Troubled Hill Crest mental health ward unsafe, says regulator

Savannah Whyte said she saw staff fall asleep when they should have been caring for her

A former patient of an under-fire mental health unit says serious safety improvements were needed and staff often fell asleep on shift.

Savannah Whyte was an in-patient at Hill Crest in Redditch which has been criticised for safety and staffing by the Care Quality Commission (CQC).

She said her experience meant she could never return to a psychiatric hospital.

Herefordshire and Worcestershire Health and Care NHS Trust has apologised and said it was improving care.

It cut the number of beds last week in a bid to focus on quality of care.

The CQC watchdog visited the site in Redditch in July after multiple issues were raised.

During the unplanned visit, inspectors found a "significant deterioration" in "safety and quality" on the ward.

Claims reported to the CQC included incidents of staff asleep on duty, attacks on patients and staff, and a culture of bullying.

A BBC investigation previously found a male patient's jaw had been broken by another patient.

Ms Whyte, 19 and from Redditch, said some "serious measures" needed to be introduced.

She said on one occasion a staff member told her that a male patient who had made a rude comment to her had also been touching other people.

The Hill Crest unit is based on the Alexandra Hospital site in Redditch, Worcestershire

Looking back, she said she did not feel cared for during her four months at Hill Crest.

Ms Whyte said she was supposed to have one-to-one care for observations, but she described four occasions on which staff were sleeping while they should have been monitoring her.

Her father was so concerned about her safety that he camped outside the building and refused to leave.

"There needs to be more regular staff. Staff who know the patients. It needs to be more secure. Also have the right patients there… just to make the ward a little bit more settled," Ms Whyte said.

She urged anyone struggling with their mental health to reach out early in a bid to avoid being hospitalised.

If you are affected by the issues covered in this article, help and support is available at BBC Action Line.

The mixed-gender 18-bed Hill Crest ward supports people between 18 and 65 with acute mental health difficulties, and those detained under the Mental Health Act.

Craig Howarth, CQC's deputy director of operations in the Midlands, cited an incident during which a patient had attempted to throw boiling water and sugar at a member of staff.

"On the day of inspection, two boilers were still in use indicating that lessons had not been learned following this incident and no actions had been taken to mitigate any future risk," he said.

Other key findings included:

• Insufficient nursing and medical staff with basic training to keep people safe

• Sexual safety incidents, with unmitigated "blind spots" in rooms and corridors

• Male patients able to access female-only areas, including bedrooms

• Patient risk assessments not created or reviewed in a timely way to manage risk

• Staff failing to assess the physical and mental health of all patients on admission

• A poorly maintained building, including exposed electrical wires and "visibly dirty" areas of the ward

Inspectors heard male patients regularly entered a female-only lounge without being challenged by staff, the report said.

According to staff, a door between male and female areas was kept open with a towel over the handle.

A draft copy of the CQC report was delivered to the NHS trust after the inspection

The BBC has previously heard reports of staff resigning after violent attacks on the ward.

Staff 'under pressure'

The CQC report detailed high vacancy rates, with seven out of 10 nursing posts, and seven out of 18 healthcare assistant roles unfulfilled at the time of inspection.

Workers reported "staffing issues" had left them under pressure, and they did not always feel respected or supported by managers.

The ward could not guarantee high numbers of bank and agency nurses were familiar with the hospital or patients, inspectors said.

In response, the trust said it had made immediate improvements to environment, risk assessment and handover procedures since the inspection, but personnel remained an issue.

Sleeping on duty was not tolerated and was investigated with appropriate action taken. If it involved an agency worker it was reported to the company and the person not used again, a spokesperson said.

Chief executive Sarah Dugan said: "We recognise that the standards of care and professionalism at Hill Crest at the time of the inspection last July were not good enough.

"I would like to apologise to the patients and families concerned."

Ms Dugan said there were still "significant staffing challenges which affect our ability to embed and sustain these improvements".

A temporary reduction to 10 beds would "help alleviate the pressures", she added.

"It will also help us focus on continuing to implement our improvement plan and sustain the changes that we are making."

The trust said it would work with other inpatient wards and community teams to ensure patients could continue to access care.

It submitted its action plan to the CQC on 5 September.