Northampton mental health hospital restricted from admitting new patients on three wards over safety concerns

No new patients are allowed at three wards at Northampton biggest mental health hospital without the care watchdog's permission over safety concerns.

The Care Quality Commission (CQC) has ordered St Andrew's Healthcare must also ensure there are adequate staffing levels, training and incident reporting audits at its Billing Road base.

The conditions were placed because numerous issues were found during inspections of the men's and women's services at the beleaguered hospital in July and August, with a report published today (Wednesday, November 10).

St Andrew's interim chief executive Jess Lievesley apologised for the shortfall in care and accepted there are 'a number of areas' it needs to improve, which he says has already started.

CQC head of inspection for mental health and community services Stuart Dunn said: “When people with mental health needs receive care, all possible steps must be taken to ensure they get appropriate care in a safe environment.

"Our inspectors found that this wasn’t always happening at the men’s and women’s services at St Andrew’s Healthcare."

'People who needed these services told us that they didn’t always feel safe'

St Andrew's Healthcare's women's service was put into special measures after receiving the worst possible rating of 'inadequate' in September last year while the men's service has been scored one better as 'requires improvement' since 2018.

The areas of each service under inspection this time were acute wards for adults of working age and psychiatric intensive care units, long stay/rehabilitation mental health wards for working age adults, forensic/inpatient secure wards and wards for people with learning disabilities or autistic people.

Mr Dunn added: “People who needed these services told us that they didn’t always feel safe, and inspectors evidenced practice that reflected this.

"For example, people told us that staff fell asleep when they were supposed to be observing, and women in the long stay and rehabilitation wards told us that the ward often felt dangerous due to understaffing."

Inspectors found St Andrew's Healthcare's senior managers and staff did not always treat patients with compassion and kindness and did not always inform and involve families in the care plans of their loved ones.

Staff also told the CQC they did not always feel respected, supported or valued on the long stay rehabilitation and learning disability and autism wards, with little support or supervision from managers to further develop their skills.

Mr Dunn continued: “Understaffing continued to be a significant concern with both services being regularly short-staffed which often led to patients having their escorted leave, therapies or activities cancelled.

"In addition, not all staff were suitably qualified or competent to be carrying out their roles.

“The leadership team had not addressed issues the CQC had highlighted at previous inspections, or ensured existing concerns were identified and acted on.

"This culture was also reflected at staff level, with some not knowing how to identify or manage risks such as blind spots which could place patients at risk of harm. Incidents weren’t escalated effectively meaning lessons were not being learned and the risk of reoccurrence was high."

What action has been taken by the CQC?

The CQC's conditions demand the provider must not admit any new patients to the forensic, long stay rehabilitation wards and the wards for people with a learning disability at the women’s service and to the wards for people with a learning disability at the men’s service, without consent from the CQC.

It must also ensure there are adequate staffing levels so observations can be carried out safely, that staff receive appropriate training for their roles and that audits of incident reporting are completed.

An action plan detailing the various necessary improvements made by St Andrew's must be sent to the CQC on a fortnightly basis and the services' ratings remain the same.

Mr Dunn said: “We will continue to engage with the provider and will return to check whether sufficient improvements have been made and will take further action if we don’t see this.”

'We accept there are a number of areas where we need to improve'

Mr Lievesley, who took over from Katie Fisher after she resigned last month, explained the 'prolonged' inspection was undertaken at a 'highly challenging time' but they were disappointed by the outcome.

"I’d like to apologise to our patients, as well as to their families and carers, that we haven’t been able to provide the care consistently across all our wards at all times, particularly during what has already been a challenging period," he said.

Staffing levels 'underpinned a great many of the issues identified', which has been challenging throughout the coronavirus pandemic for both St Andrew’s and other healthcare providers, Mr Lievesley added.

"But everything that could be done was implemented to make sure that we had enough staff on every shift and they have all worked tirelessly over the last 18 months to support our

patients and their families," he continued.

"We accept there are a number of areas where we need to improve and we look forward to working with the CQC as part of commitment to improve and welcoming them back to

demonstrate the improvements we have put in place."

Chief nurse Andy Brogan added it was 'reassuring' the CQC recognised staff treated patients with compassion, kindness and respect 'in many cases' but overall, there are clearly issues to address.

"We have started this process and our commitment to improving quality has already resulted in a reduction in the number of patients we care for as well as improvements in outcomes

that will support the recovery of those in our care," he said.

"We have also formally partnered with a local outstanding rated NHS foundation trust, who alongside our NHS partners across the East Midlands are committed to help us improve the quality of care we provide."