Inadequate Rating for Hospital in Ealing

Four patients at Cygnet House self-harmed within two months

Cygnet House. Picture: Google Streetview

A hospital in Ealing specialising in eating disorders and personality disorders has been rated as inadequate.

Cygnet Hospital was deemed deficient on safety, caring and leadership, with issues including four patients self-harming in the space of two months despite being observed on a one-to-one basis by staff.

There were also issues with staff falling asleep when they were supposed to be observing, meals being late, and inappropriate comments about food and portion sizes – despite staff working on a ward treating patients with eating disorders.

The hospital was placed into special measures, which means it will be kept under review and, if needed, could be closed if another inspection within the next six months does not show marked improvement.

In November 2018 following an inspection the provider voluntarily agreed to suspend admissions to one of its wards – the Sunrise Ward.

Sunrise Ward is a 17-bed ward for women aged 18 or over with complex eating disorders.

The CQC returned in June and found significant improvements were still needed and imposed a decision to stop admissions to the ward.

Inspectors deemed the hospital was not delivering safe care, with patients on Sunrise Ward deemed to be at high risk of avoidable harm.

Inspectors found four patients had self-harmed during a two-month period despite being observed on a one-to-one basis by staff.

Patients reported they were treated in an off-hand manner and a spokesman for the CQC said inspectors observed nursing staff did not always display kindness or compassion.

The CQC said in a press release: “The ward did not offer a therapeutic environment for patients with eating disorders.”

“Patients said that staff fell asleep during one-to-one observations, their meals were late, and agency and bank staff made inappropriate comments about food and portion sizes.”

A second ward, the New Dawn Ward, specialises with adult women who have diagnosed personality disorders.

Eight patients were receiving care and treatment on the nine-bed ward at the time of CQC’s inspection.

A report noted New Dawn Ward had a permanent ward manager in place and was better managed than Sunrise Ward.

The CQC also noted a high turnover of senior staff within the hospital.

Inspectors concluded that, although some improvements had been made to paperwork, this had not led to a consistent improvement in practice, according to a CQC report.

Kevin Cleary, CQC’s Deputy Chief Inspector Hospitals Mental Health and Community Services, said: “Having taken enforcement action following an inspection at the end of last year, we revisited the service to check that all the necessary improvements had been made; disappointingly, they had not.

“We found that the hospital was not delivering safe care and that staff did not always treat people with compassion.

“Staff on both wards reported instances of bullying. Patients on both wards complained about a lack of timely feedback when they raised any issues.

“Another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service.”

Since the most recent inspection, inspectors found improvements in the leadership of the hospital and ward, with staff being offered competency-based learning to support people with an eating disorder.

It has been agreed that admissions can start again at a maximum of one patient each week, until the ward is half full.

A spokesperson for the hospital said: “We took the inspection in June extremely seriously, since then we have been working hard to address the issues raised.

“The findings of the report date back to three months ago, more recently the CQC has recognised all our efforts to improve our quality of care and refurbishments. We are now accepting referrals to the hospital’s specialist Eating Disorder service.

“Our Personality Disorder service continues to be dedicated to offering the best possible quality care to those individuals placed with us.

“We have made significant investment in recruitment, training our existing and new staff with robust induction processes, improving the physical environment and we have introduced a new management team.

“Delivering high quality care is our priority. Where standards fall short we will take all the necessary steps to transform and improve the service we provide. We remain committed to working with our stakeholders and appreciate the ongoing support provided by our Commissioners.”

Ged Cann - Local Democracy Reporter

September 30, 2019