The Care Quality Commission (CQC) has published a report on Ardleigh Ward, an acute inpatient ward for women at The Lakes, Colchester Hospital, run by Essex Partnership University NHS Foundation Trust (EPUT), following an unannounced focused inspection in January.
This inspection was carried out following information of concern received by CQC about staffing levels and high rates of self-harm on the ward. Inspectors found breaches of regulation regarding safe care and treatment, good governance and staffing. Due to the seriousness of the concerns identified, CQC required the trust to take immediate action. The trust submitted an action plan which reassured CQC that it had mitigated the immediate risks to people.
As this was a focused inspection, CQC did not re-rate the service and the previous rating of requires improvement remains in place for acute wards for adults of working age and psychiatric intensive care units at the trust overall.
Inspectors found:
- Inspectors found a serious incident in care records that had not been recorded on the ward’s serious incident log. During this incident, a person on one-to-one observations was able to self-harm while the observing staff member’s attention was elsewhere.
- Staff did not always respond appropriately to ligature alarms. During a tour of the ward, inspectors observed at least three ligature alarms being triggered. Staff responded to only one of the alarms, with no urgency shown on another occasion and a further alarm going unacknowledged entirely.
- Staff did not always manage environmental risks safely. Inspectors found high-risk items, including a discarded towel and bottle lids in communal areas of the ward. One person’s bedroom was in a poor condition and contained plastic bags and empty bottles, posing a risk of avoidable harm.
- A staff member provided a person with a prohibited item, which led to them harming themselves and requiring surgery.
- The ward had four registered nurse vacancies and one healthcare assistant vacancy. The trust had used bank and agency staff 432 times in the preceding three months, while staff sickness remained around 17% throughout the inspection period. Staff told inspectors they felt burnt out and that the ward felt unsafe.
However:
- Permanent staff were experienced, qualified and knowledgeable about the people they supported, and demonstrated commitment to working in mental health services.
- Leaders had recently appointed a permanent ward manager and introduced registered general nurses to support more holistic care planning.