The Care Quality Commission has rated Cygnet Hospital Wyke, an independent mental health hospital in Bradford and part of the Cygnet Health Care group, as Inadequate following two separate inspections in June 2019, and is considering further enforcement action.
The service is comprised of three wards: male psychiatric intensive care unit (PICU), male acute admission unit and a locked ward for older males with challenging behaviour. It can accommodate up to 51 people. CQC previously rated the service Requires Improvement after an inspection in February 2018, finding continuing poor standards of care and a lack of sustainable improvements.
Inspectors revisited the service in November 2018, in part prompted by notifications of several incidents including two patients being injured. Inspectors identified concerns exposing people to avoidable risk of harm, insufficient staffing, risks going unrecognised and lack of improvements to the service. CQC fined the provider £1250 for not submitting notifications, relating to Cygnet Hospital Wyke, as required.
Following the inspection, CQC took immediate enforcement action preventing the service from accepting any new patients until 10 March 2019, Cygnet Health Care Limited appealed against the action. In December 2018 inspectors returned to the service and found improvements had begun, but outstanding concerns remained. Inspectors agreed to lift the halt on admissions and instead restricted admissions to one patient in any 24-hour period.
Inspectors again visited on 13 February 2019 finding further improvements, but not all previous concerns had been addressed. The restriction on admissions remained in place but amended to three patients. The condition was lifted on 10 March 2019.
CQC returned to inspect the service between 2 and 4 June 2019, responding to concerns raised by anonymous whistleblowing. Inspectors reported that restrictive practices to patients were being used disproportionally, records not being kept and risk assessments on environmental and patient support needs were not undertaken. Inspectors also reported observing some staff delivering care that was antagonistic and not respectful. The provider was not acting in a timely manner to make recommended improvements. Cygnet Hospital Wyke was rated Inadequate for being safe, effective, caring and well-led, and overall placing it into special measures. Responsive was rated Requires Improvement.
Inspectors revisited the service on 19 June in response to further concerns raised. Inspectors reported a patient, who required enhanced observations, was able to tie a ligature unnoticed, exposing themselves to a serious risk of strangulation. Staff were not reporting incidents, preventing risks from being followed up and were not trained in patient observation and engagement. Management had little understanding of identifying and managing risks to enable improvements to be made and allowed failures in adherence to policy to go unchallenged.
Following the 2 to 4 June 2019 and the 19 June 2019 inspections, CQC applied conditions preventing the service from accepting new patients and requiring the provider to review all patients’ clinical records, to take action where appropriate, and to report the outcome to CQC.
Cygnet Health Care Limited appealed against the condition preventing new admissions. An agreement was reached between the provider and CQC to allow patients to be admitted to the hospital’s Bramwell Ward only, but with additional conditions applied in respect of these admissions. A consent order varying the conditions has been signed by both parties and is with the Tribunal for approval. The final order will be reported on when complete.
CQC is currently considering additional enforcement action.
A full history of CQC’s findings is available at www.cqc.org.uk/location/1-130486838
Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health) said:
“The safety of people who use services is our highest priority and they deserve safe high-quality care. We have found the standard of care provided at Cygnet Hospital Wyke to have deteriorated further. Therefore, we are considering further enforcement action to protect the people living there.
“We will continue to closely monitor the hospital with support from our partner agencies, to ensure people are safe. We will publish any action we take when it is appropriate to do so, any action we do take is subject to appeal by the provider.”
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