Stains “likely to be either food or faeces” were left on the ceiling of a Merseyside mental health ward for over a week.
The grim find was made during an inspection of two mental health wards at the Clatterbridge Hospital in Wirral. The inspection, which also included another ward in Macclesfield found conditions have “deteriorated” for vulnerable mental health patients across Cheshire and Wirral.
While the Cheshire and Wirral Partnership NHS Foundation Trust’s rating overall remains good, it has been issued with a warning notice after an inspection by the Care Quality Commission (CQC).
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The inspection was carried out unannounced at two wards at Clatterbridge Hospital on the Wirral as well as the Mulberry ward in Macclesfield between November 8 and 15 2022.
The CQC carried out the inspection after concerns were raised and found overall that the quality of care was inadequate with leadership quality dropping from good to inadequate. Safety was also rated inadequate.
But the report said patients were “treated with dignity and respect” and there was evidence things had improved since past serious incidents including steps to improve monitoring of patients.
At Clatterbridge, the inspection was carried out on Brooklands ward which is a psychiatric intensive care unit and Lakefield, a ward for adults with functional mental health conditions such as schizophrenia and bipolar mood disorder.
In Brooklands, a stain likely from food or faeces was found on the ceiling but hadn’t been cleaned. The report said inspectors “could not identify the substance causing the stains but it was most likely to be either food or faeces thrown by a patient.”
The stain was spotted on the first day of inspection but a week later was still there. The report added: “This was despite written assurances we received directly by the trust in October 2022 following similar concerns about cleanliness of the seclusion room ceiling.
“In that response the trust acknowledged similar ceiling debris was noted in May 2022, was removed by the Modern Matron, a deep clean undertaken the following day and systems in place to check the cleanliness.”
There was also no ward manager at Brooklands but “the trust had put a supportive team and improvement plan around the Brooklands ward team” according to the report.
In Lakefield, carers said it was sometimes difficult to speak to other staff when phones wouldn’t be answered and there was no CCTV in communal areas to monitor patients.
The report did praise improvements made since a death at Lakefield in 2018. These included a member of staff being deployed at the entrances to bedroom corridors and improving visibility of patients.
The report said: “When the most serious untoward incidents occurred, managers shared lessons learned with the whole team and the wider service” and “there had been no further deaths by ligaturing or as a result of the compromised layout on Lakefield ward.”
The report said a serious incident in June 2022 in Brooklands is still under investigation but improvements had been put in place since.
Karen Knapton, CQC deputy director of operations in the North, said: “Leaders at the trust should be acting as advocates for the vulnerable people in its care, but we found this wasn’t always happening and took enforcement action to focus their attention on this area.”
She added: “We will return to see what improvements have been made and embedded. If we’re not satisfied people are receiving safe care, we will not hesitate to take further action in line with our regulatory powers.”
Tim Welch, chief executive, of Cheshire and Wirral Partnership NHS Foundation Trust said: “We fully accept the findings in the CQC report and acknowledge we have fallen short of the high standards we pride ourselves on.
"We sincerely apologise and are supporting those people affected and have taken immediate action in line with the targeted recommendations to improving environments, documentation and governance to enable our practices to be as safe as possible - specifically relating to seclusion.
"We are pleased the CQC observed “staff’s commitment to ensure patients receive good quality care”, recognising CWPs core values including care and compassion treating patients with “dignity, respect and kindness”.
“We are in regular contact with our regulators and partner organisations and will continue to update them on the actions we are taking as a result. If you, or someone you care for, have been affected please contact the CWP Patient Advice and Liaison Service on 0800 195 4462 (10am – 3pm) or via cwp.pals@nhs.net. If you want to speak to somebody independent from the Trust, your local advocacy services are aware of the situation and are on standby to support you.
Cllr Yvonne Nolan, Chair of Wirral Council's health and social care committee said: “ I am concerned to hear the outcome of the CQC inspection of psychiatric services at Clatterbridge Hospital. This provision serves some extremely vulnerable members of our community who need high quality, safe services.
"I am sure that Cheshire and Wirral Partnership will be acting quickly to make all necessary improvements to restore this facility to its previously high standards”
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