- Independent mental health service
St Andrews Healthcare Northampton
Report from 16 October 2024 assessment
Contents
Ratings - Forensic inpatient or secure wards
Our view of the service
We carried out an unannounced onsite assessment within the medium secure division of St Andrews Hospital Northampton. The onsite assessment took place on the 20 and 21 November 2024 and our off-site assessment activity concluded 6 December 2024. We carried out this assessment in response to cases and notifications of concern which had been raised in relation to patient safety, alleged poor attitude of some staff, high use of agency and low staffing levels. At this assessment we assessed a total of 21quality statements from the safe, caring, responsive and well led key questions. We rated the service as Requires Improvement. We found breaches of the regulations in relation to Regulation 18: Staffing, Regulation 12: Safe care and Treatment and Reg 10: Dignity and Respect. We identified some areas of concern under the safe, caring and well led key questions which will require an action plan. Patients and staff at all levels spoke to us about staffing being a concern. The service had a high level of vacancies together with a high use of non-permanent staff. Ward staff were not always available for patients, who told us that they had to wait for their needs to be met. We found that patients and staff did not always feel safe on the wards. Some patients told us that they had been subject to verbal and physical aggression. We were told that not all staff had protected patients from abuse and that there were concerns about a closed culture, particularly on Rose ward. Patients told us that they had not been involved in their care planning or risk assessment process, however, the provider shared the results of a provider au. We found evidence of blanket restrictions relating to access to hot and cold drinks and snacks. Staff were experiencing ongoing issues with the electronic prescribing system (EPMA) going offline, and staff did not follow the provider’s contingency plans . We have asked the provider for an action plan in response to the concerns found at this assessment.
People's experience of this service
We spoke with 15 patients across 4 wards. Not all patients felt safe on the wards. Patients spoke to us about ongoing problems with staffing levels on the ward, staff not being present in main ward areas and a high use of non-permanent staff. Out of the 15 patients we spoke with; 8 patients (53%) told us that staffing levels on the ward were a concern. Three patients told us that sometimes you often won’t see staff in communal areas for some hours. A fourth patient told us that “staffing is a joke, adding “often I can’t even see a staff member”, whilst a fifth patient told us that “I come out of my room at times and cannot see a staff member”. Two patients told us that there were “a lot of staff around today which is very unusual’. A sixth patient told us that staff are always busy; they are either in the office or on observations. Ten patients told us that that they were bored, that activities were often cancelled, and that they were not always able to access authorised section 17 leave. Six patients we spoke with said the wards were not always clean. Three patients on Mackaness ward told us that due to patient’s soiling on the carpet, ‘it was dirty and was smelling.’ One patient told us that there was a strong smell of body odour on the ward. Nine patients spoke to us about their medicines. Six patients (66%) told us that staff explain their medication with them. Eleven patients told us that staff were not always kind, compassionate or treated them with dignity. Although the provider gave us evidence that 97% of care plans had patient involvement with goal setting, most patients told us that they had not been involved in their risk assessment or care planning process. However, the provider shared a provider audit which indicated that 97% of care plans had patient involvement with goal setting’ Not all patients felt safe to share their views with staff.