A NORTH-EAST MP has called on the Secretary of State for Health to ensure the safety of patients at a crisis-hit hospital after health regulators downgraded it from Good to Inadequate.

Middlesbrough MP Andy McDonald also said those still receiving care at West Lane Mental Health Hospital in Middlesbrough needed to know measures were being taken to provide a “safe caring environment”, that had been absent.

The hospital, which was already under investigation following the deaths of two inpatients since June, had been previously rated good in an inspection carried out a year before the death of 17-year-old Christie Brayley in June.

Several weeks later, 17-year-old Nadia Sharif died while in the care of the hospital on August 9.

Responding, Andy McDonald, MP for Middlesbrough, called on Health Secretary Matt Hancock to “take whatever steps necessary” and said: “The report of the Care Quality Commission into West Lane Hospital is damning and highlights very serious failings."

The Northern Echo:

Andy McDonald has responded

He said: “Patients and their families need urgent reassurances and they will want to know that all the measures that can be taken are being taken to provide the safe caring environment patients need but has clearly been absent.

“Tragically two young patients have died whilst in the care of West Lane.

“Of course, the medical conditions of patients present immense challenges but this hospital has crashed from a “good” rating to “inadequate” between two CQC reporting periods.

“The families and the public have a right to know what has gone so drastically wrong in such a short space of time.

“Obviously given these tragic deaths, there will be a number of formal inquiries and ultimately I expect there to be full inquests in both cases, but the conclusion that safe care is not being delivered, rings very loud alarm bells.

“I have said previously that staff turn up to do their very best but their task appears to have been completely compounded by poor management in terms of rostering of staff, lack of availability of alarms, weaknesses in record keeping and critically, in monitoring patients and so on.”

In the Care Quality Commission’s report into West Lane Hospital, it found staff did not receive adequate support from managers to carry out their roles and responsibilities safely - while it found staff did not feel valued and morale was very low.

Mr McDonald said: “It seems staff members themselves were complaining about the weaknesses in the systems and the management of the patients and it beggars belief these warnings weren’t heeded.

“Parents, families and friends of patients and the all the staff at the hospital will be totally devastated by these events but for the safe functioning of the hospital right now, the CQC, the Hospital Trust and NHS England all have to take continuing responsibility on a day to day basis for ensuring the safety of patients.

“The Secretary of State for Health will need to take whatever steps are necessary.

“I would be extremely worried if there was any attempt to lay this at the door of individual members of staff as the CQC report makes it clear there has been a systemic breakdown in processes, correct staffing, monitoring and supervision.

“A huge amount of work is necessary to turn this situation around and whilst I hope this is achievable, the Trust will have to consider all the options available to them to provide the safest possible environment for the patients.”

Elizabeth Moody, Director of Nursing and Governance and Deputy Chief Executive at Tees, Esk and Wear Valleys NHS Foundation Trust, said: “The Trust fully accepts the findings of the Care Quality Commission’s (CQC) inspection carried out in June 2019.

“Our patients are always our priority so we are sorry that we have not always delivered the high standard of care that we aim to provide at West Lane Hospital, and that the young people in our care deserve.

“No-one admits a young person to a mental health ward lightly and when we do their needs are extremely complex. As the report highlights, staffing in this area of healthcare is difficult, particularly given the acuity of some patients. However, these young people should be cared for in safe, high quality environments and we are committed to making the improvements necessary.

“It was positive to see that the young people on the wards at West Lane Hospital at the time of the CQC inspection commented that our staff were respectful, caring and kind. The report also acknowledged a number of areas of good practice at both Baysdale and Holly Unit, and it was particularly pleasing to see carers so positive about the staff and services at those units.

“The CQC highlighted a number of issues that we were already aware of and we have taken urgent and immediate action to address them. The decision by the CQC to close the wards to new admissions at West Lane Hospital has helped to stabilise the staffing situation and following the inspection in June we have instigated a significant programme of work.

“In July we consolidated the number of wards at West Lane Hospital from three to two. Doing this helped us to address staffing problems and improve safety in order to better meet the needs of the young people in our care. It has also allowed us to bring together skills and capacity to enable more staff training and support, improve supervision and to address the concerns identified by the CQC. We have increased clinical and managerial leadership and provided additional support for staff on the wards. There has also been ongoing work to reduce the use of restrictive interventions with a number of partner organisations.

