Priory Hospital Blandford in Dorset was rated ‘inadequate’ for being safe, effective, caring and well-led and ‘requires improvement’ for being responsive.
Kneesworth House hospital in Hertfordshire was rated ‘inadequate’ for being safe, caring and well-led and ‘good’ for being effective and responsive.
Priory Hospital Blandford cares for children and young people up to the age of 18 who have a learning disability or autism diagnosis as well as a mental health problem.
During an inspection in May, young people told inspectors that they felt unsafe on the wards. There had been a number of incidents where young people had assaulted or were bullying each other. There were also several assaults on staff.
Some young people told inspectors that staff did not treat them or behave well towards them. They said they felt degraded, that staff were not caring, and that there was no compassion. They also said that staff stayed in the office and that they could hear them talking about their care. They believed staff were not interested in them.
Inspectors also found that staff used physical restraint frequently. They did not report all incidents, particularly around physical assault and racial abuse. In addition, the hospital could not provide safe and effective support to young people with an eating disorder due to not having timely access to a dietician or occupational therapist to provide specialist support.
Kneesworth House hospital provides inpatient care for people with acute mental health problems, locked and open rehabilitation services, and medium and low secure forensic services for people with enduring mental health problems, including some patients with a learning disability.
Inspectors visited the facility between 19 and 24 March and on 4 April 2019 and found that the provider had not addressed all the breaches identified at the last inspection. When staff secluded patients, they did not record this in line with the provider’s policy and the Mental Health Act Code of Practice.
Inspectors also found that patients had not been kept safe from improper treatment and some staff were uncaring and disrespectful. Two patients told the CQC some staff on the Icknield ward used a key to prod their feet if they did not get up in the morning. Some patients altered their sleeping position or wore trainers in bed to prevent this from happening. Seven patients commented that a few staff were rude, unfriendly, did not listen to them or antagonised patients.
‘The care provided at Priory Hospital Blandford fell well below the standard that people should expect. We identified several serious problems regarding the quality of care and patient safety that needed immediate attention,’ said Dr Paul Lelliott, deputy chief inspector for hospital inspection (and lead for mental health). ‘Due to our concerns for the safety of young people, we issued a warning notice immediately after the inspection. At time of the inspection, staff lacked an understanding of what was required to provide a good quality service to young people who require a specialist learning disability Child and Adolescent Mental Health Service.’
‘The care provided at Kneesworth House fell well below the standard that people should expect, and our inspection team were very concerned by some of what they found,’ Lelliott continued. ‘Our greatest concerns were about the forensic service, which consisted of Clopton, Ermine, Icknield and Orwell wards.’
Lelliott went onto say that some of the clinic rooms at Kneesworth House hospital were disorganised and some ward areas were dirty, and in need of repair and redecoration: ‘This included stained and dirty toilets and unpleasant odours. Furniture was ripped and the system for ensuring maintenance jobs were completed was ineffective.’
A spokesman for Priory Healthcare said: ‘We take the CQC findings extremely seriously and are making immediate changes at Blandford which has suffered from being unable to attract suitably-qualified nurses and clinicians with the expertise to meet the needs of this complex patient group.
‘At Kneesworth, a major investment plan is underway to ensure the environment is improved. While we accept the forensic service fell below expected standards, the CQC rated the hospital’s acute mental health and rehabilitation services, which make up the greatest proportion of patients, as ‘good’, and said that, overall, the hospital was ‘good’ for being effective and responsive. Our immediate priority is to address the issues raised by the regulator to ensure good practice is replicated throughout.’