The Care Quality Commission (CQC) has published two reports on services being provided by Kent and Medway NHS and Social Care Partnership Trust. CQC inspected one of the forensic inpatient and secure wards at the Tarentfort Centre, as well as their ward for autistic people and people with a learning disability at Brookfield Centre, both in Dartford.
Although there was some good care, CQC found there were improvements needed across both services to make sure people were receiving safe and effective care following inspections in March and April.
Tarentfort Centre was previously inspected as part of the wards for autistic people and people with a learning disability, but due to commissioning changes since the last inspection, this centre is now inspected as part of the forensic inpatient and secure ward core services.
CQC carried out the inspection at both services in response to several sexual safeguarding notifications received from the local authority and the trust. We had received a level of assurance from the trust and CQC carried out the inspection to ensure that the services were safely caring for people and managing any risk appropriately.
Following the inspection, the rating for the ward for autistic people and people with with a learning disability has declined from outstanding to requires improvement. The forensic ward was inspected but not rated because it is part of the larger forensic inpatient and secure ward core service.
Serena Coleman, CQC deputy director of operations in the south, said:
“Although we saw kind, caring staff who were working hard to meet people’s needs, leaders didn’t have good enough processes in place to make sure they always had the knowledge and skills to keep people safe.
“Most staff told us they had generic mental health backgrounds but some staff had little to no previous experience of working with autistic people and people with a learning disability. Although training was available, it wasn’t mandatory, so some staff couldn’t identify the needs of people using the service.
“As a matter of urgency, we’ve told the trust they must ensure people being admitted to the forensic wards are placed there appropriately and are supported with therapy to reduce the increased number of incidents involving sexualised behaviour.
“People told us that some staff across both services sometimes had an attitude and were rude when they spoke to them, this needs to be addressed to ensure people are treated with dignity.
“However, people also told us they were generally happy, and we found that staff supported them to lead independent lives, encouraging them to pursue their interests. People were able to personalise their bedrooms, and mostly had good access to amenities and were able to move around freely. Staff also understood how to protect people from poor care and abuse and worked well with other agencies to do so.
“We’ve told the trust they must have mandatory training for all staff, so they are competent and equipped with the essential knowledge and skills to understand and work with the specific needs of people using their services. All staff at Brookfield Centre must also complete their immediate life support training and make sure someone trained is always on shift in case someone becomes unwell.
We’ll continue to monitor the trust to make sure people are safe and that these improvements are implemented, and they are building on their areas of good practice. We’ll return to ensure this is happening.”
At Tarentfort inspectors found:
- There had been an increase in incidents of a sexual nature, but staff were managing the risks and care plans reflected this
- People who lived at the centre told inspectors that food quality was poor, preferring to buy their own snacks rather than eat what was provided. They consistently raised this with management, but nothing had been done
- The centre was located close to amenities, shopping centres and other activities allowing people to access the local community, both escorted and unescorted
- Staff supported people to improve their skills in working towards being more independent. Staff focused on their strengths and promoted what they could do, allowing a fulfilling and meaningful everyday life
- Staff worked with people to plan for when they experienced periods of distress and staff did everything they could to avoid restraining people.
At Brookfield inspectors found:
- There was a lot of information on notice boards, with some people telling us they found them quite overwhelming
- Due to staff toilets and a linen cupboard being on the same corridor as their bedrooms, the noise from the opening and closing of these doors often woke people at night. This had been raised but that nothing had been done
- People prescribed paraffin-based skin products did not have a fire risk assessment in place
- The fridge on the ward had been broken since January and medicines were being stored in another ward on the same site
- People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and quality of life
- Staff placed people’s wishes, needs, and rights at the heart of everything they did
- Staff worked with people to plan for when they experienced periods of distress and staff did everything they could to avoid restraining people.