Tag: Mental health units

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.

First restraint legislation passed by MPs

Article 39 is delighted that the Mental Health Units (Use of Force) Bill has passed through the Commons. We have been working on the Bill all this year, as part of a coalition of mental health and human rights charities co-ordinated by YoungMinds. This is the first standalone law in the UK specifically designed to protect children and adults from abusive restraint.

After filibustering by two MPs, Philip Davies and Christopher Chope, last month, the Private Members’ Bill was genuinely under threat. However it passed without objection today (6 July), after which it received a round of applause by MPs present in the Chamber.

Watching the proceedings was the family of Seni Lewis, who died in 2010, aged 23, after being restrained by up to 11 police officers who were called to his hospital. In a moving tribute, Steve Reed MP, whose Private Members Bill it is, said the legislation will be “a lasting and proud legacy for Seni Lewis”.

At earlier stages, Article 39 pressed for parents or others with parental responsibility to be notified when a child patient is restrained. This was extended to all patients and is included in Clause 6 of the Bill. We also wanted the impact of restraint on a child’s development to be included in the Bill’s training requirements: this is contained in Clause 5 (covering all ages).

Other priorities, which we plan to continue to pursue when the Bill enters the Lords, include a prohibition on restraint techniques deliberately designed to inflict pain; patients to be informed of the techniques used in their unit; the recording of the patient’s perspective after each use of force; and patients to be informed of their right to independent advocacy.