The Care Quality Commission (CQC) has taken action to protect people after rating the wards for people with a learning disability or autistic people provided by Shrewsbury Court Independent Hospital in Redhill, Surrey inadequate overall following an inspection in August.
Over the last 12 months the provider has been undertaking a move towards delivering a learning disability and autism service as well as a long stay/rehabilitation service.
Inspectors did not visit the long stay/rehabilitation core service and so the previous rating of good currently remains for those wards. However, since this inspection, CQC have undertaken a Mental Health Act visit to specifically look at the long stay/rehabilitation services to ensure safe, good quality care is provided to patients in these services. Inspectors found a number of concerns with these service and will continue to follow up on the quality for these services as well as the services for people with a learning disability and/or autism.
Immediately, following the inspection in August, CQC imposed seven urgent conditions requiring rapid improvements to ensure the safety of people receiving care and treatment in the learning disability and autism service at Shrewsbury Court. The conditions included not admitting or readmitting new patients to these wards, without CQC’s prior permission The full range of conditions can be found in the report.
The overall rating for wards for people with a learning disability or autistic people was inadequate and it is also rated inadequate for the key questions describing whether services were safe, effective and well-led. Caring and responsive were rated as requires improvement.
On 5 November the provider, The Whitepost Health Care Group told CQC that they intended to close Shrewsbury Court Independent Hospital by 17 December. Inspectors will work with local and national healthcare communities to ensure all patients are cared for until appropriate good quality care placements can be found for patients to move to.
Karen Bennett-Wilson, CQC’s head of hospital inspection, said:
“When we inspected the wards for people with a learning disability or autistic people at Shrewsbury Court Independent Hospital, we found a disorganised service with staff who didn’t fully understand the needs or how to meet them, of the vulnerable people in their care and who weren’t supported appropriately by senior leaders.
“It was concerning that inspectors saw that some staff could be confrontational and argumentative with people over avoidable situations. Inspectors also found a number of blanket restrictions had been applied to people staying on these wards, without good reason, and with no date for review.
“Leaders at the service did not have a good understanding of what was required to run this service or what staff needed to do to provide the high-quality care their patients deserved.
“Staff weren’t properly trained people’s care plans were lacking in detail and leaders didn’t conduct audits to monitor and drive improvement. It was also concerning that medicines were not managed safely and physical health checks required following the administration of some medication was not carried out.
“Although The White Post Health Care Group have told us they are closing the service we still require them to make urgent improvements in order to keep people safe will continue to monitor the service closely to ensure that these are made. If we are not satisfied that sufficient improvements have been made, we will not hesitate to take further enforcement action.”
Inspectors found the following issues at the service:
- The management team did not understand what was required to provide a service for people with a learning disability and autism
- Staff did not understand Section 17 leave. Section 17 leave is permission to leave a hospital with agreement from the responsible clinician or the Ministry of Justice. Inspectors found examples of patients going on leave without the correct section 17 processes in place
- A number of blanket restrictive practices were in place on the wards without good reason and without being reviewed
- Not all staff were managing medicines safely. This put people at risk of medication errors which could harm them
- The buildings were in a poor state of repair. Previous patients had drawn on walls, including in bedrooms but the hospital had not removed this before new patients had been admitted to the rooms
- Not all staff understood the needs of patients with learning disabilities and autism. Inspectors saw they staff could be confrontational and argumentative with patients over situations that were avoidable.
Full details of the inspection are given in the report published on our website.
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