Mental health hospital for adolescents placed into special measures

St Andrew’s Healthcare Adolescent Service in Northamptonshire has been placed into special measures following an inspection, which rated it as ‘inadequate’.

Inspectors, who visited the service in March and April, found staff did not always treat patients with kindness, dignity, compassion and respect.

Eleven of the 15 seclusion rooms did not include furnishings such as a bed, pillow, mattress or blanket and records referred to patients as sitting or lying on the floor while in rooms.

Managers at the hospital in Northampton had not ensured they identified or addressed safety concerns quickly enough, a Care Quality Commission (CQC) report said.

There were sharp edges on door frames in seclusion rooms and extra care suites, blind spots in rooms and exposed sharp metal in suites. Staff did not always follow safety procedures in relation to cutlery checks and food hygiene.

Inspectors rated the hospital as ‘inadequate’ overall as well as for being safe, caring and well-led. The service was rated as ‘good’ for being effective and responsive.

The service has been told it must make improvements including that it ensures staff treat patients with kindness, respect and dignity. They must ensure patients’ comfort when using seclusion rooms and that their privacy and dignity is upheld at all times.

The hospital, which provides services for male and female patients under the age of 18 with eating disorders, learning disabilities and mental health conditions was rated by the CQC as ‘requires improvement’ in May 2017.

The regulator then carried out a focused inspection between October 2018 and January this year, in response to concerns. While that inspection did not alter the trust’s rating, the CQC told the service it must make improvements to how it manages patients who required long-term segregation.

However, inspectors were not satisfied in its latest inspection.

‘This is the third time that we have inspected St Andrew’s Healthcare Adolescents Service in the past two years,’ said CQC’s deputy chief inspector of hospitals (and lead for mental health), Dr Paul Lelliott. ‘Over that time, the service has failed to address some of the concerns we have raised. In some important respects, the safety of care has deteriorated.

‘We were particularly concerned about how the service responds to patients whose behaviour staff find challenging,’ he continued. ‘Staff did not follow best practice when using seclusion and long-term segregation. This is an issue that we have raised with the provider on 12 separate occasions following previous inspections of the various hospitals that they manage.’

Lelliott added that staff had not undertaken reviews of patients in seclusion or segregation or completed seclusion care plans.

Katie Fisher, St Andrew’s Healthcare chief executive, said: ‘We deeply regret that we have fallen below the standards we aim to uphold, and those expected by the CQC.

‘Our process, reporting and governance need to improve. Wherever possible we have taken immediate steps to address issues raised by the CQC, and have temporarily closed our Child and Adolescent Mental Health Services (CAMHS) to new admissions.

‘We need a bigger rethink of our seclusion and long-term segregation process, so have begun a charity-wide review. This will ensure that, when safety concerns make it necessary to seclude or segregate a patient, the facilities provided and monitoring undertaken are consistently safe and robust. We are seeking independent advice from another CAMHS provider, whose services are rated ‘outstanding’ by the CQC, to help us improve.’

The group has appointed an improvement director to oversee its implementation of its review.

This CQC report follows another St Andrew’s hospital being placed into special measures. In February, St Andrew’s Hospital in Mansfield, Nottinghamshire, was rated ‘inadequate’.

Private mental health services have come under fire of late with the Danshell Group, Raphael Medical Centre Ltd and the Huntercombe Group all receiving either ‘requires improvement’ or ‘inadequate’ ratings. Last month, a BBC Panorama investigation into Whorlton Hall, in County Durham, showed patients with learning disabilities and complex needs being physically and psychologically abused.