High-security hospital 'still needs to improve'

Rampton Hospital had an announced inspection by the Care Quality Commission (CQC) in March

A high-security psychiatric prison is still in need in need of "urgent improvement" the healthcare watchdog has said.

Rampton Hospital, run by Nottinghamshire Healthcare NHS Foundation Trust (NHFT) has been rated "requires improvement" by the Care Quality Commission (CQC) following an unannounced inspection in March.

It was rated "inadequate" in January 2024 with the NHS trust under close scrutiny at the time over its care of Valdo Calocane, who carried out the Nottingham attacks in June 2023.

While the CQC found some "clear improvements" had been made at the hospital, it said the trust had work to do "to address staff shortages and support staff".

Rampton provides services to people who are detained under the Mental Health Act 1983 and are classified as having a learning disability, mental illness or psychopathic disorder.

The latest CQC visit of the site follows a series of inspections that began in June last year as part of a 12-month inspection programme the watchdog has carried out at the wider trust.

This was prompted by a special review into NHFT for which the final report was published in August last year.

The care Valdo Calocane - who fatally stabbed three people in June 2023 - received from the NHS trust prompted the wider review of its services

During the latest inspection, staff reported incidents where the hospital wards were "not meting safe staffing levels" with therapies and activities "frequently cancelled" due to staffing shortages.

Managers told inspectors the wards "hardly ever" had the right number, experience and gender of staff to keep patients and staff safe.

Between 1 March 2024 and 27 February 2025 staff submitted 777 incident forms where the reasons stated were "clinically unsafe staffing", the report said.

Sometimes staff were working alone at night, leaving them unable to take breaks and some unhappy they were regularly moved from their ward to support others.

Managers told inspectors lone working left staff feeling "anxious, isolated and unsafe".

In the report, released on Friday, the CQC said it had found four breaches of regulation during its latest inspection, related to safe care, safeguarding, privacy and dignity, premises and equipment and safe staffing.

The watchdog said it had asked the trust to submit a plan showing what action it was taking to address the concerns but added it had provided assurances around staffing concerns.

'Build on positive areas'

Leaders at the trust showed it had measures in place to to minimise lone working and that the service was in the middle of a large recruitment drive.

The CQC added staff at Rampton respected people's privacy and dignity, were responsive to people's needs, provided help, emotional advice and advice when they needed it and worked well with partner organisations.

Greg Rielly, CQC deputy director of operations in the Midlands, said: "We have told leaders at Nottinghamshire Healthcare NHS Foundation Trust where urgent improvements are needed.

"The service needs to build on the positive areas in our report and focus on making the service safer for people."

In April, the BBC revealed the trust announced plans to withdraw from a contract to provide healthcare to prison inmates at seven jails across the East Midlands and an immigration centre.

'Committed to improve'

Dr Susan Elcock, executive medical director and deputy chief executive of Nottinghamshire Healthcare NHS Foundation Trust, said the service was pleased the CQC reflected on improvements it had made.

She added: "We welcome inspections as they are an important way to understand how we are doing and highlight areas where we can do better.

"Where the CQC told us we needed to take urgent action, we immediately took steps to address the issues raised.

"The CQC noted among the improvements those relating to physical health support and described care plans as personalised and truly reflecting patients' needs.

"Whilst we recognise we still have a way to go, I would like to thank colleagues for their work to date.

"We are absolutely committed to making further improvements to ensure our services consistently provide excellent, safe care and will continue working closely with the CQC, our colleagues, our patients and their families to achieve this."