The Care Quality Commission (CQC) has taken action to protect people at LANCuk (Learning Assessment and Neurocare Centre) in Heywood after rating it inadequate and placing it in special measures following an inspection in October.
CQC undertook an unannounced focused inspection to look at whether it is safe and well-led, following concerns raised around medicines management.
The service, which was previously rated as requires improvement, is now rated inadequate overall and has been placed into special measures to focus their leadership team on the areas where urgent improvements are needed. CQC has also rated the service as inadequate for being safe and well-led.
LANCuk provides assessment and treatment to children and adults for attention deficit hyperactivity disorder and autistic people. Most of the staff working for LANCuk were self-employed and had other roles, mostly within NHS trusts. The service accepts private referrals as well as NHS patients.
Brian Cranna, CQC’s head of hospital inspection (mental health and community health services), said:
“When we inspected LANCuk, we were very concerned leaders didn’t have the skills to run the service safely and had little oversight over the day-to-day running to make sure patients are protected from harm. This is why we have placed them into special measures and downgraded their rating from requires improvement to inadequate.
“We had serious concerns about how they were managing people’s medicine. Most consultations were carried out remotely and prescriptions were posted to patients. Although medicine was prescribed by qualified staff, there was no clear protocol for carrying out these consultations or verifying the patient’s identity which meant that the medicine could have been received by the wrong person, also the staff carrying out the consultation may not know the person’s medical history.
“We found information wasn’t shared with their GP’s in a timely way and there was over a month’s backlog of letters informing them about what medicine people had been prescribed. This put people at risk of harm if they needed further medical treatment by their GP without them having access to up to date information.
“Prior to our inspection we were also told people had received prescriptions for the wrong medicine, or not in time to help them. One person’s late medicine led to withdrawal symptoms, and another had to access mental health services for support because they didn’t have the correct medicine.
“It was worrying documents showed people had been waiting over a year for an appointment, however we were told these records weren’t up to date which meant there was no accurate record of who was waiting for an appointment which could potentially put vulnerable people at serious risk of harm.
“The service has started to make some improvements, including recruiting two full time clinicians to provide consistency regarding prescribing arrangements and availability for face to face appointments. However, it was disappointing that more improvements had not been made since the last inspection, despite us telling managers where they needed to do so.
“We will continue to monitor LANCuk closely and will not hesitate to take further action if we feel people are not safe and are at risk of harm.”
Inspectors found the following:
- The service was not well-led, and the governance processes were not adequate to enable the service to run smoothly
- The service did not have good systems and processes in place for managing prescriptions
- Staff records did not include all required documentation and checks
- The registered manager had not taken sufficient action following the concerns we raised at the last inspection
- Patient records were not complete, and staff were not receiving supervision in line with the supervision policy.
However:
- Following the last inspection, patient records now included documentation and responses to complaints patients had raised.
Full details of the inspection are given in the report published on our website.
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