Children not safe in St Andrews mental health hospital

The Care Quality Commission (CQC) has placed a mental health hospital for children in special measures.

St Andrew’s Healthcare Adolescent Service in Northamptonshire, which is registered as a charity, has been rated ‘inadequate’ overall and the same for safety, care and leadership following an inspection by the CQC.

Among the many damming findings, inspectors reported:

“On one occasion, staff did not respect a patient’s privacy and dignity when changing her clothing. While female staff were present, there were also male staff there at the time. It was the inspection team’s view that this was uncaring, undignified and disrespectful to the patient.”

Inspectors also found:

  • Between July 2018 and January 2019, there were 1,754 incidents of restraint. In one ward (Meadow), restraint was used 546 times with just 15 children during this period. Inspectors reviewed one incident where “staff had restrained the patient and changed them into rip proof clothing when the patient was presenting as calm and compliant”.
  • Eleven of the 15 ‘seclusion rooms’ did not have furnishings such as a bed, pillow, mattress or blanket.
  • Staff applied blanket restrictions without justification. All wards had imposed set snack times. Other restrictions were placed on access to drinks and takeaways. Children were not allowed to wear shoes on Meadow ward.
  • Staff on Willow ward locked en-suite rooms which meant children had to request staff to unlock them.
  • Staff shortages sometimes resulted in staff cancelling escorted leave, appointments or ward activities. Staff on Fern, Maple and Willow wards said the high use of bank and agency staff impacted on patient care.
  • There were sharp edges on door frames in ‘seclusion rooms’ and ‘extra care suites’, blind spots in ‘seclusion rooms’ and pieces of exposed sharp metal in ‘extra care suites’.
  • Staff did not always check emergency equipment and medicines.

Helen Donohoe, Assistant Director at Article 39, said:

“It is incomprehensible that such systematic abuse of children’s human rights can go on in an institution funded by the NHS. The denial of dignity and privacy and the failure to ensure basic levels of safety reveal a toxic environment that conflicts wholly with the care that children need to thrive and be well.

“It is clear from the CQC report that staff levels and the frequent use of agency staff was a factor in the poor care. This is a recurring issue and one that Article 39 is deeply concerned about.” 

Article 39 will be seeking information about the post-inspection actions taken to ensure the rights, dignity and safety of the children and young people in St Andrew’s Healthcare Adolescent Service. The inspection took place in March-April 2019.

We are especially keen to find out how children and young people are supported by independent advocates and how they are made aware of their rights. A review of 25 records found that nearly a third (7) failed to show that children had been informed of their rights either on admission or at the point of their detention.

Read the full inspection report.

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