A Norfolk hospital has six months to save itself from closure after inspectors found a shocking list of failings that were putting mentally-ill patients at risk.
Mundesley Hospital's future is on the line after the Care Quality Commission (CQC) inspection discovered incorrectly labelled tablets, failure to protect vulnerable patients from abuse and allegations of 'inappropriate manhandling' of a patient.
Staff were suspended and police called after the inspection at the hospital, which gets millions of pounds a year from the region's mental health trust to look after those with serious mental health problems.
A spokesman for the hospital said although they were disappointed with the findings, they 'fully accept them and take on board all [the CQC's] comments'.
Inspectors found the hospital was unsafe and poorly led, and chief inspector of hospitals Professor Edward Baker said the CQC was beginning 'the process of preventing the provider from operating the service'. This means if in six months things have not improved, the CQC will shut the hospital down.
Mundesley Hospital was first put into special measures at the end of last year - just months after it had opened. The CQC visited again in January this year, and most recently in June and found a shocking catalogue of failures. These included:
• On two occasions staff did not safeguard patients from abuse. The CQC made senior managers aware, which resulted in 'suspension of the staff members involved, informing the police and the local safeguarding team'.
• There were 'allegations of the inappropriate manhandling of a patient' but this was not reported to senior managers. Inspectors said this meant they could not be sure patients were protected from abuse and improper treatment and led them 'to question whether the number reported was an accurate indication of how often staff used restraint'.
• Staff had written the name of a medication on a box stating the tablet strength was 2.5mg, but inspectors found the box actually held 5mg tablets. The box was in use and the error had not been picked up by staff.
• A serious incident of self harm occurred on a ward, which was reported by frontline staff. But the detail in the verbal account was misleading. When challenged, it was acknowledged 'that incorrect information had been given'.
• The hospital told the CQC before the inspection they had a 1.75pc vacancy rate for nurses, but inspectors discovered this was actually more than 80pc. The hospital was regularly using 63pc agency staff.
• A patient who should have been checked hourly was not under any observation overnight.
• Twice inspectors found a sharps bin was overfull.
• There was no access to any kind of psychology service.
• Patients told inspectors staff sometimes fell asleep on duty when they meant to be observing patients.
• A patient knocked on the door of a staff room several times. The four members of staff in the room did not respond and remained with their backs to the door.
• During the visit, inspectors were told there had been no serious incidents in the year up to April 2017. However, during the same period the CQC had received 77 notifications in relation to the hospital and the hospital itself had reported an attempted suicide and an allegation of injury during restraint to the regulator.
• Patients assessed as not having capacity to consent to treatment had signed forms consenting to being searched.
A spokesman for Mundesley Hospital said the issues raised were taken very seriously and they were 'addressing them all in turn'. But they refused to comment when asked what had happened to the members of staff who were suspended, to what extent the police had been involved, or why incorrect information had been given to inspectors.
Instead, chairman Elijah Adeyemi gave credit to 'the commitment and dedication of staff'. He said: 'I understand that it has been a challenging time, but we are confident our achievements to date will continue and our robust development and improvement plans have begun to have a real impact. The board is confident the actions have been and are being taken in restructuring the organisation will lead to significant improvements and address the concerns of the CQC. We are pleased the CQC was able to recognise the progress we have achieved and our commitment to continued improvement.'
In December last year, following a previous inadequate CQC report, a statement from the hospital said: 'We are certain that the ongoing developments we have made already put us in a completely different place now and that the CQC will see this when they next visit.'
'Safety of our patients is not at risk,' says mental health trust
The region's mental health trust has spent millions sending patients to Mundesley Hospital since it opened.
From April 2016 to August 2017, 7,278 days were spent at Mundesley by Norfolk and Suffolk NHS Foundation Trust (NSFT) patients. That was compared to 4,402 bed days spent out of the area.
In total £5.6m has been spent sending patients both out of the area and to Mundesley since April last year.
Jane Sayer, director of nursing, quality and patient safety, said she had been reassured their patients were not at risk and improvements suggested by the CQC were in hand. She said: 'If any concerns about patient care were to be raised we would act quickly and decisively to investigate and to gain assurances that our patients are safe and that appropriate action was being taken.
'If we ever believed that this was not the case, we would make alternative arrangements for our patients' care. We closely and continually monitor the standards of care at the hospital – as with all other providers' we use – with regular visits by senior Trust staff. Patient review meetings are held twice a week to ensure that each of our patients is receiving appropriate standards of care.'
A spokesman for the Campaign to Save Mental Health Services in Norfolk and Suffolk branded the continued use of Mundesley 'shameful' and said they had been campaigning for four years for more beds to be provided by NSFT.
He said: 'It is shameful that Norfolk patients in great need are sent to a remote and expensive private hospital that has now been found to be inadequate three times in a row. NSFT management cannot outsource the hard work and responsibility of providing decent and sufficient inpatient mental health care any longer.'
But when asked whether sending patients to Mundesley could be justified, Ms Sayer said it was normal for NHs providers to utilise other services when demand varied. She added: 'Our trust makes use of beds at Mundesley Hospital on a flexible basis, when our own beds are at maximum capacity. This is to ensure that those people who are so unwell that a hospital admission is necessary, can receive inpatient care as close to home as possible, and to avoid sending them out of our local area.'
Who are Hope Community Healthcare?
The 27-bed Mundesley Hospital is run by Hope Community Healthcare Ltd.
Its directors are businessman Elijah Adeyemi, who set up the hospital, and Dr Christopher Johnson who was appointed in January this year.
Catherine Guelbert was listed alongside Mr Adeyemi as an 'accountable person' for Mundesley Hospital by the CQC.
But she resigned as a director of Hope Community Healthcare at the start of September.
Another director Leigh Allison, who set up the hospital with his business partner Mr Adeyemi, resigned from Hope Community Healthcare in January this year.
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