that staff fell asleep when they were supposed to be observing, and women in the long stay and rehabilitation wards told us that the ward often felt dangerous due to understaffing.
“Understaffing continued to be a significant concern with both services being regularly short-staffed which often led to patients having their escorted leave, therapies or activities cancelled. In addition, not all staff were suitably qualified or competent to be carrying out their roles.
“The leadership team had not addressed issues CQC had highlighted at previous inspections, or ensured existing concerns were identified and acted on. This culture was also reflected at staff level, with some not knowing how to identify or manage risks such as blind spots which could place patients at risk of harm. Incidents weren’t escalated effectively meaning lessons were not being learned and the risk of reoccurrence was high.
“We will continue to engage with the provider and will return to check whether sufficient improvements have been made and will take further action if we don’t see this.”
Staff at the learning disability and autism wards were unable to define a closed culture or describe how they ensured patients were protected from the risks associated with a closed culture developing. Senior managers and staff didn’t always treat patients with compassion and kindness and didn’t always inform and involve families in the care plans of their loved ones.
Staff also reported that they didn’t always feel respected, supported or valued on the long stay rehabilitation and learning disability and autism wards, with little support or supervision from managers to further develop their skills.
Following the inspection, the trust was told to make several improvements, including:
At the women’s service:
- Patient observations must be carried out in line with policy
- Staff must follow the mental health act code of practice in relation to seclusion
- Wards must have the required numbers of suitably skilled staff
- Incidents must be recorded and reported appropriately.
At the men’s service:
- Lessons learned must be shared with the whole team when things go wrong
- Leadership, governance and culture must support the delivery of high-quality person-centred care
- Seclusion room environments must meet the mental health act code of practice
- Effective discharge plans must be in place for patients in the long stay and rehabilitation wards
- Staff must recognise and report any safeguarding incidents.
Full details of the inspection are given in the report published on our website:
St Andrew's Healthcare - Mens Service
St Andrew's Healthcare - Womens Service
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