“We are also looking at the longer term and how we can address issues such as staffing. There is a national shortage of the specialist staff with the training and experience to properly support and meet the complex needs of young people in mental health inpatient wards. However, we are committed to supporting and developing our staff who have worked hard in challenging circumstances over the last few months, as well as working to attract new staff to West Lane Hospital.

“There is still more work to do. The CQC has outlined a number of actions that we must deliver and we remain focused on completing all those actions. We will also continue to work closely with the CQC, service commissioners, staff and most importantly the young people in our care and their families, to ensure we provide better care at West Lane Hospital.”

THE FINDINGS IN DETAIL

A REPORT focusing on the crisis-hit West Lane Hospital in Middlesbrough has revealed patients were not safe, were at risk of avoidable harm and there was a failure of staff to carry out their roles correctly.

The Care Quality Commission, which inspected the hospital before the deaths of two 17-year-old inpatients, gave the hospital and trust’s mental health service, the worst possible safety rating in its latest inspection.

Between June 20 and June 24, inspectors visited and assessed the hospital’s child and adolescent mental health wards in the Westwood Centre, Evergreen Centre and Newberry Centre following concerns about the treatment of patients, staffing and an increase in self-harming incidents.

Inspectors also assessed the Tees, Esk and Wear Valleys NHS Trust’s other mental health services at West Park Hospital in Darlington and Roseberry Park in Middlesbrough. 

The CQC had previously inspected the hospital in June 2018, when it received an overall rating of good.

But in its latest report, the CQC found West Lane Hospital was not delivering safe, effective care and treatment, and that it wasn’t responding to the needs of individual patients.

A summary of key findings revealed the hospital had suffered substantial and frequent staff shortages, with some workers without the right qualifications, skills, knowledge or experience to fulfil their role.

It also revealed there had been a high number of interchanging agency staff at West Lane Hospital, who were not always familiar with needs of the patient they had been assigned to.

The report said: “Staff did not adequately assess, monitor or manage risks to patients and opportunities to prevent or minimise harm were missed. Where patients demonstrated higher levels of risk, staff did not follow processes and procedures to mitigate these through appropriate observation and engagement. Not all staff had the right qualifications, skills, knowledge and experience to do their job. 

“Staff were not sufficiently skilled to support patients with a diagnosis of autism spectrum disorder. Staff across all wards did not fully understand the provider’s policy on the Mental Capacity Act 2005 and whether or not a person under 16-years-old could consent to medical treatment. Compliance rates with supervision were low.”

The report found staff did not follow the Mental Health Act Code of Practice when resorting to the restraining of mental health patients at West Lane.

The findings were based on the hospital’s 1,789 reported incidents of restraint used between January 1 and June 19.

It said: “Staff had used non-approved restraint techniques with patients. 

“Staff did not always use or document seclusion in line with trust policy or the Mental Health Act Code of Practice.”

The report also flagged that staff were not actively reporting all incidents, or categorising a patient’s level of harm in the correct manner.

It revealed staff had been unable to categorise the difference between a self-harm attempt and a suicide attempt.

It said: “There was no clear rationale for the different categorisations. Staff were not accurately recording the severity of harm caused to patients when reporting incidents. 

"Five staff we spoke with at West Lane Hospital informed us that not all incidents were reported. This was also stated on one of the 11 comment cards we received at West Lane Hospital.”

In the CQC’s overall summary, it found staff did not meet the needs of patients that had been diagnosed with autism, the number of patients being given access to education had been poor, and that the positioning of some CCTV cameras infringed on patient privacy and diminished the dignity of parents.

One of several summarising comments said that there had been little evidence of staff learning from previous events, and remedial action taken to improve patient safety.

Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (mental health) said: “We continue to be deeply concerned about the safety and quality of the care being delivered to young people at West Lane Hospital. 

"We immediately engaged in dialogue with the trust and NHS England about addressing our findings as a priority. 

"We have also taken enforcement action requiring the trust to act on our findings, and because of the seriousness of our findings we are considering further action. 

"We have received assurances from the trust and NHS England that progress is being made. However, we will continue to closely monitor the care provided at the hospital and will return shortly to look at whether young people are safe and receiving good quality care.”

The CQC enforced a number of actions that the Tees, Esk and Wear Valleys NHS Foundation Trust must now take. 
To view the full report visit cqc.org.uk