The Care Quality Commission (CQC) has taken action at LANCuk Heywood, following an inspection in March and April which found shortfalls in care.
LANCuk (Learning Assessment and Neurocare Centre) based in Heywood, Greater Manchester, provides assessment and treatment for both children and adults with attention deficit hyperactivity disorder (ADHD) and autistic people.
CQC carried out the inspection to follow up on concerns raised at a previous visit last October, when the service was rated inadequate and placed in special measures.
Following this latest inspection, insufficient improvements had been made regarding safe care and treatment as well as governance which led to CQC using enforcement powers to impose conditions on the provider’s registration. This means they cannot admit any patients to the medicine prescribing service without prior written agreement from CQC.
The overall rating for LANCuk Heywood remains rated as inadequate. The ratings for safe and well-led also remain rated as inadequate, being effective and caring remain rated as good, and being responsive improved from requires improvement to good.
Brian Cranna, CQC’s head of hospital inspection, said:
“When inspectors returned to LANCuk Heywood, it was disappointing to see that its leadership team hadn’t taken the necessary action to remedy the concerns raised during the last inspection.
“We remained concerned that there was no oversight of the prescription management process to prevent the possible misuse of medications. Thorough checks should be carried out before increasing the dose of medicines which wasn’t happening.
“The service had three different systems where care records were stored which made it difficult for staff to keep track. In addition, there was a two-month backlog of letters for GPs and patients which could delay people’s care and treatment and put them at risk.
“Patients told us getting through to the service was challenging and sometimes messages weren’t being passed on or calls returned. They also said that seeing different clinicians on each visit wasn’t ideal as they felt like they were explaining their story repeatedly. Patients would benefit from knowing the time scales and what to expect in between appointments.
“Multidisciplinary meetings hadn’t taken place and key information wasn’t always shared with clinicians. This meant staff weren’t given the opportunity as a team to discuss any updates or learn from incidents.
“We were pleased to see however, that the service had introduced an incidents and complaints database which has clear records to support any decision making and learning.
“Leaders now understand where improvements must be made, and we’ll continue to monitor the service closely to ensure people are safe. If we’re not assured people are receiving safe care, we will not hesitate to take further action.”
CQC inspectors found:
- The service was not well led, and the governance processes did not ensure that procedures relating to the work of the service ran smoothly.
- Staff did not engage in clinical audit to evaluate the quality of care they provided.
- There was no information provided to patients regarding the service, including what to expect and timescales.
- Staff records did not include all required documentation and checks.
- The service did not have oversight of the prescription management process to mitigate the possible misuse of prescriptions and ensure it was safe or appropriate to increase the dose of the medicine before prescribing or continuing to prescribe for patients when clinically appropriate to do so.
However:
- Clinical premises where patients were seen were safe and clean. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
- Staff provided a range of assessments and treatments that were informed by best-practice guidance and suitable to the needs of the patients.
- The service included or had access to the full range of specialists required to meet the needs of the patients. Managers ensured that these staff received training and supervision.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients, families and carers in care decisions.
Full details of the inspection are given in the report published on our website.
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