An independent hospital for women has been rated Inadequate overall by the Care Quality Commission and placed into special measures.
Cygnet Hospital Ealing was rated Inadequate for being safe, caring and well-led. It was rated Requires Improvement for being effective and responsive, following the inspection in June 2019.
Following an earlier focused inspection in, November 2018 the provider had voluntarily agreed to suspend admissions to Sunrise Ward. The CQC returned in June 2019 and found significant improvements were still needed and imposed a decision to stop admissions to the ward.
Sunrise Ward is a 17-bed ward for women aged 18 or over with complex eating disorders. The service offers support and care relating to physical and mental health. At the time of the most recent inspection there were eight people on the ward.
New Dawn Ward is a specialist service for adult women who have diagnosed personality disorders. Eight patients were receiving care and treatment on the nine-bed ward at the time of CQC’s inspection.
CQC inspected this service as part of its comprehensive mental health inspection programme and to follow up on the warning notices served in December 2018 and breaches of regulations from the November 2018 and May 2017 inspections.
Inspectors found that the hospital was not delivering safe care. Patients on Sunrise Ward were at high risk of avoidable harm. Four patients had self-harmed during a two-month period when they were being observed on a one-to-one basis by staff.
On Sunrise Ward some patients reported that they were treated in an off-hand manner and we observed that nursing staff did not always display kindness or compassion. The ward did not offer a therapeutic environment for patients with eating disorders. Patients said that staff fell asleep during one-to-one observations, their meals were late, and agency and bank staff made inappropriate comments about food and portion sizes.
The service was not well-led. There had been a high turnover of senior staff within the hospital. Patients on both wards complained about a lack of timely feedback when they raised any issues.
The provider had not made all the necessary improvements from the previous inspection in November 2018. The provider’s self-assessment said that the work had been completed. Inspectors concluded that, although some improvements had been made to paperwork, this had not led to a consistent improvement in practice. This failure was linked to the ongoing leadership changes which meant that the necessary oversight was not in place.
However, New Dawn Ward had a permanent ward manager in place and was better managed than Sunrise Ward.
Kevin Cleary, CQC’s Deputy Chief Inspector Hospitals Mental Health and Community Services, said: “Having taken enforcement action following an inspection at the end of last year, we revisited the service to check that all the necessary improvements had been made; disappointingly, they had not. We found that the hospital was not delivering safe care and that staff did not always treat people with compassion.
“Cygnet Hospital Ealing has suffered from a high turnover of senior staff and, whilst posts had been covered for most of the interim period, this was impacting adversely on the nurse leadership.
“Staff on both wards reported instances of bullying. Patients on both wards complained about a lack of timely feedback when they raised any issues.
“We have now placed this service into special measures due to its failure to provide a safe environment for patients receiving treatment for eating disorders. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service.”
Since this inspection, inspectors have visited the hospital and found improvements in the leadership of the hospital and ward. There have also been changes in the ward team with staff being offered competency-based learning to support people with an eating disorder. It has been agreed that admissions can start again at a maximum of one patient each week, until the ward is half full. Progress will be closely monitored, and another unannounced inspection is planned.
You can read the inspection report in full when it is published on CQC’s website by clicking on: www.cqc.org.uk/location/1-130486723
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