Cavell Centre: 'Profound sense of fear' felt among staff

An internal review found staff likened the Cavell Centre "to a school playground where the school bully operates"

A "profound sense of fear" existed among staff at an NHS mental health unit where leadership was described as dictatorial, a report has found.

An internal review into the culture of the Cavell Centre, in Peterborough, found staff who spoke up felt "ostracised and alienated".

It added that "staff likened the Cavell Centre to a school playground where the school bully operates".

The NHS trust said it was "deeply shocked and saddened by the findings".

The unit, run by Cambridgeshire and Peterborough NHS Trust (CPFT), provides inpatient mental health care and specialist learning disability services.

CPFT commissioned the review in November 2021, but the reviewers said many of those they interviewed "were extremely anxious" about taking part, and were in fear of being identified.

Released to the BBC under the Freedom of Information Act after a request in September, the review said: "A cyclical theme within the culture of the Cavell Centre was reported as autocratic, dictatorial, insular, and hierarchical."

It found that behaviour by "key people in the hierarchy" led to "acts that could reasonably constitute bullying or harassment".

Reviewers heard "very distressing testimony relating to sexuality, of staff being confronted with extremely offensive and discriminatory messages".

The Cavell Centre provides inpatient mental health care and specialist learning disability services

Other findings included claims of racism from both white and non-white staff, and concerns care was being compromised because of a culture of nurse-led, rather than consultant-led, decision-making.

Staff also described it as "a place bereft of hope or enthusiasm", and public humiliation "came across as a norm of leadership".

Reviewers, who conducted interviews between January and May, said staff "required multiple reassurances that speaking with the reviewers was safe and confidential".

"The profound sense of fear expressed by some staff was tangible and real," the review said.

"Many explained how they or their colleagues had been ostracised and alienated for doing so, feeling that the only solution was to leave."

'Shocked and saddened'

In October, the same month the review was published, the Care Quality Commission (CQC) inspected the Cavell Centre and four wards at Fulbourn Hospital as part of an inspection into CPFT's acute wards for adults of working age and psychiatric intensive care.

In May, an inspection of one of those Fulbourn wards - prompted by an allegation of sexual assault - led to the CQC serving the trust a warning notice, which has been lifted since the most recent inspection.

But this inspection, in direct contrast to the trust's own review, also said "staff felt respected, supported and valued... they could raise any concerns without fear".

The CQC said it had spoken to 11 staff across the five units and was "satisfied the culture did not undermine patient safety".

But it added: "After our inspection concluded, the trust made us aware of the independent review and it subsequently shared the associated report.

"We are taking up the issues the review raises with the trust to seek assurances these concerns do not undermine the quality or safety of patient care."

Anna Hills, CPFT chief executive, said: "We commissioned the cultural review in response to concerns from our staff and are deeply shocked and saddened by the findings.

"I would like to thank colleagues who bravely came forward to speak up and I am truly sorry for what they have experienced.

"Since receiving the report we have spent time listening to and talking with staff, and together we are co-designing the next steps.

"The trust board is fully committed to addressing the issues raised."

With respect to the CQC inspection she was "pleased [it] acknowledged the improvements that have already taken place", adding: "We recognise there is still work to do but I am so very proud of the dedication of our staff."