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St Andrews Hospital bosses criticised by inspectors over child and mental health service in Northampton

A report into conditions at St Andrew’s Hospital in Northampton has revealed that some patients under 18 were not adequately cared for and that front-line staff were injured 57 times in three months.

The Care Quality Commission (CQC) report published today (February 27) was based on four unannounced visits in October and November last year, and in January 2019. The inspections involved child and adolescent mental health wards for under 18s with mental health issues and wards for children and adolescents with learning disabilities or autism.

In summary, the report stated that young patients were kept in ‘segregated’ conditions which were not appropriate. It also stated low staffing numbers had an adverse impact on patients and that appropriate records were not always kept.

“We found the provider had identified that they were not able to meet the care needs of three patients with very complex problems and behaviours that staff found challenging. For all three, the provider had worked actively to facilitate discharge without success.

“In one of these cases, the patient had been subject to repeated and prolonged periods of seclusion and segregation for about 18 months before the inspection visit. The staff at St Andrew’s had decided that this was necessary to reduce risk to the patient concerned, to other patients and to staff.

“We found one example where staff had not worked with a patient in the least restrictive way.”

The hospital, which is a registered charity taking psychiatric patients mainly through the NHS, has a huge site in Northampton stretching from Bedford Road to Billing Road, and the child and adolescent service is based at the newer buildings on Cliftonville Road. Some young patients with severe behavioural issues are held in segregation or ‘seclusion’ which should be regularly reviewed, according to the report.

Staff, carers and patients were interviewed by the inspection teams and noted that front-line staff were compassionate and caring.

The report stated however: “Staff did not feel the provider [St Andrews Healthcare] gave consistent support after incidents and that managers delivered de-briefs for ‘significant’ issues only.

“This affected staff morale and attendance at work, particularly when incidents related to staff assaults.

“Not all staff interviewed felt supported and valued for the work they did. However, despite this, those interviewed continued to do their best for the patients they were caring for, and clearly enjoyed their role and the positive contribution they made to the patients’ lives.”

In the summary of the report it states: “During the three months between 31 July 2018 and 31 October 2018, the service had recorded 57 incidents of staff injury. These included staff being punched, kicked, scratched and pushed to the floor and being stamped upon. During one incident, five different staff had to attend the local accident and emergency department for injuries to the face, head and abdomen.”

A spokesperson for St Andrew’s Healthcare said:“We welcome the CQCs review of our Child and Adolescent Mental Health Service in Northampton which focused on our use of seclusion and long-term segregation.

“Following four unannounced inspections, the CQC reported that seclusion and segregation are used appropriately, and that staff use recognised techniques to reduce the need for physical restraint wherever possible. We are pleased that the CQC noted the lengths our staff go protect patients from avoidable harm, and how they worked in collaboration with patients to develop their care plans and reduce restrictions at the earliest opportunity.

“The CQC also recognised the difficulties providers like St Andrew’s Healthcare face when transitioning patients to community settings more appropriate for their specific needs.

“We will continue to make improvements to our service and look forward to welcoming the CQC back in the future.”

A copy of the full report can be viewed here via the CQC website

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