NHS Trust censured after staff actions ‘conflicted’ with Mental Capacity Act

A mental health trust has been told to improve the way it treats people who use its services after inspectors found that staff in one of its hospitals acted in a way that “conflicted with the key principles of the Mental Capacity Act”.

The Care Quality Commission (CQC) issued a warning notice to Tees, Esk and Wear Valleys NHS Foundation Trust after ruling that the Auckland Park Hospital failed to meet standards for ‘respecting and involving’ the older people with mental health needs that use the service.

The trust said it had taken “immediate action” to address the issues identified by the CQC.

Inspectors found that staff at the hospital “assumed that all people lacked capacity” without undertaking proper assessments. A core principle of The Mental Capacity Act is that all people must be assumed to have capacity to take specific decisions unless it is established that they lack capacity to do so.

Actions by staff had “discouraged” people from making decisions over key elements of their care – such as how and where they wanted to spend their time or whether they wanted their bedroom door locked or unlocked, the report found.

“Therefore we found the provider had placed restrictions on the free movement of people around the hospital environment, without undertaking individualised, relevant and appropriate assessments which would support these type of restrictions on an individual basis,” the report found.

Today the health regulator Monitor announced it was investigating whether the CQC findings are “indicative of governance problems” at the trust.

Martin Barkley, chief executive of the trust, admitted it is “not appropriate to make blanket decisions” that impact the freedom of patients but said staff had been trying to “protect patients from harm”.

“We have now taken action to make sure that individual assessments are carried out. These changes and other measures to address the issues raised by the CQC, such as making the gardens safer are being implemented, and most will be completed by the beginning of July,” said Barkley.

Barkley said he had commissioned an external review to investigate why the hospital had again failed to meet the standard despite issues over service user independence having been flagged up by CQC inspectors last year.

Andy McNicoll is Community Care’s community editor