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A hospital has been rated as requires improvement, several months after it closed its mental health services for children and adolescents following a damning inspection.
The Care Quality Commission has instructed Cygnet Hospital Godden Green in Sevenoaks to continue improving its psychiatric intensive care unit (PICU), following an inspection in November.
This comes after Cygnet Health Care, which runs the hospital and provides mental health services for the NHS, decided to close two wards which provided child and adolescent mental health services (CAMHS).
An unannounced CQC visit in September found repeated incidents where young people suffered harm and injury on the wards.
Cygnet Health Care said at the time that "the challenge of recruiting specialist CAMHS staff in rural locations is a well-documented national issue" and it was focusing on providing support for adults.
In October, inspectors returned to review Castle ward, a PICU for adult women, following concerns raised about the safety and wellbeing of patients.
The hospital was ordered to make a raft of improvements, including staff using appropriate de-escalation techniques before moving to physical restraint and making sure there is an appropriate ratio of male to female staff.
"We will continue to monitor the service and ensure that follow-up action is taken..."
Following the latest visit inspection of the PICU ward on November 10, the service was rated requires improvement overall and for each of the key questions in relation to whether the services are safe, caring, responsive and well-led. The service was rated Good for its effectiveness.
Castle ward has six ensuite bedrooms but at the time of inspection there were six patients on the ward.
During a routine inspection in April 2019 the hospital was also rated as requires improvement.
Karen Bennet-Wilson, CQC’s head of hospital inspection for mental health, said: “Following our latest inspection of Cygnet Hospital Godden Green’s Psychiatric Intensive Care Unit, we told the provider that although the service had made a number of improvements, there was still much to do to fully embed those, as well as a number of additional improvements that still needed to be made.
“This includes ensuring that all environmental and fixed ligature point risks are identified and removed or managed appropriately, and that dangerous items are stored securely. Personal evacuation plans must also be developed to ensure that patients can leave the ward safely during an emergency.
“In addition, the service must ensure that staff only ever use physical restraint as a last resort. Patients must be allowed to make private phone calls, be given access to toilet paper and provided with enough room to store their personal belongings. Staff must also knock before entering a patient’s bedroom, except in an emergency.
“We will continue to monitor the service and ensure that follow-up action is taken.”
During the November visit, inspectors also found patients and their families or carers were not actively involved in the planning of their care
However, the inspectors noted that there was a new leadership team in place at the hospital with the experience to manage the service.
They also found that the wards were clean and had enough doctors and nurses. Patients were offered a range of treatments suited to their needs and in line with national guidance, and families were kept informed about their relative’s care.
"The improvements requested have been made..."
A spokesperson for Cygnet said: “The unannounced inspection by the CQC, on which this report is based, took place early last November and since then the improvements requested have been made, and embedded on the ward.
"We are pleased the CQC recognised the many positive aspects of good care on the ward and that the service largely performs well in all areas.
"As the inspection report notes, our staff have a range of skills needed to provide high quality care and offer treatment interventions consistent with national guidance on best practice, which is reflected in the rating of Good for the unit’s effectiveness.
"The safety and wellbeing of patients on the ward is our priority. As the report also acknowledges, all patients have Individualised care plans, which are holistic and recovery orientated, and our nursing and medical staff know the patients and how to protect them. Patients also have good access to physical healthcare and are supported to live healthier lives.
"With a new leadership team in place, we continue work closely with our commissioners, the CQC and patients’ families and carers, and look forward to demonstrating the improvements at the next inspection.”
