Cygnet Hospital Colchester was rated “inadequate” overall by the Care Quality Commission after inspection visits in April and a further review of evidence in May this year.
The hospital, which provides inpatient care for adults with serious mental health problems and those with learning disabilities and autism, is run by Cygnet Health Care – the firm responsible for Whorlton Hall, which hit the headlines earlier this year after abuse of people with learning disabilities was exposed by BBC Panorama.
At an inspection in November last year, the 57-bed setting was rated “requires improvement” overall and “inadequate” for safety.
The latest inspection focused on two wards for female patients with personality disorders – an acute ward and one that provides long-term rehabilitation.
Inspectors found risks to patient safety had increased since their last visit and found both wards were under-staffed.
“There were significant risks to patients’ safety and others due to a lack of permanent staff who knew patients’ needs and how to best deliver care and treatment,” said the inspection report, which raised concerns about over-reliance on agency staff.
Staffing data from January to March 2019 showed nearly a third of ward shifts had fewer nurses than needed in order to provide safe care and treatment, said the report.
“All of this is unacceptable”
Dr Paul Lelliott
Sometimes there were not enough female staff to observe patients. Meanwhile, there were concerns about the skills of agency staff employed to plug staffing gaps, said the report, published today.
“The provider had not ensured that agency staff providing care or treatment to patients had the qualifications, competence, skills and experience to do so safely,” it said.
Inspectors also found the hospital “did not adequately check agency staff to ensure they were safe to work with vulnerable patients”.
According to the report, 21 out of 50 agency staff records – 42% – did not record if staff had a current disclosure and barring service check.
Other serious issues highlighted by inspectors included the inadequacy of assessments, risk management and monitoring to keep patients safe.
There were several occasions when staff had fallen asleep while they were supposed to be observing patients, inspectors were told.
There were also several incidents where patients had harmed themselves in view of staff or at “arm’s length” from a staff member.
Inspectors, who rated the service “requires improvement” for being caring, went on to raise concerns about the way staff interacted with vulnerable patients including using “judgemental” language.
“Improvements were needed to ensure that staff referred to patients with compassion, dignity and respect, as we found three examples of staff using judgemental language across these wards about patients either verbally or documented in care records,” said the report.
Inspectors also spoke to three patients who “gave examples of where staff had not treated them well or behaved appropriately to them”, said the report.
“We are determined to act on the recommendations of the CQC”
They found staff were still not receiving regular training, supervision and appraisals and had not had the specialist training they needed to work with people with personality disorders – issues raised at the hospital’s last inspection in 2018.
The CQC’s deputy chief inspector of hospitals and lead for mental health, Dr Paul Lelliott, said this was “extremely disappointing”.
“All of this is unacceptable and, as a result of our inspection, we have taken action to protect people using the service,” he said.
This included placing conditions on the provider’s registration to restrict admissions to the rehab ward and ensure there were enough suitably qualified staff to care for patients.
Dr Paul Lelliott
Cygnet Health Care said it had already embarked on an improvement programme and would take immediate action to address the concerns raised in the latest inspection report.
“Following the CQC’s inspection in November last year we took a number of steps to address the issues raised, including updating the employee training programme and putting a refurbishment plan in place,” said a spokeswoman.
“We note the additional issues raised in the CQC’s most recent report, based on the inspection in April of this year, and we have developed a comprehensive action plan to immediately address these concerns.”
This would include a review of governance arrangements to “ensure a robust incident management process that fosters learning of lessons for all staff”.
“We will also be reviewing our staffing arrangements and are working hard to eliminate the use of temporary workers,” said the spokeswoman.
“We are determined to act on the recommendations of the CQC and will continue to work with them to improve this service and bring it up to the high standards our service users expect and deserve,” she added.
Cygnet acquired Whorlton Hall, in County Durham, at the turn of 2019 as part of a take-over of Danshell Group.
After the allegations came to light in the Panorama episode in May, Cygnet took action to suspend staff who were involved and referred the matter to a police investigation.
The hospital has subsequently been closed.