An independent hospital has been banned from taking new patients and placed into special measures.
Care Quality Commission inspectors had to take urgent action after a "worrying" inspection found that practices at Ashwood Nursing Unit in Warrington "could place people at serious risk of harm". After visiting Ashwood Court - which provides support for people aged 18 to 65 - in May, the inspectors served two warning notices relating to concerns around the safe care and treatment of patients and a lack of good systems and processes being in place at the nursing unit.
The CQC's report states: "Opportunities to prevent or minimise harm were missed", before it adds that the "privacy and dignity of patients was not protected. For example, male patients could see into female patients’ bedrooms from the garden, reports CheshireLive.
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"There was insufficient attention given to safeguarding. Staff did not follow the provider’s own safeguarding policy. Staff did not report all safeguarding concerns to the local authority that met the threshold for reporting."
The service was also asked to urgently ensure lifesaving equipment was in place and fit for purpose, and to complete risk assessments for all patients. The service is now in special measures, which means it will be monitored closely and re-inspected to assess whether sufficient improvements have been made.
According to the CQC's website, "If sufficient progress has not been made when we re-inspect and there are inadequate ratings for any key questions, we will begin to take action to prevent the service from operating".
The overall rating for the service has now gone down from good to inadequate. The ratings for being safe and well-led have also gone down from good to inadequate and its ratings for being effective, caring and responsive to people’s needs have gone from good to requires improvement.
Brian Cranna, CQCs head of hospital inspection, said: “When we inspected Ashwood Court, we found leaders didn’t have enough oversight of the service to ensure patients were receiving safe care and treatment, and it was worrying they weren’t aware of the concerns until this inspection.
“We found staff didn’t have the knowledge and skills needed to keep people safe. They didn’t have adequate training to safely manage incidents of violence and aggression, and weren’t up to date with mandatory training or have training in basic life support.
“We had concerns staff didn’t follow the provider’s absent without leave policy. There were two incidents where patients had gone absent without leave, following which risk assessments were not updated for both incidents and relevant staff weren’t informed which could place people at serious risk of harm.
“It was also disappointing that medical equipment hadn’t been routinely checked, as well as disposable items being out of date which was raised at the last inspection in 2018. Resuscitation equipment was also out of date or missing and had been for several months which isn’t acceptable and must be checked to ensure its safe, in case it is needed in an emergency.
“However, I’m pleased to report the staff had a caring attitude and patients spoke positively about the unit. Patients also had a good relationship with bank and agency staff.
“Due to our concerns we have issued the provider with two warning notices and placed the service in special measures to ensure significant improvements are made quickly, and embedded. We’ll continue to monitor the service closely and return to check on progress. If we feel people are at risk of harm, we will not hesitate to take further action.”
A spokesperson for Ashwood Court Nursing unit said: “We take the CQC inspection very seriously and have developed a thorough improvement action plan that addresses all areas of concern outlined in the report.
“The registered manager and newly recruited clinical lead are working closely with our central departments, senior management and the Greater Manchester Integrated Care (Wigan Locality) to implement these improvements and to demonstrate them in action. Immediately following the inspection the lifesaving resuscitation and medical equipment was sourced, and a system of checks and monitoring has been put in place.
"Our caring staff team have a good relationship with our patients, their families and carers which we value very much. Following the inspection we met with our patients to discuss the findings and what would happen next. We have also apologised and given assurances to families and carers following the findings. We will continue to keep them informed on actions being taken.
“All patients now have up to date risk assessments and crisis plans which are reviewed regularly - these are audited by our new clinical lead. Many of our staff team are up to date with their training and by the end of August all staff will have completed training in basic life support, challenging behaviour, conflict management and physical interventions.
“All safeguarding and CQC notifications are now being made and monitored appropriately. As we progress with our improvement plan we will ensure that Ashwood Court Nursing Unit provides the highest level of care to our patients and an outcome focussed, positive environment for all.”
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