The Care Quality Commission (CQC), has published a report on high secure hospital services at Rampton Hospital following an inspection in March which sees their overall rating improve from inadequate to requires improvement.
Rampton Hospital is a high secure mental health hospital in Nottinghamshire, which cares for people who have been identified as a risk of harm to themselves or others and need care in a secure environment. It's run by Nottinghamshire Healthcare NHS Foundation Trust. CQC visited all 23 wards at the hospital during this unannounced inspection.
This inspection formed part of a 12-month inspection programme that CQC has carried out at Nottinghamshire Healthcare NHS Foundation Trust.
The overall rating for the service, and the rating for how well-led the service is, have improved from inadequate to requires improvement. How caring the service is has been re-rated as requires improvement. At previous assessments in this recent inspection programme, how safe the service is improved from inadequate to requires improvement, how effective the service is improved from inadequate to good, and how responsive the service is improved from requires improvement to good.
CQC found four breaches of regulation at this inspection related to safe care and treatment, safeguarding, privacy and dignity, premises and equipment, and safe staffing, as well as a breach for safe care and treatment at a previous inspection. CQC has told the trust to submit an action plan showing what action it is taking in response to these concerns.
Greg Rielly, CQC deputy director of operations in the midlands, said:
“During our recent inspections, we found some clear improvements at Rampton Hospital. However, at this inspection we identified that Nottinghamshire Healthcare NHS Foundation Trust still had some work to do to address staff shortages and support staff.
“Staff that we spoke to on this inspection told us about incidents where their wards weren’t meeting safe staffing levels and where staff had to cancel activities and therapies for people which made them feel frustrated. Staff shortages also meant that people in long term segregation couldn’t always access fresh air and showers. Staff were sometimes lone working at night, which meant they couldn’t take breaks and puts them at risk.
“However, leaders at the trust were putting in place measures to avoid staff lone working and were currently addressing staff shortages with a large recruitment drive.
“Staff treated people with kindness and compassion when providing support, and people felt that staff listened to them. Staff were on hand to provide help, emotional support and advice to people, while being respectful and responsive. Staff felt positive and proud to work on their base wards and felt well supported at ward level.
“We have told leaders at Nottinghamshire Healthcare NHS Foundation Trust where urgent improvements are needed. The service needs to build on the positive areas in our report and focus on making the service safer for people.”
Inspectors found:
- The service didn’t make sure people had access to appropriate equipment. People with mobility issues couldn’t access certain areas and appropriate mobility aids and appropriate size beds weren’t always available.
- Some staff didn’t feel supported by the wider management team and questioned whether senior leaders at the trust fully understood staffing issues.
- Leaders organised debriefs after incidents had occurred to identify learning opportunities. However, due to short staffing these often occurred a long time after the incident.
- Senior clinicians felt that senior leaders at the trust didn’t listen to them.
- Staff didn’t always make sure that people’s care plans were kept updated with their needs.
However:
- Staff respected people’s privacy and dignity. They were responsive to people’s needs and provided help, emotional advice and advice when they needed it.
- The service worked well with partner organisations to provide people with consistent care. These included the local NHS hospital trust, the prison service and organisations providing mental health inpatient care.
- The service provided information in a range of formats which made information accessible for everyone.
- Staff developed a dedicated trauma informed cervical screening pathway which made sure that people in the service had access to cervical screening. They also had plans to organise a visit from a mobile breast screening unit, benefitting staff and people in the service.
- Staff on women’s wards had been involved in a reconfiguration of the service, where both staff and people in the service were supported to move to meet clinical need.
The report will be published on CQC’s website in the coming days.