Leaked report rejects dementia care abuse claims

The 13-bed Bryn Hesketh ward has just undergone a £500,000 refurbishment to make it more dementia friendly

An investigation into the care of patients at a dementia unit in north Wales has taken place, a leaked report shows.

However, all allegations of neglect and abuse at the 13-bed Bryn Hesketh ward in Colwyn Bay, Conwy, were rejected.

The details of the 2016 inquiry emerged ahead of a long-awaited report into how the region's health board is run.

It follows the closure of the Tawel Fan unit at Denbighshire's Glan Clwyd Hospital in 2013 amid abuse claims.

Betsi Cadwaladr University Health Board is due to receive the findings of the review which looked into its governance and mental health services on Thursday.

The leaked report passed to BBC Wales showed a team of investigators was called in following allegations by a whistleblower.

They raised concerns about patient care at the ward at Bryn Hesketh.

The subsequent inquiry described a lack of clinical leadership and a divided staff team.

Six staff members initially suspended by the health board when the investigation was launched were later cleared of any wrongdoing in relation to patients.

The inquiry was launched after complaints made in September 2016

But the heavily redacted report written in October 2016 and passed to BBC Wales revealed a series of shortcomings.

The inquiry centred around five claims of neglect, physical and emotional abuse.

One patient was found with bruising.

The inquiry showed no care plan was put in place to treat the bruising, however it said the patient had received appropriate care for leg ulcers and had not been subjected to neglect.

In another case, investigators expressed concern that reclining chairs may have been used to restrict patients movement - with stools placed under the foot rest to stop individuals getting out of the chair.

• Tawel Fan: 'A health board in turmoil'

• Q&A: What is the background to Tawel Fan?

• Tawel Fan timeline

In a separate case of alleged physical abuse, the report found restraint of an aggressive male patient was justified.

However, it said staff did not appear to understand procedures and plans for restraining patients, terming their actions "safe holds".

The inquiry did raise a number of further concerns about staff behaviour.

It found examples of staff swearing at each other during shift handovers, arguments on the ward, and staff smoking outside patients' windows.

It said patient information and documentation was "inconsistent", and the process for sharing information between staff varied.

The inquiry was launched a year after the health board had already been placed in special measures following the closure of the Tawel Fan unit.

The dementia ward was shut following claims of abuse and patient mistreatment, although a later report rejected claims that it amounted to institutional abuse of patients.

The chief officer for the North Wales Community Health Council said he was alarmed by the leaked report's findings

The chief officer of the North Wales Community Health Council, which represents patients in the region, told BBC Wales he was "very, very concerned to see this".

"The thing that strikes me is how similar it is to the experiences of those families who complained about Tawel Fan," said Geoff Ryall-Harvey.

"Looking through it, some allegations are almost exactly the same.

"It was two years ago - and nearly three years after Tawel Fan had been discovered... it is really very, very, concerning."

In 2017, the Bryn Hesketh ward was subjected to a fresh unannounced inspection by the Healthcare Inspectorate Wales where wide-ranging improvements had been made and all outstanding concerns raised have now been addressed.

The ward has just undergone a £500,000 refurbishment to make it more dementia friendly.

In May, the memory clinic run by the ward was also named as the British Medical Journal's Mental Health Team of the Year award.

Wife's story: He walked into Bryn Hesketh "physically fit"

The wife of one patient spoke to BBC Wales anonymously about when her late husband was admitted to the Bryn Hesketh Ward to treat his dementia:

"My husband went into Bryn Hesketh for an assessment on 13 March 2015. While he was there he became quite poorly and just nine weeks later he was admitted to Glan Clwyd Hospital.

"He was so dehydrated that he had acute kidney injury. He had a chest infection which presented as pneumonia and he had sepsis.

"He had also lost six kilos in weight.

"Although he had dementia, he walked into Bryn Hesketh a relatively physically fit 72-year-old man. Nine weeks later he had lost six kilos and was so dehydrated his kidneys were injured. He died on 2 July. He didn't really recover.

"I complained to the health board. They never admitted neglect but they did say there was a lack of detail in his medical records which meant it wasn't always clear enough exactly when actions were introduced in terms of mouth care and dietary supplements.

"I have never been happy with that conclusion. I have been told (in letters from the health board) that notes were inadequate, poorly completed and filed in a mess with some information missing. One letter from the health board says that the quality of care was not what would have been expected."

Responding to the findings of the report, the health board confirmed that all disciplinary proceedings in the cases had concluded.

"People can have confidence that if they or their loved ones require admission to Bryn Hesketh they will receive high quality care, which is delivered by well-trained staff in a truly dementia-supportive environment," said a spokeswoman.

"Improvements to standards of care on Bryn Hesketh Ward have been noted in a recent report by Healthcare Inspectorate Wales, which praised the ward's strong leadership and the dedication of staff."