A mental health provider has been told to improve the way it supports frontline staff at one of its young people’s units after a highly-critical inspection report revealed a series of problems at the service.
The Care Quality Commission took ‘enforcement action’ against St Andrew’s Healthcare after inspectors found that the provider’s adolescent service in Northampton failed to meet all of the eight standards of care it was assessed against at an inspection in September of this year. The provider failed to “take appropriate steps” to ensure sufficient staffing levels and appropriate supervision and training for staff, the CQC found.
St Andrew’s Healthcare said it had “challenged” the accuracy of some of the inspector’s conclusions but was “awaiting feedback” from the CQC on the improvements it had made in response to several concerns identified by inspectors.
The CQC’s highly-critical inspection report, published in late November, identified a number of problems at the service. These include:
- Patients and staff warned that staffing levels were “unsafe” at times. On one occasion only five staff were working on a ward with 10 patients. Staffing problems meant patients had their activities cancelled and staff had to cancel their breaks.
- The service had an overreliance on bank staff to plug staffing gaps. Rotas for one ward revealed there were no permanent qualified staff on 18 overnight shifts over a four-week period.
- Staff felt unsupported by management. One staff member told inspectors: “The main problem is lack of support; the management don’t care about staff, and we are just numbers.” Another said “morale is at the lowest I can remember”.
- There was no formal system in place for staff supervision. Staff said that when supervision was offered, they were asked to choose between having a “rest break” or supervision.
- Staff identified as requiring their training updated over 12 months ago had still not received it at the time inspectors visited.
- Patients had to “restrain one another” on occasions when staff were busy responding to other incidents, inspectors were told.
- No action had been taken to remove the “immediate risk” of ligature points on one ward despite the service manager sending an email in August raising the need for this to be addressed. Inspectors were informed that “there had been a recent incident” where a patient attempted to hang themselves from a ligature point.
- Some kitchen areas were in poor repair. A broken floor was an infection control risk.
The CQC’s report said:
“We have taken enforcement action against St Andrew’s Healthcare – adolescents service to protect the health, safety and welfare of people using this service.”
A St Andrew’s Healthcare spokesperson said:
“It is important to highlight that none of the inspector’s comments to us following their previous visit suggested poor quality of care for our patients and we remain confident that the young people are receiving high standards of care from qualified and dedicated staff.
“We have challenged a number of the the inspector’s conclusions in their November report regarding some factual inaccuracies and some of these have been accepted.
“We regret that some of their concerns involved actions we had previously agreed with the commission which had not been completed at the time of their visit. We have rigorous processes in place to monitor our services and have worked closely with the commission to address these matters.”