Watchdog orders improvements in mental health unit

Inspectors found "inconsistent care planning and risk management" at the Langdon Hospital wards

An NHS trust has been told to take immediate action after inspectors found regulation breaches at a mental health unit.

The Care Quality Commission (CQC) carried out an unannounced inspection in April of the wards at Langdon Hospital in Dawlish, Devon, following concerns over the safety of people using the service.

The watchdog said the forensic inpatient and secure wards at the site, run by Devon Partnership NHS Trust, required improvement and bosses were told to submit an action plan showing what immediate action they would take.

Hazel Powell, chief nursing officer and allied professions lead at the trust, said an "intensive programme of improvement" had been put in place.

The CQC said it identified five breaches of regulations related to safe care and treatment, person centred care, dignity and respect, staffing and good management of the service.

It issued a warning notice to "focus the trust's attention on making rapid and widespread improvements to ensure safe care and treatment and good management of the service".

Inspectors said they also identified positive signs at the hospital including staff promoting healthy lifestyles, strong relationships with external agencies and patients getting access to "meaningful community-based activities".

Inspectors visited the hospital in April

Catherine Campbell, CQC's deputy director of operations in Devon, said inspectors found "inconsistent care planning and risk management" which affected the quality of people's daily lives and recovery.

"Staff were committed to providing good care, but were hindered by gaps in training, unclear guidance, and limited access to resources," she said.

She said care plans were often outdated, not tailored to individuals and did not reflect people's goals or preferences.

"Many people told us they weren't always involved in decisions about their care, medications or risk assessments," she said.

"This left some feeling frustrated, powerless or stuck in their recovery.

"Staff sometimes used risk assessment tools inconsistently, which made restrictions feel unfair or punitive."

'Very challenging circumstances'

Ms Powell said an improvement programme carried out over five months to address issues raised had delivered a number of "major changes".

Improvements included a review of the seclusion and extra care area with the aim of making it a "more appropriate and dignified place for de-escalation to take place", the NHS boss said.

She said staff training had also taken place in a number of areas while incident escalation processes, risk review meetings and safety huddles had been "reviewed and improved".

"Our staff work incredibly hard, often in very challenging circumstances, and we are pleased that some of the positive aspects of their work have been acknowledged by the CQC," she said.