A troubled mental health hospital has been slammed by inspectors, whose 'worrying' visit uncovered 'disproportionate levels of restraint'; 'care plans not being followed'; and 'people spending most of their time alone in their rooms'.
The Breightmet Centre for Autism in Bolton has been deemed 'inadequate' for a second consecutive time by health watchdog the Care Quality Commission (CQC). A damming report has now been released.
"Vulnerable people were relying on all staff members to act as their advocates, to help them live their best lives and it is unacceptable the people they relied on were treating them this way," they wrote.
“We also saw staff laughing at the people they were supposed to be looking after."
The hospital was previously rated 'inadequate' and placed in special measures following an inspection in March 2022. The latest review in December saw officials 'witnessing incidents that gave them real concerns about people’s dignity and their experience of using this service'.
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The Breightmet Centre for Autism is an independent hospital run by ASC Healthcare Limited. It provides support to adults with a learning disabilities and people with autism. At the time of the inspection, there were 12 people using the service.
Inspectors found 'disproportionate levels of restraint'; 'care plans not being followed'; and 'people spending most of their time alone in their rooms'. Inspectors said they were left 'worried' by the inspection.
The latest inspection was carried out to follow up on the warning notices issued at the 2021 inspection and assess whether improvements had been made. CQC did not find enough improvement had been made.
The facility remains 'inadequate' overall and 'inadequate' in the 'safe', 'effective', 'caring' and 'well-led' categories.
CQC is now taking further enforcement action, and if there is not rapid, widespread improvement, will start the process of preventing the provider from operating the service.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said: “Much like the findings from our previous inspection, we still didn’t see enough significant improvement to reassure us that leaders at Breightmet had turned things around. More worryingly, we witnessed incidents that gave us real concerns about people’s dignity and their experience of using this service.
“We witnessed staff using a disproportionate level of restraint, and care plans weren’t followed in ways such as helping people who needed it to eat and drink.
“We also saw staff laughing at the people they were supposed to be looking after, and that people spent most of their time alone in their rooms. People also told us staff could be loud at night time and disrupt their sleep, and their preferences such as to be supported by carers of a specific gender wasn’t always being respected.
"Vulnerable people were relying on all staff members to act as their advocates, to help them live their best lives and it is unacceptable the people they relied on were treating them this way."
Inspectors also found that people’s risks were not assessed regularly and managed safely and people were not involved in managing their own risks whenever possible.
People’s care, treatment and support plans did not reflect their sensory, cognitive and functioning needs. "Staff did not follow the requirements of the Mental Capacity Act 2005 in relation to assessing capacity and making decisions in people’s best interests," added the inspector.
"People did not receive care, support and treatment that met their needs and aspirations. Care did not focus on people’s quality of life and did not follow best practice. Staff did not use clinical and quality audits to evaluate the quality of care.
"Staff did not support people through recognised models of care and treatment for people with a learning disability or autistic people. Governance processes did not help the service to keep people safe, protect their human rights and provide good care, support and treatment."
The service had, however, improved from 'inadequate' to 'requires improvement' for being' responsive to people’s needs'. "We did see some small improvements since the previous inspection in how the service was handling complaints and working well with services that provide aftercare to ensure people received the right care and support when they went home," the CQC director continued.
“We have told the provider that it must make urgent improvements and we won’t hesitate to take further action and use our legal powers to keep people safe, which could include closing the service. It is not acceptable to keep people waiting for improvements much longer in a service which is not meeting their needs.”
'Improvements have been made'
A spokesperson for The Breightment Centre for Autism said: "We are passionate about delivering high quality care to our service users and their safety and wellbeing is our number one priority. The Breightmet Centre for Autism is a small community hospital for adults with Autism and/or Learning Disability and has an ethos of least restrictive practice and enabling community care for our patients with positive outcomes.
"The new management team at The Breightmet Centre for Autism are working constructively with the CQC and other external stakeholders such as NHSE and our focus is on making ongoing sustained improvements for our service users and families.
"The CQC have acknowledged that improvements had been made at the time of inspection in December 2022 and we are further confident that further sustained improvements continue to be made as we continue to work collaboratively with all external stakeholders."
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