The Care Quality Commission has rated Newbus Grange Inadequate overall and placed the service into special measures.
Cygnet Newbus Grange, in Darlington, is an independent hospital operated by Cygnet (OE) Limited and part of the Cygnet Health Care group. It is registered to provide care and treatment to people with a learning disability or autism.
The service was last inspected in December 2018 when it was rated Outstanding overall and for being caring and well-led, Good for being safe, effective and responsive.
CQC returned to the service on 12 May 2019 to conduct a responsive inspection. This was after concerns had been raised with CQC about the service. It also followed serious concerns raised by BBC Panorama about another hospital run by Cygnet Health Care which prompted a CQC review of all services run by this provider. At the time of the inspection 10 people were residing in the hospital.
Due to concerns identified at the inspection, the visit was extended across three days and a full comprehensive inspection was conducted. Inspectors found significant issues with the quality of the care, support and environment of the service. The service was rated Inadequate for being safe, responsive and well-led, and Requires Improvement for being effective and caring.
A safeguarding alert was raised by inspectors following the visit, after two carers identified unexplained injuries to a patient. Inspectors observed several interactions between staff and the people they supported and found nearly half of them were poor. People had to repeat themselves to get attention and some staff did not interact or engage with people when they were directly supporting them. Inspectors reviewed staff files and they showed one incident where an inappropriate restraint technique had been used and two episodes where staff members were found asleep whilst on duty. The provider had acted appropriately in response to the incidents.
Inspectors learned that the registered manager had been promoted to regional management in January 2019. However, they were still responsible for the day to day running of the service but due to the regional responsibility they were not in the hospital often. As a result, concerns were raised about the service’s governance and ability to monitor the quality of the care being provided. The service’s infection prevention and control practices were inconsistent and essential documents relating to the administration of a medication in crushed form were not in place. Inspectors also raised concerns about the service’s restrictions on patients having access to their own possessions, and the lack of appropriate consideration or documentation to justify these.
Whilst the service appeared to be clean, inspectors reported strong smells of urine and damp, and areas of the hospital had not been well maintained and were run-down. The service recognised some windows were potentially unsafe, however remedial actions were not sufficient and the windows continued to pose a risk. Inspectors found three bedrooms had exposed window blind cords which posed ligature risks. There were plans to improve the windows safety, but no date had been set for their completion. The service’s Outstanding rating was suspended during the inspection.
Inspectors raised immediate concerns during the inspection and imposed several conditions on the provider’s registration, requiring it to review aspects of the hospital’s care planning and delivery, and report to CQC. The conditions can be viewed on the CQC website here: www.cqc.org.uk/location/1-894282280/registration-info
NHS England and other bodies responsible for commissioning care are supporting people living at Newbus Grange to access alternative care arrangements whilst Cygnet work on improving the service. CQC is currently considering additional enforcement action.
A further inspection of the service, in response to new whistleblowing information, was conducted 1, 2 and 12 June 2019. The report will be published in due course.
A full history of CQC’s findings is available at: www.cqc.org.uk/location/1-894282280
Professor Ted Baker, Chief Inspector of Hospitals, said:
“On this inspection we found that people were not receiving safe care, their dignity was not respected and they were not treated with compassion. The environment was poorly maintained, risks to people’s safety were not addressed and we observed a disinterested attitude from some staff to the people they were meant to be caring for.
“We raised immediate concerns with the provider following the inspection and took enforcement action requiring the service to act on our findings to ensure people were kept safe from avoidable harm. We are now working with NHS England and other bodies responsible for commissioning care who are supporting people to access alternative care arrangements whilst Cygnet work on adapting the service. We are monitoring this service very closely now and will continue to do so in the future to ensure people are protected.
“There had clearly been an unacceptable deterioration in the managerial oversight of this hospital, and subsequently in the physical environment and the quality of care, since our last inspection. However, some important factors, such as ward culture and staff behaviour, are more difficult to assess than the physical fabric of the building or the quality of written plans.
“We have strengthened our approach to inspecting these type of services so we can better incorporate the experiences of the people who use them to make our assessments of quality and safety and to help us to spot poor care. We will continue to improve our regulation of these services by working with providers and the public and increasing the use of people who use services and their families and advocates in our work.
“In addition to a review of all services operated by this provider, we have recently re-inspected a number of other services for people with learning disabilities and/or autism, in several cases taking enforcement action to protect people.”
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For further information please contact Mark Humphreys Regional Engagement Officer 01912011675 / 07384 902623 or mark.humphreys@cqc.org.uk
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