The Care Quality Commission (CQC) has found improvements need to be made in acute wards for adults of working age and psychiatric intensive care units (PICU) at Cheadle Royal Hospital, following an inspection in February and March.
Cheadle Royal Hospital, is run by Affinity Healthcare Limited and provides mental health services. It has 13 wards that provide inpatient care including acute wards for adults of working age and psychiatric intensive care units (PICU), child and adolescent mental health wards, specialist eating disorder services, and rehabilitation and recovery services.
CQC carried out an unannounced comprehensive inspection of seven acute wards for adults of working age and PICU wards, in response to receiving information of concern about the service.
Due to issues found around physical health monitoring and medicines management, Affinity Healthcare Limited was issued with a warning notice to focus its attention on making rapid improvements. CQC will return to carry out another inspection to ensure these improvements have been made.
Following this inspection, the overall rating for the acute wards for adults of working age and PICU wards has dropped from good to requires improvement. It has declined from good to inadequate for being safe. Well-led has again been rated as requires improvement. Being effective, caring and responsive have again been rated as good.
The overall rating for Cheadle Royal Hospital remains as requires improvement.
Alison Chilton, CQC deputy director of operations in the north, said:
“When we inspected acute wards for adults of working age and psychiatric intensive care units (PICU) at Cheadle Royal Hospital, it was disappointing to see a deterioration in the safety of care being provided.
“Although there had been some improvements around staffing levels and culture since the previous inspection in April last year, there were still some areas which need to be addressed.
“We were concerned that leaders hadn’t implemented a clear process for ensuring people were monitored after having rapid tranquilisation. Also, screening for blood clots should have taken place when people were admitted to the ward, however this wasn’t always happening. The provider must address this as a priority to keep people safe.
“Additionally, staff didn’t always review the effect medicines were having on people’s mental and physical health, which could put people at risk and make them unwell.
“However, staff had access to the full range of specialists required to meet the needs of people on the wards and understood how to protect them from abuse. They also worked well with other agencies to do so.
“Since the inspection, the provider has informed us they have made some improvements. We will continue to monitor the service closely and if we’re not assured improvements have been made and embedded, we will not hesitate to use further enforcement powers to keep people safe.”
Inspectors found:
- The service was not always well-led and although there were processes in place, these did not always identify where there were gaps in the delivery of care
- The service did not always use systems and processes to safely prescribe, administer, record and store medicines
- Staff were not always completing records appropriately after the use of rapid tranquilisation, in accordance with national guidance.
However:
- The ward environments were mostly safe and clean. The wards usually had enough nurses and doctors
- Staff treated people with compassion and kindness and respected their privacy and dignity
- Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave people honest information and suitable support.