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Women in a newly opened psychiatric intensive care unit had concerns for their sexual safety, a Care Quality Commission report has revealed.
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Women in a newly opened psychiatric intensive care unit had concerns for their sexual safety, a Care Quality Commission report has revealed.
Inspectors found women in the PICU at Cygnet Health Care’s Godden Green Hospital, in Kent, were afraid to shower because male staff did not always knock before entering bedrooms and staff entered bathrooms without permission. Patients were often looked after by male staff despite having asked for a female staff member and, in some cases, had an all-male care team.
Most patients the inspectors spoke to had concerns about their sexual safety.
The CQC carried out an unannounced inspection of the PICU in October, following concerns raised by members of the public and to check concerns identified in an earlier inspection of the hospital’s child and adolescent mental health services were not organisational.
The PICU opened in November 2019. Since the summer, Kent and Medway NHS and Social Care Partnership Trust has commissioned some of the beds, but HSJ understands it stopped admissions for a time to review the care being provided.
‘Troublemakers’
Inspectors found records referred to PICU patients as “difficult” and “troublemakers” and warned a ”culture of negativity towards patients had developed among some staff”.
The watchdog warned restrictive practices were “routinely” used. It added: “We saw some staff acting in an intimidating manner when patient’s behaviour became disturbed with little attempt made to use a calm and considered approach to de-escalate the situation or reassure and comfort patients.”
The report noted the ward was dirty, with grime on cupboard doors, dead insects on woodwork and stained carpets.
The CQC also warned physical healthcare was not well managed, with records containing conflicting information, appropriate care plans not always being in place and relevant specialist referrals not always being made. Some patients reported having been given the wrong medication.
The report, which also covered the CAMHS inspection in September, was critical of Cygnet’s senior leadership, saying they “had not picked up that young people and patients were not receiving the care that they should have been and had not acted to make improvements in a timely manner”.
Problems in CAMHS
In the CAMHS unit, the CQC found several incidents of young people self-harming with broken tiles, while other environmental risks — including ligature points — had not been identified or mitigated. One young person who had self-injured was not taken to an accident and emergency department for several days, before an ambulance was eventually called for them.
Inspectors found most of the CAMHS unit’s staff, including one ward manager, had no prior experience of working with young people. Checklists for neurological impact following headbanging incidents were sometimes carried out by healthcare support workers, rather than doctors or nurses.
After the inspection, the CQC said the CAMHS unit should be temporarily closed but Cygnet decided to close it permanently in October and the patients were moved elsewhere.
The PICU has remained open, with the CQC having weekly meetings with Cygnet and specifying improvements which must be put in place. The CQC also served Cygnet with three requirement notices, two of which related to the PICU.
The hospital’s rating did not change as part of the inspection and it remains rated “requires improvement” overall.
Addressing concerns
Cygnet said it had addressed the ratio of male and female staff as soon as it heard feedback on this and had reinforced messages around privacy and dignity with staff.
A Cygnet Godden Green spokeswoman said: “Since the inspection two months ago, we have worked with the CQC to address their requirements through a detailed and robust action plan.
“The CQC has told us they are satisfied with the steps we have taken and can see the progress that has been made. We are heartened that the CQC recognised that most patients and carers on the adult PICU ward said staff were kind, respectful and caring.”
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