Archived: Huntercombe Hospital - Stafford

Updated 29 October 2018

Huntercombe Hospital-Stafford is a child and adolescent mental health service for 36 young people of both genders aged 8 to18 years. The hospital can also admit detained patients. Huntercombe Hospital-Stafford is divided into three separate wards; Hartley, Thorneycroft and Wedgwood wards.

Hartley ward is a psychiatric intensive care unit (PICU) providing 12 beds. The PICU unit at Stafford offered inpatient care to young people suffering from mental health problems who require specialist and intensive treatment to address their needs.

Thorneycroft ward is a general CAMHS acute assessment unit with 12 beds for young people aged 12-18 years. The young people treated in this unit have a range of diagnoses from psychosis and bipolar disorder to depression and deliberate self-harm.

Wedgewood Unit is a specialist Eating Disorder Unit, which previously provided services for up to 15 young people and now provides services for 12 young people. The young people treated on the eating disorders unit have a diagnosis of Anorexia Nervosa, Bulimia Nervosa, or other similar.

Huntercombe Hospital-Stafford has a registered manager and is registered to provide the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983.
• accommodation for persons who require nursing or personal care.
• treatment of disease, disorder or injury.
• diagnostic and screening procedures.

A responsive inspection was carried in April 2016 and identified the need for urgent action on safeguarding. That inspection led to the CQC issuing a warning notice for urgent improvement in safeguarding arrangements.

The CQC carried out a full comprehensive inspection in May 2016 and found the service to be inadequate overall. This led to the CQC putting the hospital in special measures in August 2016. The Huntercombe Group took a decision to close the psychiatric intensive care unit at the time.

We last carried out a comprehensive inspection for this hospital in January 2017, we rated it as requires improvement overall. We rated safe, effective, responsive and well-led as requires improvement and caring as good. We issued the hospital with four requirement notices and these related to:

Regulation 12 HSCA (RA) Regulations 2014, Safe care and treatment

• Clinical policies were out of date and not in line with national guidance. Training to support good clinical practice in rapid tranquilisation did not address the needs of children and young people.
• There was a lack of psychological therapies available to young people and other therapy staff lacked leadership, which affected their effectiveness.

Regulation 13 HSCA (RA) Regulations 2014, Safeguarding service users from abuse and improper treatment.

• We found that blanket restrictions were in place that were not necessary or proportionate as a response to the risk of harm posed to the service user or another individual this is a breach of regulation. There was no evidence of any individual risk assessments to justify their application.

Regulation 17 HSCA (RA) Regulations 2014 Good governance

• There was no ongoing monitoring of the use of the Mental Capacity Act and application of Gillick competency in those under 16 to guide practice development.

Regulation 18 HSCA (RA) Regulations 2014 Staffing

• Therapy staff were not receiving regular supervision and lacked a management structure to appraise and support their professional development.

During this inspection, we found that the hospital had made some improvements to address these breaches.

The CQC also carried out a Huntercombe CAMHS Group well-led inspection in September 2017 for CAMHS locations. We issued the Huntercombe Group for CAMHS locations with two requirement notices and these related to:

Regulation 18 HSCA (RA) Regulations 2014 Staffing

• There was a reliance on agency staff in all services. The recruitment of experienced CAMHS staff is required.

Regulation 17 HSCA (RA) Regulations 2014 Good governance

• The providers did not have a programme of specialist CAMHS training required by staff. There was no corporate oversight of role-specific training.

During this inspection, we found that the hospital had made progress towards improvements to address these breaches.

Updated 29 October 2018

We rated Huntercombe Hospital - Stafford as good because:

• The hospital had taken action and showed that improvements had been made in areas that the provider was required to improve on in January 2017 and September 2017 inspections. These improvements included, staff training, psychological therapies and leadership, blanket restrictions, adherence to the Mental Capacity Act and the recruitment strategy for permanent staff.
• Staff managed risk well. They made a comprehensive risk assessment for every patient, reviewed this regularly and updated it when required. They carried out regular environmental risk assessments to ensure the environment was safe.
• The wards had enough staff to meet the patients’ needs and allowed patients to have regular one-to-one time with their named nurse.
• Staff ensured that every patient had an up to date, personalised, holistic and recovery orientated care plan. They ensured that patients had good access to physical healthcare, including access to specialists when needed.
• Staff tailored one-to-one engagement, leisure activities, and support to develop social and independent living skills to address the individual needs of each patient. Patients had access to a wide range of therapeutic activities. Staff encouraged and worked in creative and flexible ways to promote educational activities
• Patients spoke highly of support they received from staff. They told us that staff understood their individual needs, were polite, compassionate and always willing to offer that emotional and practical support. Staff actively involved patients in decisions around their care and the service. The hospital had demonstrated high commitment to develop the service with the full participation of patients. Staff gave patients information on how to make complaints and patients knew how to complain or raise concerns.
• Managers provided staff with regular supervision and an annual appraisal. Staff overwhelmingly reported high levels of satisfaction including those on contract from agency. All staff told us that they felt greatly respected, supported and valued. The leaders showed the high levels of experience and ability needed to provide high quality care.
• There were effective systems in place to monitor and review progress against the strategy and plans. There were effective working systems and ways for governance structure and arrangements.
• Staff followed good practice in medicines management process, all medication was stored appropriately. Medication was audited regularly.

However:

• The service relied heavily on agency staff to cover high number of vacancies.
• Not all staff were up to date with prevent and manual handling practical training.

Updated 29 October 2018