Care regulator the Care Quality Commission (CQC) has warned Central and North West London NHS Foundation Trust (CNWL) that it must improve the care it provides at two mental health facilities.
This warning came after CQC inspections of the facilities – the Campbell Centre in Milton Keynes and 3 Beatrice Place in Kensington – revealed that both were failing to meet minimum standards of care.
CQC inspected The Campbell Centre, in Standing Way, Eaglestone – a 38-bedded inpatient unit providing acute mental health services – in November 2013 to follow up on concerns identified at a previous inspection and concerns raised since.
Inspectors found that, while the trust had put improvement plans in place, the service was failing to meet all 8 standards checked. On 3 of these – care and welfare of people, safety and suitability of premises, and assessing and monitoring the quality of service provision – warning notices were issued.
Among CQC’s findings at the Campbell Centre:
• Care plans and risk assessments were not always updated placing people at risk of harm
• Processes in place to protect patients from the risks associated with the management of medicines and safeguarding were not always followed
• Governance and quality monitoring of the service was in need of improvement
• There was a heavy reliance on agency staff, which impacted on the continuity of care and welfare of patients.
Meanwhile, at 3 Beatrice Place, a continuing care nursing home for people with severe and enduring mental illnesses, including dementia, with 24 beds, a CQC inspection in December 2013, found that:
• Care delivered was not appropriately recorded or reviewed, and care arrangements focused on the delivery of personal interventions as opposed to recovery and wellbeing
• The provider had failed to respond appropriately to an allegation of abuse
• Half the clinical staff had not been trained to restrain people appropriately and safely. This put people at risk of harm. Strategies to de-escalate potentially violent situations were inadequate
• While the provider had implemented systems to improve the service, these were not sufficiently robust to protect people from the risk of unsafe or inappropriate care and treatment.
Matthew Trainer, regional director of CQC in London, said: “Central and North West London NHS Foundation Trust has been failing to meet the required standard in these services for some time. These are complex services that provide care to vulnerable people and the improvement plans that the trust has in place need to start showing hard results.
“At the Campbell Centre, we found that processes designed to protect people from harm were not always being followed. Patients’ care plans had not been updated to reflect incidents or the current individual needs of the person concerned – and we know that this can result in unsafe or inappropriate care.
“At Beatrice Place, we found that people were at risk of being restrained inappropriately, and that the provider had failed to respond in the right way to an allegation of abuse.
“People are entitled to be treated and cared for in services which are safe, effective, caring, well run, and responsive to their needs. We will return to both the Campbell Centre and Beatrice Place shortly to check whether the required improvements have been made and whether we need to take further action - and will report further in due course.”
Apology to patients and families
In response, Claire Murdoch, chief executive of CNWL, said, “We accept the CQC’s judgements and apologise to patients and families who feel let down. Our staff will feel that too; we’re proudly NHS and want services to be the best they can be. Safety is our top priority and we’re investing in it but that’s a dented claim when inspectors don’t see accurate paperwork, training up-to-date and recorded, and every legality and protection observed - something, as a nurse myself, I know very well.
“CQC inspectors can come here at any time to check but I rely on the ‘inspectors’ here every day, our staff, to deliver the standards they would want their own relatives to receive. We will deliver improvements.”
In relation to this, CNWL has already started to implement an action plan. The trust adds that £1.85 million has been invested in the Campbell Centre and £400,000 in Beatrice Place on extra staff and bringing services up-to-date.