Greater Manchester NHS mental health trust ordered to improve

Undercover BBC filming revealed concerns about patients at the Edenfield Centre

Bosses of an NHS trust where mental health patients were filmed being mistreated have been told to urgently improve the standard of care provided.

Warning notices were served after the Care Quality Commission (CQC) inspected the Greater Manchester Mental Health NHS Foundation Trust (GMMH).

On Wednesday the trust was told it would face the highest level of intervention from NHS England.

The trust said improvement work was already under way.

A BBC Panorama investigation, broadcast in September, found patients at the Edenfield Centre in Prestwich, near Bury, were being put at risk.

Since that programme, some staff have been sacked or suspended as a result of the trust's formal disciplinary procedures.

GMMH's outgoing chairman Rupert Nichols previously said the trust was facing "significant challenges" after "inexcusable behaviour" at the unit.

The trust has also been under scrutiny after the deaths of three young people within nine months.

An inquest in October ruled communication failures "probably caused or contributed to" the death of 18-year-old Rowan Thompson at the trust's Prestwich site.

The CQC served the trust with two Section 29A warning notices - one relating to ligature and fire risks, the other to staffing and governance, requiring significant improvements within a set timescale.

The report said inspections over the summer found problems with:

• suicide risk assessment

• the management of medicines

• levels of cleanliness

• consent to treatment

• patients' safety

Inspectors found there were not enough staff and there was a lack of proper oversight and scrutiny by the trust's board.

Inadequate fire safety standards and poor levels of maintenance were uncovered, while wards were "dated".

'Not enough nurses'

The CQC report concluded: "The trust did not provide safe care. The ward environments were not all safe, clean, maintained or well-presented.

"We had significant concerns about fire safety in the acute wards. Ligature audits were poor because they did not identify all risks or effectively mitigate these."

The service also did not have enough registered nurses or healthcare assistants to help patients, with staff "frequently" working under the "minimum staffing establishment levels".

The CQC also raised concerns about mixed-sex wards and the "sexual safety" of patients.

It added: "Services were not always caring, some patients told us that wards were noisy and chaotic, and that they did not always feel safe."

The secure Edenfield Centre is intended to care for people at risk of harming themselves or others

Patients also told inspectors there were not a lot of activities on the wards "other than television", while "food portions were small" and patients thought "the food was unpleasant".

After the inspections, the CQC said the overall rating for acute wards for adults and intensive care had deteriorated from "good" to "inadequate".

The ratings for being "safe and well-led" also dropped to "inadequate", while marks for being "effective, caring and responsive" moved from "good" to "requires improvement".

The overall rating for forensic inpatient and secure wards also dropped from "good" to "inadequate", as did the "safe and well-led" ratings.

How effective, caring and responsive the service was declined from "good" to "requires improvement".

Ann Ford, the CQC's director of operations network North, said: "Since our inspections in June and July, we've been contacted by whistleblowers and additional serious concerns have emerged.

"We have carried out further inspections in other services run by the trust in response to those concerns and found further breaches of regulation which the trust must address as a matter of urgency."

A spokesperson for the trust said it was "committed to making the changes and improvements that our service users deserve", adding work was already under way to "build better and more sustainable services".

"Furthermore, our enrolment in the NHS England Recovery Support Programme will provide us with access to additional expertise and resource to ensure that sustainable improvements are made as quickly as possible."

Undercover Hospital: Patients at Risk

A BBC Panorama undercover investigation has found evidence that a secure NHS psychiatric hospital is failing to protect some of its vulnerable patients.

Available now on BBC iPlayer (UK Only)