Mental health hospital rated ‘inadequate’
A COVENTRY mental health hospital has been rated inadequate after two people died on one of its wards.
A number of other serious issues were raised in the report published yesterday, which is from the July inspection at the Cygnet Hospital in Hillfields.
The report found the two deaths on the same ward – Dunsmore – were linked to a failure by staff to carry out patient engagement and observations correctly.
As well as the deaths, another patient almost died from self-harm, in which it was found there were high levels of patients harming themselves on the same ward.
Wards at the female only hospital were not clean with dirty fridges and soiled furniture. The seclusion room on one ward was also found to be foul smelling, had bodily fluids on the outside of the toilet and drinks stains on the walls and ceiling.
Inspectors also found out of date medicines and missing entries in records to show whether checks had been carried out on the emergency resuscitation equipment.
A summary of the report’s findings said that particular problems arose due to other patients who posed a risk. It was also said there was a lack of oneto-one support.
When asking if the services were ‘safe,’ the report found care on both the Dunsmore and Middlemarch wards were not and this was to do with lack of permanent staff, areas that weren’t clean and other patients having to look after each other.
The Dunsmore ward did not have a good track record on safety, inspectors found.
There had been two deaths on the ward, one which could have been avoided and another patient almost died from self-harm.
Both deaths and the near miss were linked to a failure by staff to carry out patient engagement and observations correctly. There were high levels of patients harming themselves on the ward.
Staff assessed risks to patients and themselves well but struggled to anticipate, de-escalate and manage challenging behaviour because there were not enough regular staff to build relationships with patients.
The report stated that there weren’t enough staff who knew patients well enough to keep them safe from avoidable harm.
It also said both wards were routinely staffed with a significant amount of agency staff.
Almost all of the patients said they did not feel comfortable with the large number of temporary staff who worked at the hospital and told inspectors it was because many were men who were of a different background and culture to them.
Inspectors spoke to five family carers and none were satisfied with levels of communications. They claimed they were left in the dark if their relative had been unwell.