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Improvements at Royal Hospital for Neuro-Disability
A patient death and the illness of four others prompted a Care Quality Commission unannounced inspection in November 2019 at The Royal Hospital for Neuro- Disability in the London borough of Wandsworth.
However, the subsequent ratings suspension has now been reversed and the organisation’s previous rating has been reinstated - Good overall.
A further comprehensive inspection took place on 5 and 6 February 2020. Following this inspection, the provider has addressed CQC’s concerns.
The Royal Hospital for Neuro-Disability (RHN) is a residential independent hospital run by a charity. RHN provides acute assessment and rehabilitation for 46 patients with severe brain injuries or illness. It provides care to patients throughout England.
RHN has a high dependency nursing home providing long term care for about 122 residents who have become disabled following a brain injury. There are approximately 220 beds across the hospital.
CQC Inspectors found that:
- The service did not make a safeguarding referral to the local authority in a timely manner. Not all staff had received safeguarding training which was tailored to the vulnerabilities and needs of the patient group they were caring for.
- The service did not consistently control infection risks on Chatsworth Ward. Staff did not keep all equipment and ward areas clean.
- On Chatsworth Ward, inspectors could not be assured that the design, maintenance and use of facilities, premises and equipment kept people safe. Staff did not manage waste well.
- Some staff expressed concerns on whether the service had enough nursing and support staff to keep patients safe from avoidable harm and to provide the right care and treatment.
- Staff did not keep detailed records of patients’ care and treatment. Records were not consistently clear or up-to-date on Chatsworth and Wellesley Wards.
- The hospital did not always manage patient safety incidents well. Managers did not always robustly investigate incidents and there was limited evidence that lessons learned were shared with the whole team and the wider service.
- Families CQC spoke to did not always feel they could raise concerns without fear. Inspectors were also concerned that healthcare assistants on Chatsworth Ward did not have the training to cope with violence and aggression displayed by some patients.
However, inspectors also found the following areas of good practice:
- In relation to infection prevention, cleanliness, hygiene, environment and equipment on other wards at the hospital.
- Staff identified and quickly acted upon patients at risk of deterioration.
- The service had enough medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
- Executive leaders were visible and approachable.
- The hospital demonstrated it had plans to cope with unexpected events, such as a major incident.
- Every patient on Drapers Ward had a bespoke hoist at their bedside, which was outstanding innovative practice.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals, said: “The Royal Hospital for Neuro-Disability needs to ensure that its previously good care standards are maintained, and I believe the leadership team is working toward that goal.
“There are areas where the service can improve its standard of care, which is essential to look after the vulnerable people in its charge. We did though note improvements were being made.”
You can read the report in full when it published on CQC’s website at: www.cqc.org.uk/location/1-117350917
For media enquiries, contact Ray Cooling, Regional Engagement Manager (London), on 020 7448 9136 or call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here www.cqc.org.uk/media/our-media-office. (Please note: the duty press officer is unable to advise members of the public on health or social care matters).
For general enquiries, please call 03000 61 61 61.
- Last updated:
- 27 February 2020
Notes to editors
The Royal Hospital for Neuro-Disability (RHN) is a residential independent hospital run by a charity. It is located in Putney, West London. Patients and residents come mainly from London and southern England, but some come from other parts of England. RHN has total of 237 beds. It provides acute assessment and rehabilitation for 48 patients with severe brain injuries or illness through the NHS England Specialist Rehabilitation Contract. The hospital provides specialist help to patients with a wide range of complex neurological disabilities caused by damage to the brain or other parts of the nervous system because of brain haemorrhage, traffic accidents or progressive neurological conditions. It includes people who are highly dependent and have complex care needs, people in a minimally aware state, people with complex behavioural needs, and people needing mechanical ventilation. RHN has a high dependency nursing home providing long term care for 121 residents who have become disabled following a brain injury.