A private mental health hospital in Wandsworth, south-west London, has been rated Inadequate overall by the Care Quality Commission and placed into special measures.
The Huntercombe Hospital in Roehampton, was rated Inadequate for being safe, and well-led. It was rated Requires Improvement for being effective and caring and Good for being responsive, following the inspection in May 2018.
The service provides 39 psychiatric intensive care beds for patients on one male-only and two female-only wards. On the days of inspection, there were 38 patients in the hospital. The service had experienced a recent increase in the use of agency staff.
Staff at this service used rapid tranquilisation regularly on patients. Inspectors found in 24 of the 35 incidents of rapid tranquilisation, staff did not follow best practice guidance in relation to monitoring the physical health of patients after rapid tranquilisation.
Staff did not consistently record patients’ daily National Early Warning Scores (NEWS) to assess and monitor patients’ physical health risks and escalate concerns when their patient might be deteriorating.
Staff engaged minimally with patients when carrying out one-to-one observations. The service had not yet implemented a reducing restrictive practices programme on the wards to reduce violence and aggression.
Staff did not complete up to date ligature risk assessments and could not always identify where ligatures were present on the wards and how patients would be kept safe.
A water cooler in the communal areas did not have cups available for patients to use to get themselves a drink of water.
Whilst the service had systems in place to engage and receive feedback from staff, patients and relatives these were not working effectively. The provider’s staff survey 2018 had a low response rate at only 28% of staff completing it. No relatives had completed the friends and family survey.
Governance arrangements were not robust and quality assurance processes did not ensure patients and staff were kept safe. CQC concluded that senior managers in the hospital did not have the skills, knowledge and experience to provide leadership of the quality required to maintain safe and effective care. Ward managers could not explain how they maintained quality and ensured that care met fundamental standards.
Despite these problems, staff morale was good and staff reported feeling supported by their managers and teams. The service had recently set up an academy for staff to attend further training. Staff mandatory training had improved at the service and the majority of staff had completed training to keep patients safe from harm and abuse.
Dr Paul Lelliott, Deputy Chief Inspector (Mental Health), said:
“We found some serious breaches of regulations at Huntercombe Hospital. Senior managers in the hospital did not have the skills, knowledge and experience to provide leadership of the quality required to maintain safe and effective care.
“CQC is placing this service into special measures. Unless the provider has made sufficient improvements within six months, we will begin the process of preventing the provider from operating the service. We would expect the hospital to have made some improvements sooner than that.”
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We found some serious breaches of regulations at Huntercombe Hospital
Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (and lead for mental health)