Restraint incidents on Northampton adolescent mental health wards revealed in new inspection

An inspection has revealed new figures about the use of restraints at a Northampton mental health hospital.

Wednesday, 5th April 2017, 6:06 pm
Updated Saturday, 8th April 2017, 10:21 pm
Fitzroy House was inspected by the CQC in February.

St Andrew's Hospital, in Billing Road, Northampton, was criticised for its use of secluding and restraining patients in an episode of Channel Four's Dispatches in March.

Particularly, they were widely condemned for use of the high-risk 'prone' - or face-down - restraint, of which 600 incidents were recorded between 2015 and 2016 across the facility's child and adolescent wards.

Now, an inspection carried out at St Andrew's new child & adolescent mental health facility, Fitzroy House, by the Care Quality Commission in February has given a breakdown of the ward's use of restraints in the past year.

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The inspectors found a 60 per cent drop in use of restraint at the facility.

St Andrew's Healthcare records any hands-on contact with a patient as use of restraint.

A statement from St Andrew's in March 2017 said restraint could be used as a "last resort... to protect the individual, other patients and their medical teams."

The inspection found that between January 1 2016 and January 26 2017, there were 905 incidents of restraints across four of St Andrew's 10-bed children & adolescent wards.

Of these, 212 incidents resulted in prone restraint, a drop of nearly 60 per cent on the previous year.

Fitzroy House's design took patients ideas into account.

The majority of any use of restraint came from the hospital's two neurodisability and autistic spectrums wards, Brook ward and Fern ward, which shared 689 incidents between them.

Amazingly, a single patient on the Brook ward was restrained 218 times over the year, accounting for 59 per cent of all incidents on this ward.

The report states: "Data provided showed a downward trend overall in the use of restraint. Staff avoided using prone restraint where possible due to the known associated risks.

"If a patient did end up in prone position, staff would turn the patient over or into a different position at the earliest opportunity."

The inspectors found a 60 per cent drop in use of restraint at the facility.

Additionally, a total of 281 incidents of seclusion were reported in the same time period.

Nine out of the 14 patients who inspectors spoke to had spent time in seclusion, and four said they did not understand why.

Of those same 14 patients, 11 had been restrained at some point. Eight said staff had explained why this had happened and had spent some time with them after the incident.

But inspectors also found that not all patients in seclusion or segregation had care plans, and four out of 12 patients did not have a restraint care plan in place

Fitzroy House's design took patients ideas into account.

However, the inspectors found staff were kind and respectful and tried to do their best for patients.

They noted that patients had been able to contribute to the design of the new Fitzroy House building they now lived in, and that staff were up-to-date on their training.

St Andrew's was graded 'requires improvement' in 2013 and again in 2016. However, child and adolescent services were rated 'good' in the last inspection.

This most recent report on Fitzroy House inspection was a 'focused inspection' and has no bearing on St Andrew's rating, but the facility is due for inspection in May.

Inspectors say St Andrew's must ensure all patients in seclusion or long-term segregation have appropriate care plans in place before the May inspection.

St Andrew's Northampton has more than 50 wards and has 659 beds.

A spokeswoman from St Andrew's said: "A focused inspection of our adolescent service took place in February 2017 and we are pleased with the continued improvement highlighted in the report. This includes a notable downward trend in the use of restraint, including prone restraint and a strong focus on least restrictive practices. The findings also highlighted the kind and respectful interactions of staff and patients."