St John’s House has closed its doors following a Care Quality Commission (CQC) investigation which found the Suffolk mental health hospital had failed to improve patient care.
The CQC inspected the hospital in July to check on progress following a previous inspection which rated it inadequate and placed it in special measures due to concerns around patient safety, incident management, staffing and the use of restraint.
The 49-bed hospital, run by Partnerships in Care, which is part of the Priory Group, cared for adults living with learning disabilities and associated mental health issues.
During the CQC’s latest inspection, inspectors found insufficient progress had been made regarding patient safety, staffing, risk management and adherence to patient care and risk needs.
The CQC added that due to the serious level of concerns it uncovered, previous CQC conditions placed on the provider remained in place, including restricting admissions to the hospital and further urgent conditions were imposed to prevent harm and to protect patients.
The provider has since closed the location and is working to find alternative care services for patients.
The CQC also raised concerns about the hospital’s recruitment – claiming it was short staffed, heavily dependent on agency workers who lacked adequate training or experience, and that staffing levels were below the number needed to consistently maintain patient observation levels.
Required improvements
Following its latest inspection, CQC told the hospital that it must make several improvements, including:
• Patients must be offered appropriate support and protection following a safeguarding incident;
• Staff must follow national guidance and the provider’s policy when using mechanical restraint on patients, including seeking appropriate approval, ensuring patients have an individual care plan for the use of handcuffs and ensuring staff are adequately trained in the use of handcuffs;
• Patients in long term segregation must always have access to drinks;
• All allegations of abuse or reportable safeguarding incidents must be notified to the appropriate authorities;
• The provider must ensure that the reporting of incidents is clear, accurate and details the rationale for decisions made in relation to patient care and safety;
• Patients must be transferred to A&E, without delay, following incidents when this is required.
Unacceptable service
CQC head of inspection for mental health and community services Stuart Dunn, said: “Our latest inspection of St John’s House found an unacceptable service where insufficient improvements had been made to protect patients from harm and abuse and the number of safety incidents remained high.
“Staff weren’t responding appropriately to patients who were self-harming, with one patient not being sent to hospital quickly enough after swallowing a foreign object, despite complaining of abdominal pain.
“We reviewed CCTV footage and found staff were sometimes asleep when they should have been observing patients to make sure they were safe. This was all the more concerning as we identified this as a concern during the previous two inspections of this service, demonstrating a lack of improvement to keep patients safe.”
He added: “This service’s continued failure to refer all instances of abuse and thoroughly investigate concerns has put its patients at prolonged risk of harm.”
Wholly exceptional circumstances
In response, the hospital revealed that it had told the CQC on 23 July that it would be closing St John’s House, which it added was not taken lightly but given the “wholly exceptional” circumstances, it was the most appropriate course of action.
“Despite our best efforts and substantial investment, St John’s House continued to suffer from significant recruitment difficulties stemming from the nationwide shortage of specialist nursing staff for learning disability services,” the spokesman said.
“As such, it had become increasingly challenging to meet the needs of the people we look after and over the last two months we have worked diligently with all stakeholders to find appropriate alternative provision for service users.
“There are now only two service users remaining and we expect alternative provision to be found for them later this month.”