The Care Quality Commission (CQC) has published a report following an inspection of the Franklin ward at Cygnet Hospital Hexham in Northumberland after concerns were raised about patient safety.
The inspection took place in April following concerns raised about several self-harm incidents where patients had required hospital treatment and fears that risks were not being managed appropriately.
The CQC found that staff had learnt from these incidents and had made changes in relation to assessing and managing patient risks. This involved removing high risk items from patients and increasing observation levels.
As this was only a focused inspection, the CQC says, Cygnet Hospital Hexham was not re-rated as the service type had changed since its previous comprehensive inspection in May 2019, so its previous rating of inadequate remains.
Following the previous inspection, enforcement action was taken, and the service was rated inadequate and placed in special measures. The hospital closed in September 2019 and reopened in October 2020 providing acute admission and psychiatric intensive care wards.
Inspection findings
Inspectors found the ward did not have sufficient space for patients to provide a safe and therapeutic environment and the seclusion room was small and provided patients with very limited space.
However, the ward environments were clean and well maintained, there were enough nurses and doctors, that staff assessed and managed risk well and they minimised the use of restrictive practices and followed good practice with respect to safeguarding.
The CQC found the service was well led, governance processes ensured ward procedures ran smoothly and that new managers in the service were well supported.
CQC head of hospital inspection for mental health Brian Cranna said: “When we visited Cygnet Hospital Hexham in April, we were pleased to find that staff had learnt from incidents which had taken place and made improvements to keep patients safe.
“The seclusion room allowed clear observation and two-way communication. However, we found that it was also very small, and patients had limited space to move around the room when the mattress was on the floor. When staff needed to enter the room, patients had to stand in the toilet area for staff to be able to enter safely, which is not appropriate.
“We were pleased to see that staff knew about any potential ligature risks. Issues with curtain rails had been identified, as well as the tables having square corners, these had been reported to get them changed to ensure patient safety.
“Staff made every attempt to avoid using restraint by using de-escalation techniques. Patients were only restrained when these techniques failed to keep people safe.
“The leadership team are aware of the actions they need to take, and we will continue to monitor the service to ensure the required improvements are made and embedded.”
Cygnet response
In response, a spokesperson for Cygnet Hospital Hexham said: “We are pleased that the first inspection of the new service at Cygnet Hospital Hexham is such a positive one, with the Care Quality Commission recognising our good track record on safety, and that staff manage risks well.
“We are particularly proud that the service users themselves on Franklin Ward told the CQC inspectors they felt safe and that staff supported them.
“Having opened the new service at the end of last year, we take our responsibilities seriously, providing expert, intensive, short-term, individualised care for service users with the aim of supporting them to move to less restrictive care settings and ultimately return home.”
The hospital added that while it met national specifications, it had taken on board feedback and made changes.
“We are naturally disappointed that the CQC did not award a rating for the new service this time which would have reflected on the transformation of the hospital; however we look forward to building on this positive assessment of Franklin Ward and to being able to demonstrate to new staff and to service users’ families the strong support that is available for people in the region who are experiencing mental ill-health and need help,” it said.