Patients with learning disabilities and autism suffered a "significant number of injuries" on NHS wards - while inspectors were also concerned about a rise in assaults on staff, too.
The Care Quality Commission (CQC) inspected three wards run by the Cumbria, Northumberland, Tyne and Wear NHS Trust - Mitford Unit in Morpeth, Rose Lodge in Hebburn, and Edenwood in Cumbria. As a result, it has rated the services as "requires improvement".
The CQC inspections took place between July 16 and July 18 - and then on September 12. The initial inspection was triggered after concerns from external agencies were shared about staff welfare. During that visit, the inspectors found breaches of regulations and the trust was warned to make "rapid and widespread" improvements.
By September, inspectors said they were satisfied a "robust" plan was in place to address the issues. In the report published today, the inspectors have highlighted how they feared staff weren't being appropriately supported and this had an impact on care.
The inspectors also recalled how one family member had told them their loved one had actually seen their health worsen while in hospital. The issue of staff safety too was also one raised last year by the Health and Safety Executive.
The HSE wrote to the trust in 2024 warning that it "wasn't doing enough" to keep staff at the Mitford Unit - which is on the site of Northgate Park hospital - safe. This related to "levels of violence and aggression towards staff" and concerns included that staff attack alarms did not work correctly in a section of the hospital grounds. The latter issue had - the trust said - been dealt with through the installation of additional sensors on-site.
Victoria Marsden, the CQC's deputy director of operations in the North, said: "When we inspected wards for people with a learning disability or autistic people at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, we were concerned to find that some staff didn’t feel listened to and weren’t always being supported to carry out their roles safely, which was having an impact on people’s care.
“Before the inspection, we were notified by external partners about a high number of injuries to staff working at the Mitford Unit, often caused by physical assaults from people staying on the wards. During our visits we found that these concerns were substantiated, however the number of assaults on staff had reduced, but the use of restraint on people had increased.
"We weren’t assured that staff had the required skills and training to manage the complex nature of people’s individual needs, and we were concerned that this was why they were carrying out more restraint. One family member told us that they didn’t always feel their relative was safe and staying on the Mitford Unit actually made them feel worse."
Ms Marsden also highlighted how service users had sustained a "significant number of injuries" in the year prior to the inspections. She added: "Records didn’t always show how these injuries were sustained, for example if it was due to being restrained or due to people hurting themselves. It also wasn’t clear if they’d been investigated, so lessons could be learnt to help prevent them from happening again and reduce the number of injuries people were sustaining.
“The trust had continued to use methods of physical restraint with people which didn’t follow national best practice guidelines, which could put people staying on the wards at significant risk of psychological harm.
“Additionally, people’s care plans didn’t always include which types of restraint should be used to keep them safe. However, since the inspection, the trust has informed us that they have started to address the issues we identified and are carrying out restraint in a safer way to prevent people from coming to harm."
The CQC said it was now receiving monthly updates and would continue to monitor the situation.
Sarah Rushbrooke, executive director of nursing, therapies and quality assurance, said: “The quality and safety of the care we provide to our patients is our top priority, and we welcome the Care Quality Commission’s inspections which hold us to rigorous standards.
"Following the concerns raised by the CQC after their inspection in July last year, we worked hard to quickly make improvements. We are pleased that the CQC recognised the progress made when they re-inspected services in September. We are also keeping the CQC regularly informed of our ongoing work to make further improvements."
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