Inspectors find 'burnt-out' staff at Elmleigh Hospital run by Southern Health NHS with 'serious concerns' about patient safety
SERIOUS concerns about patients’ safety forced a health watchdog to launch enforcement action against a trouble-hit NHS trust after finding ‘burnt-out’ staff at a mental health hospital.
Inspectors visited Elmleigh Hospital in New Lane, Havant, after being told of concerns at the 34-bed open acute mental health hospital.
Southern Health NHS Foundation Trust has been ordered to make a series of improvements after the watchdog raised ‘serious concerns’.
It comes after the mental health trust was fined £2m in 2018 over the avoidable death of two patients at other facilities and admitted ‘systemic failures’.
A Care Quality Commission report found staff were ‘stretched, stressed, burnt-out’ and too busy ‘constantly firefighting’. It added: ‘Morale across both wards was low.’
Patients at the hospital ‘may be at increased risk to themselves or others whilst on leave’ as medical examinations were not carried out beforehand, the report said.
Southern agreed to cap admissions on both wards at the hospital in response to inspectors’ concerns, reducing the capacity by three in each.
Inspectors visited on April 21 but returned on April 26 after having ‘significant concerns’ about the lack of monitoring of patients’ physical health.
Three days later the CQC sent a ‘letter of intent’ about the safety of patients - warning it may take urgent action or affect Southern’s registration.
Enforcement action was discontinued after the trust responded with a detailed action plan on May 4.
Karen Bennett-Wilson, CQC’s head of hospital inspection and lead for mental health, said: ‘It is disappointing to find that the improvements made in recent years at Southern Health NHS Foundation Trust have not been sustained at Elmleigh hospital.
‘Despite the immediate improvements the trust has put in place, there is still more to do, especially as we found there were not enough staff to meet patients’ needs.
‘The trust still needs to make a number of additional improvements, but the leadership team knows what it must do, and has already embarked on the first stages of the improvement strategy.’
Among the findings were:
:: ‘The physical health needs of eight patients with known conditions and risks had not been adequately assessed or monitored’.
:: Only one locum consultant psychiatrist covered both wards, with a high number of agency staff who did not know patients' needs and risks.
:: Not enough staff with the right skills and knowledge.
:: Self-harm increased in April to September last year across the trust when wards postponed group activities leading patients to be ‘bored’. The trust resumed group activities across its sites - but Elmleigh did not.
:: Staff ‘felt their concerns were not taken seriously’ and did not feel supported.
:: The ward team did not have access to the full team of psychologists, occupational therapies and activity co-ordinators to meet the needs of patients.
:: Incident forms were not filled in as staff were too busy.
:: Numbers were not increased when patients’ demands increased.
Patients told inspectors they were cared for with dignity and respect, but staff were always busy - with leave cancelled or reduced.
Staff were recognised as following best practice for challenging behaviour.
Dr Riaz Dharamshi, South East Hampshire clinical director at Southern said: ‘The quality of our services is our top priority and we are supporting the team at Elmleigh to make the necessary improvements.
‘We have a detailed action plan in place and additional senior staff are now working at the site. We have also recently recruited specialist occupational therapists, psychologists and activity co-ordinators to the team.
‘Staffing levels are a challenge for Elmleigh and the wider NHS.
‘We continue to carry out regular recruitment drives as well as prioritising the wellbeing and support for our existing staff. We work with staffing agencies to ensure sufficient staff are in place to cover all shifts.’
‘We make careful assessments to ensure all eligible patients are able to take leave safely and this is reviewed on every shift.
‘The CQC inspectors found an instance where this check had not been properly recorded. We have reminded staff of the correct procedure and are monitoring this closely.
‘Our dedicated User Involvement Manager has visited the site to ensure patients have access to a range of activities and also to gather their feedback to help us further improve.’
‘The CQC also highlighted areas of best practice during their visit, including how staff delivered care in the least restrictive way to minimise the use of restraint and seclusion.’
‘We thank the team at Elmleigh for their ongoing efforts to make improvements despite the challenges of responding to the Covid-19 pandemic.’