Not all Baldock Manor patients get regular showers, CQC inspectors find

Baldock Manor

Baldock Manor - Credit: Archant

Some women at the Baldock Manor mental health unit do not receive regular baths or showers, inspectors have found – with a chronic staff shortage meaning patients sometimes miss outside leave.

Care Quality Commission inspectors visited the private hospital, run by Nouvita Ltd, from February 21 to 23 – and found it had improved in most aspects since probes in November 2015 and May 2016.

But the report from team leader Deborah Holder maintains that there is still much work to be done in areas such as risk assessments, documenting restrictive interventions and learning from serious incidents.

Among other things, it was found that potentially life-saving equipment was not kept ready for use – with a defibrillator kept in an emergency response bag without a battery or pads.

And in their summary, the inspectors wrote: “Qualified staff were not visible on all wards and some worked across two or three wards. There was little evidence that patients were having 1:1 time with their named nurse.”

There were some 27 staff vacancies at the time of the inspection, with staff turnover for the previous year at 33 per cent – and a high dependency on agency personnel.

Baldock Manor received ratings of ‘requires improvement’ in all five categories – safety, effectiveness, care, responsiveness and leadership.

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This is a marked step up from its last CQC report, based on visits in November 2015, when the London Road site received ‘inadequate’ ratings in four categories out of five.

According to the inspectors, the manor had 66 “serious incidents requiring investigation” from December 2015 to December 2016, including aggression between patients – with staff having “a low threshold” for reporting and recording these.

The report notes that male patients were permitted to spend time on female wards, with no evidence of assessment or care planning to cater for this.

It was also found that “patients’ dignity was not maintained on Oakley female ward”, and that women there did not receive regular baths or showers.

Not all patients were offered regular leave, with some lacking regular time outside for fresh air. During the inspectors’ discussions with patients, three reported “a lack of therapy and activities”, and that leave was “sometimes cancelled or postponed due to staffing issues”.

It was found that only six out of 16 serious incident reports were fully completed, confidential information was sometimes insecure, and that patients and carers were not involved in developing care plans.

Management was deemed to be below scratch, among other things because managers failed to give staff regular supervision and annual appraisals.

The inspectors spoke to 10 patients, who were positive about their care and treatment and said staff were kind – though the use of agency personnel was high enough that they did not always know the staff.

Positive notes in the report included regular ligature audits by management, the unit’s cleanliness and the high rate of mandatory training among staff, who are described as interacting with patients “in a caring and respectful manner”.

It was also noted that staff usually felt listed to and supported, that senior managers were available to personnel, and that there were no reported cases of bullying or harassment.

In response to the report, Baldock Manor manager Karen Hartland told the Comet: “The new clinical director and chief of staff are now in post to support the management team, who have been focusing on developing clinical care and innovation.

“There is a robust business plan to deliver quality care to all the current residents, and for new admissions to Baldock Manor in the future.”

The CQC report can be read in full here.