The Care Quality Commission (CQC) has told a hospital owned by mental health provider Cygnet that it must make significant improvements on a number of areas following an urgent unannounced inspection.
The Cygnet Hospital Godden Green near Sevenoaks in Kent was visited by CQC inspectors in January following up areas of concerns raised by staff and external stakeholders about leadership of the service, the number and severity of incidents affecting the health, safety and welfare of young people on the wards and the safety of the ward environment.
Inspectors found some senior managers and ward managers did not have the skills and knowledge to perform their roles. Some did not have a good understanding of the services they managed and were not considered approachable by young people and staff.
Staff also described to inspectors a culture that did not value staff or encourage them to speak up when things were not going well. There had been no permanent manager on Littleoaks ward for several months prior to the inspection, which is said to have impacted on the quality of care and staffing levels.
There was a lack of therapeutic activity and engagement between staff and young people and an over-reliance on increased observation levels to manage young people’s behaviour. Staff could not describe any other ways to support young people and reduce incidents.
Communication between the hospital and external agencies was not always appropriate. Incidents which required a safeguarding referral were not always a true and accurate reflection of the incident. Information was either missing or incomplete.
The CQC issued two Warning Notices requiring the hospital to improve its oversight systems and to make sure they continually assess, monitor and improve the service and delivery of safe care and treatment. The hospital must also ensure young people’s risk assessments and risk management plans are updated and reviewed following incidents to prevent future risk. The hospital must also ensure interventions used to support young people or manage their behaviour are appropriate for their needs.
CQC’s head of hospital inspection Pauline Carpenter said: ‘We are concerned that some of the deep-seated cultural issues that we have found over a number of inspections of Cygnet Hospital have still not been resolved.
‘In the past the hospital had been under enhanced surveillance by our inspectors, alongside a range of other stakeholders, because of the nature of our concerns. During that time there had been a number of improvements, but the problems have resurfaced.
‘Following this new inspection, we have issued two Warning Notices. The provider has brought in managers from other services to focus on improving quality and safety and agreed to reduce the number of available beds until they have made the required improvements.
‘If we don’t see real improvement we will consider taking further action.’
The Cygnet Hospital Godden Green had previously been praised for making significant service improvements last February following warning its services required significant improvement in November 2017.