Child restraint and sedation fears at hospital

Concerns have been raised about the privacy and dignity of child patients at the hospital

Concerns about the use of emergency sedation and the privacy of child patients at a major hospital have been raised in a new report.

The Care Quality Commission (CQC) highlighted issues at the Gloucestershire Royal Hospital after carrying out an unannounced inspection of the site's children's centre in September.

The inspection was triggered by information from the trust that manages the hospital - with concerns that children ready for discharge were inappropriately placed at the hospital.

In response to the CQC report, a spokesperson for Gloucestershire Hospitals NHS Foundation Trust said the team has strengthened processes around appropriate hospital admissions, administration of emergency sedation, reviewed mandatory training and strengthened recruitment and use of registered mental health nurses.

The CQC report said it was alerted to the fact that "due to behaviours, physical restraint was being used together with the administration of emergency sedation and involuntary detention".

The children's centre at the hospital - which is currently graded as "requires improvement" - consists of 38 beds including general medical and surgical beds, four high-dependency unit beds, and a four-bed oncology unit.

Gloucestershire Hospitals NHS Foundation Trust raised concerns about the safety and quality of services and contacted the CQC with fears children had no clear discharge pathway, as reported by the Local Democracy Reporting Service.

Inspectors found there was no privacy in young people's rooms, were told de-escalation and restraint took place in the rooms and that people moving along the corridor could see into young people's rooms.

Child sedation

They also said the hospital’s care plans and records did not reflect national guidance for restraint, observation, and emergency sedation.

And level three training records showed they were below 50 per cent and not all staff had received training on the mental health needs of children and young people.

There were also concerns about the competency of agency nurses to provide specialist mental health care to the young persons, and the trust's policies around emergency sedation were not being followed.

According to the report, staff were not following the national guidance on the use of emergency sedation in children, and managers did not have full oversight of its use.

Despite these worries the CQC noted staff were responsive when caring for young people and they interacted with patients in a respectful and considerate manner outside of clinical interventions.

A spokesperson for Gloucestershire Hospitals NHS Foundation Trust said: “The report is challenging and we recognise the patients at the heart of the children centre inspection should not have been in our hospitals, which is why the trust took the decision to proactively raise the safety concern and seek support from the CQC.”