A mental health hospital in Bolton has been rated inadequate for a second consecutive time by the Care Quality Commission (CQC) following an inspection carried out in December. CQC is also taking further action.
The Breightmet Centre for Autism is an independent hospital run by ASC Healthcare Limited and provides support to adults with a learning disability or autistic people. At the time of the inspection there were 12 people using the service.
The hospital was previously rated inadequate and placed in special measures following an inspection in March 2022. This latest inspection was carried out to follow up on the warning notices issued at the last inspection and assess whether improvements had been made.
CQC did not find enough improvement had been made, so as well as The Breightmet Centre for Autism remaining inadequate overall, it also remains rated inadequate for being safe, effective, caring and well-led. The service has improved from inadequate to requires improvement for being responsive to people’s needs.
CQC is now taking further enforcement action, and if there is not rapid, widespread improvement, will start the process of preventing the provider from operating the service.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“Much like the findings from our previous inspection, we still didn’t see enough significant improvement to reassure us that leaders at Breightmet had turned things around. More worryingly, we witnessed incidents that gave us real concerns about people’s dignity and their experience of using this service.
“We witnessed staff using a disproportionate level of restraint, and care plans weren’t followed in ways such as helping people who needed it to eat and drink.
“We also saw staff laughing at the people they were supposed to be looking after, and that people spent most of their time alone in their rooms. People also told us staff could be loud at night time and disrupt their sleep, and their preferences such as to be supported by carers of a specific gender wasn’t always being respected. Vulnerable people were relying on all staff members to act as their advocates, to help them live their best lives and it is unacceptable the people they relied on were treating them this way.
“However, we did see some small improvements since the previous inspection in how the service was handling complaints and working well with services that provide aftercare to ensure people received the right care and support when they went home.
“We have told the provider that it must make urgent improvements and we won’t hesitate to take further action and use our legal powers to keep people safe, which could include closing the service. It is not acceptable to keep people waiting for improvements much longer in a service which is not meeting their needs.”
Inspectors found:
- People’s risks were not assessed regularly and managed safely. People were not involved in managing their own risks whenever possible
- People’s care, treatment and support plans, did not reflect their sensory, cognitive and functioning needs
- Staff did not follow the requirements of the Mental Capacity Act 2005 in relation to assessing capacity and making decisions in people’s best interests
- People did not receive care, support and treatment that met their needs and aspirations. Care did not focus on people’s quality of life and did not follow best practice. Staff did not use clinical and quality audits to evaluate the quality of care
- Staff did not support people through recognised models of care and treatment for people with a learning disability or autistic people. Governance processes did not help the service to keep people safe, protect their human rights and provide good care, support and treatment.
However
- There had been improvements in the management and investigation of complaints
- If restrictive practices were used, there was a reporting system in place and there were comprehensive reviews to try and reduce the use of these practices.