23 and 24 January 2024
During a routine inspection
Our rating of this location went down. We rated it as inadequate because:
- The service did not provide safe care. The wards did not have enough nurses and reliance on agency workers was high. Staff did not always assess or manage risk well and incidents causing harm to people using the service occurred during our inspection. Staff did not minimise the use of restrictive practices and people using the service told us about the negative impact this had on them.
- The service did not provide a full range of treatments suitable to the needs of the patients or in line with national guidance about best practice. We observed care being delivered which did not align with nationally recommended practice for the treatment of eating disorders. People using the service were not receiving adequate psychological therapies to support their recovery. Relatives and stakeholders had raised concerns about some people not progressing during their admission. Due to the staffing pressures and the complex needs of the patients, staff did not have the capacity to adequately engage in clinical audit to evaluate the quality of care they provided.
- Managers did not consistently ensure that staff received adequate training, supervision or appraisal. Staff did not always engage effectively with those outside the ward who would have a role in providing aftercare.
- Staff did not always treat patients with compassion and kindness, respect their privacy and dignity, or understand their individual needs. Staff did not consistently involve patients and their families in care decisions.
- People told us that they felt bored and that there was little to do at the hospital. We did not observe many organised activities taking place during our inspection.
- Admissions and discharges were not always managed well, which resulted in additional pressures on the ward staff.
- Governance processes did not identify some of these significant shortfalls in the care provided at the hospital and staff did not feel well supported by senior managers.
However:
- The ward environments were safe and clean.
- Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
- People were receiving meaningful support from the dietetic team.
- Senior managers had started a number of improvement projects including the creation of patient inclusion lead and autism champion posts
Letter from the Interim Chief Inspector of Adult Social Care and Integrated Care, James Bullion:
I am placing the service into special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.
A final version of this report, which we will publish in due course, will include full information about our regulatory response to the concerns we have described