Kneesworth House Hospital rated ‘inadequate’ by CQC
PUBLISHED: 07:01 30 July 2019 | UPDATED: 12:35 30 July 2019
Alan J Millard 15 SG4 0BS
Kneesworth House Hospital has been placed into special measures after being rated as ‘inadequate’ by health watchdog the Care Quality Commission.
The independent mental health service in Kneesworth's Old North Road is run by Partnerships in Care, part of The Priory Group, and provides inpatient care for people with acute mental health problems, locked and open rehabilitation services, and medium and low secure forensic services for people with enduring mental health problems - including some patients with a learning disability.
The Care Quality Commission - which regulates all health and social care services in England - inspected the hospital, between March 19-24 and on April 4, and found a number of serious concerns. As a result, the service has now been placed into special measures, as stated in the inspection report, released today.
The service will be reinspected within six months and, if improvements have not been made, the CQC will take action to begin the process of preventing the provider from operating the service.
The service is rated as 'inadequate' overall, as well as for whether the service being provided is safe, caring and well-led. The hospital is rated as 'good' for whether it is effective and responsive.
Following its previous inspection, in November and December 2017, the service was rated 'good' overall.
Dr Paul Lelliott - the CQC's deputy chief inspector of hospitals, and lead for mental health - said: "The care provided at Kneesworth House fell well below the standard that people should expect, and our inspection team were very concerned by some of what they found.
"Our greatest concerns were about the forensic service, which consisted of Clopton, Ermine, Icknield and Orwell wards.
"Some of the clinic rooms at the hospital were disorganised and some ward areas were dirty, and in need of repair and redecoration. This included stained and dirty toilets, and unpleasant odours. Furniture was ripped and the system for ensuring maintenance jobs were completed was ineffective.
"When staff at the hospital secluded patients, they did not always follow the provider's policy and the Mental Health Act Code of Practice.
"We found three instances where staff had not recorded the justification for secluding patients for a prolonged period. This was a concern when we last inspected the hospital in 2017.
"In the forensic service, staff sometimes denied patients access to certain parts of the ward, cancelled patients' leave or cancelled ward activities because of a shortage of staff.
"Some staff at the hospital were uncaring and disrespectful. Patients on Icknield ward told the inspection team that some staff used keys to prod their legs and feet to get them out of bed. As a result, patients had altered their sleeping position or wore trainers in bed.
"Seven patients that we spoke with told us that a few staff were rude, unfriendly and did not listen to them or antagonised patients.
"Staff had used negative and judgemental language about a patient in a seclusion record. This is why we have rated the service as 'inadequate' in respect of our key question of whether services are caring.
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"All of this is unacceptable and not what anyone should expect when receiving mental health care. The leadership team at Kneesworth House knows that it must take immediate action to address the problems we identified.
"We will continue to monitor the service very closely. If urgent improvements are not made to ensure people are safe, we will take action to prevent the provider from operating this service."
The service has been told it must make a number of improvements, including:
- The provider must ensure that all ward areas, seclusion rooms and clinic rooms are clean and properly maintained.
- The provider must ensure there are rigorous processes in place to prevent contraband items from entering the ward environments.
- The provider must ensure staff seclude patients and record seclusion in line with the provider's policy and the Mental Health Act Code of Practice.
- The provider must have robust plans to manage patients displaying challenging behaviour in upstairs bedroom areas.
- The provider must ensure staffing levels are sufficient to ensure that patients have access to the whole ward.
- The provider must ensure patients are safe and protected from improper treatment.
- The provider must ensure staff respect patients' privacy and dignity, and staff do not use restrictive practices to manage the ward environments.
- The provider must ensure staff complete robust risk assessments for all patients in a timely manner, and ensure identified patient risks are effectively managed, regularly reviewed and updated following incidents.
- The provider must ensure it has processes in place to identify and address poor quality care, such as using keys to encourage patients to get dressed.
- The provider must ensure an effective system is in place to record, action and monitor that all maintenance issues are highlighted and resolved in a timely manner.
A hospital spokesman said: "We have taken immediate action to address the CQC's concerns and have implemented a comprehensive action plan to drive improvements in the forensic service provided at Kneesworth House.
"While we accept the service fell below the expected standards in some areas of the hospital, it is important to note the CQC also rated the acute mental health and rehabilitation services, which make up the greatest proportion of beds, as 'good' and that overall the hospital was rated as 'good' for being effective and responsive.
"Our absolute priority now is addressing the issues identified in the report to ensure good practice is replicated throughout the hospital. A major investment plan is already in development to ensure the environment in which the forensic service is delivered is improved, and we are committed to ensuring the individuals in our care are given the best possible support."
A full report of CQC's inspectors' findings can be viewed via cqc.org.uk/location/1-129389215.