Inspectors visiting the child and adolescent mental health unit at Cheadle Royal Hospital have classed its services as inadequate in response to concerns about safety.
Care Quality Commission Inspectors during an unannounced visit earlier this year found inspection breaches in relation to safe care and treatment, premises and equipment, systems and staffing.
Cheadle Royal Hospital, run by Affinity Healthcare Limited, is a 150-bed hospital with 13 wards which provides care to people with diverse nursing needs. Including adults with acute and psychiatric intensive care needs, personality disorders, eating disorders and adults requiring long stay rehabilitation.
This inspection only looked at three CAMHS wards – Woodlands, Orchard and Meadows.
Following this inspection, the rating for this service has dropped from good to inadequate, it has also gone from good to inadequate for being safe. Well-led has dropped from requires improvement to inadequate. Being effective and responsive has declined from good to requires improvement and caring remains rated as good.
The service will be kept under close review by CQC to ensure people’s safety and re-inspected to assess whether improvements have been made.
Alison Chilton, CQC deputy director of operations in the north, said:
“When we inspected mental health services for children and young people at Cheadle Royal Hospital, we found standards of care were well below those people have a right to expect.
“The child and adolescent mental health (CAMHS) wards weren’t well-led and information systems didn’t ensure that wards ran smoothly.
“We found ward environments weren’t always well maintained. On Meadows for example, people had graffitied doors, on Woodlands there were rooms with broken windows, although there was no safety risk from broken glass, they didn’t provide a therapeutic environment for people to live in. Also, on Orchard we saw several bedrooms either without curtains or they were too short, although the provider informed us curtains were on order. People shouldn’t have to live in an environment with these poor conditions and the provider must address these issues as a matter of priority. Also, young people couldn’t easily access the outside space which is really important to help them live healthier lives.
“Additionally, the wards had high vacancy rates and were reliant on agency and bank staff. Some young people told us that agency staff didn’t always treat them with dignity and respect.
“Some carers told us they didn’t feel supported, and communication from staff wasn’t always good. It was concerning that they weren’t informed about any incidents which had taken place, or supported when their loved ones were on home leave, which must be addressed.
“However, it was promising that ward teams had access to the full range of specialists required to meet the needs of the children and young people on the wards.
Priory CEO, Rebekah Cresswell, said:
“We are disappointed with the CQC’s overall rating which does not accurately reflect the quality of our child and adolescent mental health services at Cheadle, and have disputed the factual accuracy of many aspects of the report.
“Our responsibilities are first and foremost to our patients and their families, and while we take the report very seriously and remain committed to addressing any issues raised, the misrepresentation of our service is unhelpful both to them, and to our dedicated and hard-working staff. The headlines of the CQC’s press release fail to identify many positive aspects found by inspectors, including that ‘all wards were safe, clean, well-equipped, well-furnished and fit for purpose’, patient incidents were managed well, our staff were ‘discreet, respectful, and responsive when caring for children and young people,’ and that patients felt our staff were ‘supportive, kind, respectful and caring.’ They state we had enough nursing and support staff to keep patients safe. They stated our care was ‘personalised, holistic and recovery-orientated’ and ‘staff from different disciplines worked together…to make sure children and young people had no gaps in their care’.
“To meet increasing national demand, we have invested £360,000 this year in refurbishing Orchard ward as a high dependency care ward for young people with additional support for disordered eating. This was already planned for 2023. And since January 2022, almost £2m has been invested overall in services at Cheadle Royal Hospital. We remain totally focussed on reducing agency use, which is down by two-thirds since the inspection, and have recruited 99 new permanent colleagues at Cheadle this year alone, which includes nine new nurses and 46 healthcare assistants, with a further 13 new nurses and 37 healthcare assistants in the pipeline.
“We are concerned that this kind of rating, when care has been highlighted as good, gives the wrong impression and could exacerbate the very problem the regulator appears to want to address, namely staffing. This inspection happened five months ago and we were working on increasing our permanent staffing levels long before this, which is why we have already seen our staffing levels increase.”
