Care regulator the Care Quality Commission (CQC) has formally warned Vista Independent Hospital in Winchfield, Hampshire, that it must make urgent improvements to protect its patients from abuse.
The warning follows an unannounced visit by inspectors to the hospital in November 2014 to follow up safeguarding concerns. Since then the provider has agreed not to admit any further patients while a specialist team has been brought in to oversee improvements.
Following the inspection, CQC issued two warning notices requiring the provider, Fairhome Care Group (WL) Ltd, to take action to protect the health, safety and welfare of the patients. Inspectors found that the hospital was in breach of 12 national regulations.
Vista Independent Hospital is registered for up to 69 patients with mental health needs or learning disabilities, including people who are detained under the Mental Health Act.
CQC has been working closely with NHS England, Hampshire County Council and 17 clinical commissioning groups to ensure that patients’ needs are met properly. Inspectors will return unannounced in the near future to check progress.
The hospital was inspected over a 3-day period by a team that included specialist inspectors, two specialist clinical advisors and an expert by experience with many years’ experience of caring for a person with learning disabilities. It found numerous problems:
• The provider had not taken reasonable steps to identify the possibility of abuse, and prevent it, or to respond appropriately to allegations of abuse
• There were not always enough members of staff to care for people safely. Some staff and patients said that they did not always feel safe on the wards
• In 7 months, the hospital recorded 334 incidents of physical abuse or violence involving patients. There were 272 incidents where staff were reported to have been subject to physical assault, sometimes needing hospital treatment
• Police had been involved in 22 incidents – although many were not reported to CQC as required
• There were no arrangements in place to protect people from unlawful or excessive restraint. Staff who were not appropriately trained to undertake floor restraint were frequently doing so, which had caused injury to staff and patients
• The lack of enough skilled and experienced staff and poor clinical leadership meant that a culture of restrictive practices had not been identified, or dealt with.
Action must be taken
Karen Wilson, CQC’s head of inspection, said: “We have told Fairhome Care Group (WL) Limited that they must take action to protect the health, safety and welfare of the people in their care.
“Some patients told us that they were well cared for – but too many felt angry and frustrated by how they were treated. They told us that staff did not listen to them and did not treat them with respect.
“The number of violent incidents is disturbing – yet we found little evidence that the provider had the specialist skills or systems to learn from these incidents and prevent them happening in the first place. We know that patients are at risk of harm as a result of staff undertaking restraint without the appropriate training.
“All patients are entitled to services which are safe, effective, caring, well led, and responsive to their needs. It is a matter of concern that this hospital did not have systems in place to monitor the quality of the service.
“We expect Vista to make immediate improvements. We will return imminently to check that it has made all the changes we require to ensure people are safe and well cared for. Otherwise we will consider using our legal powers further to protect the people who depend on this service.”
In a statement on its website, Fairhome acknowledged the CQC’s report was “an uncompromising catalogue of the issues that have faced the new clinical and management team at Vista Healthcare. The formal warnings reinforce the importance and urgency that the new Vista management, and the specialist team they brought in, have been and are bringing to making and sustaining the improvements for patients.
“Following the inspection in November 2014… the board, led by its new chairman, Simon Harrison, has given its full and active support to the staff and new clinical and management team to set and sustain the highest standards of care. Working with NHS England, CQC as well as regional and local stakeholders considerable strides have been made to meet the targets set by CQC at a difficult and testing time for specialist health and social care services throughout the country.”