CQC press release embargoed until 00:01hrs on 30 March
Embargoed copy of the inspection report can be found at the end of this email.
The overall rating for the Hillside ward at Ash Green Learning Disability Centre, run by Derbyshire Community Health Services NHS Foundation Trust has remained rated as good overall, following an inspection in December and January.
CQC carried out this unannounced focused inspection to look at how safe and well-led the ward is, after receiving concerns relating to staffing, care planning, restraint and staff engagement.
CQC did not re-rate the overall service or how well-led it is following this inspection, so the previous rating of good remains. However, CQC re-rated the safe domain as requires improvement, this was previously rated as good.
The overall rating for the trust remains as outstanding.
Hillside ward is an assessment and treatment unit for adults with a learning disability or autistic people. To meet urgent local needs, the service has been reconfigured to meet the needs of people with a learning disability waiting for longer-term care.
The trust, Clinical Commissioning Group (CCG) and local mental health trust have arranged for appropriate staff to work at the service to meet the needs of the three people on the ward with very high-level complex needs, who were all in long-term segregation, in isolation from each other.
Craig Howarth, CQC’ head of mental health hospital inspections, said:
“During our inspection of the Hillside ward at Ash Green Learning Disability Centre, we found approachable leaders who had the skills, knowledge and experience required to run the service during these challenging circumstances. Managers had effective oversight of the care required for the three people on the ward and had made the necessary changes to meet their needs.
“Although the ward had been partially adapted to cater for the current people living there. Some of the alterations hadn’t been fully completed. In one of the bathrooms, not used unsupervised by patients, there were some unsecured cables and pipes. Staff told us they had requested that these be covered up so people could not come to any harm. However, this had still not happened several weeks later.
“Not all parts of the ward were clean and well maintained. One person’s bay, including their bedroom, utility room and corridor had dirty floors, windows and plug socket. We raised this during the inspection and staff improved this before the end of the day.
“We were assured that the service had enough day and night medical cover, as well as a doctor who could attend the service quickly in an emergency. Also, the number of restrictive interventions were reducing, and managers had more available funds to buy additional alarms for staff and employ a full-time occupational therapist.
“Overall, even though there are some areas for improvement, we would like to acknowledge that staff have adapted sensitively to the needs of people in their care during a difficult time. We encourage them to finish planned alterations promptly and to ensure the ward is clean and well maintained."
Inspectors found:
• Staff completed personalised care plans, positive behaviour support plans and risk assessments for people using the service. Staff had completed and kept up to date with mandatory training.
• Although the service had experienced a loss of staff, existing staff and managers ensured the unit was adequately staffed.
• Agency staff worked to Hillside ward’s risk assessments and care plans and saw the ward manager as having overall responsibility for care.
• Staff cared for people with respect and kindness. Staff ensured they applied the safeguards from the Mental Health Act Code of Practice to all three persons in long-term segregation.
However:
• Staff supporting people using the service were not all trained in the same techniques for restrictive interventions. There were insufficient alarms for all the agency staff on the ward.
• People who used the service had different multidisciplinary arrangements in place as the service was short of permanent learning disability doctors and had to arrange cover from other services.
• The morale of some of the trust staff was low at the time of the inspection.
The report will be published on the CQC website on 30 March.
