Greater Manchester’s scandal-hit mental health services have been served with another warning notice to improve after inspectors found wards for older people were unsafe.
The Care Quality Commission (CQC) carried out unannounced inspections of wards for older people with mental health problems at Woodlands Hospital in Little Hulton, Salford, run by Greater Manchester Mental Health Trust (GMMH). The investigation was prompted by ‘concerns received about the safety of the wards and the care and treatment being provided in the wards’.
In a report published today (February 17), the CQC revealed the wards' safety rating has been downgraded from a good to inadequate. The wards were given a rating of requires improvement overall, again declining from a good rating.
The report found that nursing associates - not registered nurses - were left in charge as there was a lack of qualified nurses, staff had not completed life-support training, risk assessments, handovers and care plans were incorrectly completed, and that wards were physically unsafe with ligature risks. The latest inspection comes after months of turmoil for GMMH, including undercover footage broadcasted last year on the BBC Panorama programme, appearing to show staff bullying, humiliating and mocking patients at the mental health unit, the Edenfield Centre.
Following the Panorama programme, GMMH overall was served in November with warning notices to improve after inspectors found the service to be unsafe over the summer. Since the episode aired, multiple investigations have been launched and NHS England has placed the trust 'in the equivalent of special measures’.
The trust has also been under scrutiny after three young people died within nine months, with families saying staff needed to be held to account.
The CQC report published today focused on the elderly wards of Woodlands. Inspectors found the service did not have enough nursing and medical staff. Staff turnover and sickness rates were high.
Furniture was found to be ripped and broken, bathrooms had evidence of damp, and in one bathroom there were plastic bags full of clothes left there. There were potential ligature points within the hospital but no actions to mitigate the risks, meanwhile on all three wards patients were assessed as medium risk, despite some being admitted who were a significant suicide risk.
“We had significant concerns about lack of qualified nurse cover, with frequent occasions where one nurse was allocated to more than one ward and registered nurse associates allocated as the nurse in charge,” said the watchdog.
“Clinic room checks were not always undertaken regularly, including resuscitation equipment checks and cleaning and servicing of equipment. There were concerns about medicines management, including safe storage and checks of controlled drugs, as well as medicines fridges left unlocked including one which contained food and drink.
“People’s notes were not comprehensive and not all staff could access them easily. The electronic records system and incident reporting system were not accessible for many bank and agency staff. This meant they were unable to access care plans, risk assessments and progress notes, or to enter their own records.”
Karen Knapton, CQC deputy director of operations in the north, said: “When we inspected the wards for older people with mental health problems, we found staff hadn’t completed all the mandatory training required for their role. This included life support, moving and handling, prevention of violence and aggression, as well as safeguarding. The provider must ensure all staff are trained in these areas as it was affecting their ability to keep people safe.
“Inspectors found risk assessments, care plans and handover records weren’t completed appropriately for staff to have all the information required to safely look after people in their care. This was particularly concerning given the staffing pressures on the service and high use of temporary staff.
“Additionally, people were being cared for in ward environments which weren’t safe. There were issues with broken furniture and fittings, ligature risks not mitigated and alarm systems which didn’t always work which could put people at risk of harm. Leaders must address these issues as a matter of priority.
“Due to our findings, we have served the trust a warning notice so that they are clear about what changes must be made to improve patient care and safety at pace. We will continue to monitor the service and return to check on the progress.”
A Spokesperson for Greater Manchester Mental Health NHS Foundation Trust said: “We welcome the Care Quality Commission’s (CQC) report into our Woodlands Hospital, following their inspection in November 2022. We have taken serious note of the concerns they raised at the time and immediately addressed them.
“Some of the improvements have included appointing a Clinical Lead Nurse at Woodlands who is focused on the improvement of quality and safety outcomes for patients. We are also addressing staffing levels to make sure they are not just safe, but are at the optimum levels needed to deliver the best care possible.
“Like many areas of the NHS we do rely on temporary staffing to support us during periods of staff sickness, vacancies or increased acuity. However since this inspection, we have made sure that temporary staff have the same access to our electronic systems, policies, procedures, training and reporting arrangements as permanent GMMH staff members so that all patients will receive the same high standards of care from every team member.
“We have made improvements to the physical environment and equipment, and weekly checks are in place to make sure standards are maintained. We have also addressed the medicines management issues by carrying out regular audits to ensure medicines are safely and securely stored.
“We will continue to work with the CQC to ensure we maintain these improvements. However we would like to take this opportunity to apologise to the patients and carers whose standards of care fell below what they should have received. Along with other areas of the Trust we are working very hard to make GMMH better for those we care for and who work for us. We would like to thank everyone who is working with us as we continue on this improvement journey.”
Read more of today's top stories here
READ NEXT:
