The Care Quality Commission (CQC) has published a report following a focused inspection of the acute wards for adults of working age, and psychiatric intensive care units at Elmleigh hospital, one of the acute mental health hospitals run by Southern Health NHS Foundation Trust.
The inspection took place in April, due to information received about the safety and quality of the service. The concerns included incidents not always being reported, patients being unable to leave the hospital on a regular basis due to insufficient staffing levels, a lack of activities for patients and therapeutic intervention from staff, issues with medicines administration, and a poor culture amongst the staff team at all levels. Inspectors visited the Red and Blue bay wards. Both are for adults of working age, Red is for females, Blue is for males.
Following the inspection, CQC sent the trust a letter of intent, setting out the serious concerns it had about the safety of patients on Blue and Red bay wards. The trust responded with a detailed action plan which provided assurance on what had been done immediately to improve care and treatment on the wards. The trust also voluntarily capped admissions by reducing bed numbers on each ward by three.
As this was a focused inspection, the ratings for the service do not change and the rating for the service remains good overall.
Karen Bennett-Wilson, CQC’s head of hospital inspection and lead for mental health, said:
“It is disappointing to find that the improvements made in recent years at Southern Health NHS Foundation Trust have not been sustained at Elmleigh hospital. Despite the immediate improvements the trust has put in place, there is still more to do, especially as we found there were not enough staff to meet patients’ needs.
“The trust still needs to make a number of additional improvements, but the leadership team knows what it must do, and has already embarked on the first stages of the improvement strategy.
“We will continue to monitor the hospital to ensure the required improvements are made and will return to inspect and report on developments."
Inspectors found:
- Patients did not always receive a range of care and treatment that was consistent with national guidance on best practice
- There were not enough staff with the right skills and knowledge to ensure that patients had high quality care and treatment. The wards did not have a full multi-disciplinary team and were missing input from key areas such as clinical psychology and occupational therapy
- The ward team did not include, and did not have access to, the full range of specialists required to meet the needs of patients on the wards, for example, there was only one locum consultant psychiatrist covering both wards. Staff at all levels did not feel supported or listened to by the trust
- Staff told inspectors they felt stretched, stressed, burnt-out and that they were too busy and constantly “fire-fighting”. Morale across both wards was low.
However, inspectors also found:
- Staff followed best practice in anticipating, de-escalating and managing challenging behaviour, only using restraint and seclusion after attempts at de-escalation had failed
- The ward staff participated in the provider’s restrictive interventions reduction programme
- The trust had recently recruited to fill the occupational therapy, psychology and activity co-ordinator vacancies.
Full details of the inspection are given in the report published on our website.
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