A centre which treats people with learning disabilities and autism has been placed under special measures following a scathing report from the Care Quality Commission (CQC). The Breightmet Centre for Autism on Milnthorpe Road, Bolton, was classed as 'inadequate' in a number of areas after the inspection in March this year.
The service has been placed in special measures before, in June 2019, but had been removed after improvements were made in November 2020 with it being given a 'good' rating overall. However, the site was visited again just five months later after safety concerns were raised about the care and treatment of the people using the service.
This most recent inspection once again found numerous problems, with the service being placed into special measures again with an overall rating of inadequate. The service was rated inadequate in all areas of the CQC's report, including safety, effectiveness, caring, responsiveness to people's needs, and being well-led.
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The report details how the service did not have enough appropriately skilled staff to meet people's needs and keep people safe and that did not follow infection control precautions that were required to minimise and control the spread of infections. It also states that people were not supported to be independent and have control over their own lives and comprehensive reviews were not completed to identify and reduce all restrictive practices in the service.
The report added that staff did not support people in their care to 'achieve their goals' and that many staff had 'no prior experience of working with autistic people'. Despite rating the service as inadequate overall there were some aspects that were praised by inspectors.
The report said that autistic people’s care and support was provided in a clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs and managers had ensured that staff, including regular agency and bank, had regular supervision and appraisal. It also said that advocates were actively involved in reviewing autistic people’s care and that staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
Debbie Ivanova, CQC’s director for people with learning disabilities and autistic people, said: "When inspectors returned to The Breightmet Centre for Autism, they were disappointed to see a significant decline in the quality of care being provided to people with a learning disability and autistic people. We found that the support and treatment given did not meet people’s needs and aspirations. Care did not focus on people’s quality of life or follow best practice and audits undertaken did not reflect the quality of care given.
"It was concerning that many staff were not suitably skilled or trained to work with people with a learning disability or autistic people. This led to people receiving limited support with making choices and having control over their own lives. People weren’t supported to input into their care plans and weren’t empowered to take part in activities which were part of their planned care and support.
"Feedback from families and carers about the quality of the service was poor. They told us they’d all had issues with communication and that the service didn’t provide updates or respond to emails or phone calls.
"They also described staff as being defensive when issues were raised and said they were made to feel unwelcome on the wards. The service has been placed in special measures and is being supported to make the required improvements by the wider system, including the local clinical commissioning group.
"Inspectors will continue to monitor service closely to ensure people are safe. If we are not assured people are receiving safe care, we will not hesitate to take further action."
An ACS spokesperson said they take the feedback from the CQC 'very seriously' and are working to make improvements. They said: "We are passionate about delivering high quality care to our service users and their safety and wellbeing is our number one priority.
"We therefore take all feedback from the Care Quality Commission very seriously. We are disappointed by the CQC’s findings and are working to ensure improvements are made. A full and detailed response to the inspection report can be found on our website following the publication of the inspection report.
"We are sorry for any distress caused to both our service users and their families. We are working closely with our Host Commissioner, NHSE and Bolton Safeguarding and have implemented robust and comprehensive action plans to improve our standards which we have shared with our Host Commissioner, NHSE and Bolton Safeguarding.
"In addition, we have ongoing meetings with our Host Commissioner, NHSE and Bolton safeguarding who are supporting ASC towards the improvements we have made. We continue to collaborate closely with relevant local partners to sustain improvements and are confident the Breightmet Centre will have made sufficient progress by the next inspection."
Their response to the CQC's report provided to the MEN says they are 'shocked' to see it contains 'a number of inaccuracies' saying there was an " over-reliance on unsubstantiated third-party opinions communicated to it". " This naturally puts our service on the back foot given that all of our patients are detained under the Mental Health Act, and the relevance and factual accuracy of such feedback from the patients themselves and/or their families cannot readily be taken at face value at all times," it adds.
"The conclusions reached by CQC are ones that we feel no reasonably independent person would conclude when the evidence we have submitted is properly considered. The resulting quality of the report is deeply disturbing and we are very disappointed that the CQC would release into the public domain something that they know is unreliable and blatantly one-sided and clearly prejudicial. The CQC's decision to publish the report has us question whether the CQC have the capacity to fairly inspect our service."
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