Damning report for Dorchester mental health unit

The Minterne Ward at the Forston Clinic failed to meet all 10 of the national standards of quality and safety in an inspection by the Care Quality Commission (CQC).

The watchdog said it is now considering further action over the failings.

The report slated the locked unit, which cared for people with acute mental health difficulties until it was closed after the inspection in November, as reported in the Echo.

Inspectors said that three patients described the ward, on Herrison Road, Charminster, as 'a prison' or 'a concentration camp', and one patient remarked 'I spend every waking hour planning how to escape from here because there is nothing to do'.

Staff added the ward was 'regime orientated'.

The report also found: “One patient told us they felt intimidated by two patients who were 'very verbal'.

“Another patient told us they did not feel safe.

“A relative of one patient expressed concerns about the safety of female patients at night.”

Empty bookcases, dirty toilets and tepid water on the ward were also noted.

James Barton, director of mental health services at Dorset HealthCare, admitted the report was 'damning' but said work has been underway since the inspection to improve the service with a view to re-opening the ward in April.

The CQC carried out the routine, unannounced inspection in November.

The other ward at the Forston Clinic, Melstock House, was also inspected but is not connected to the criticisms made of the Minterne Ward.

Ian Biggs, deputy director of CQC in the south, said the concerns should have been dealt with 'some time ago'.

He said: “This is not the first time we have told the trust it must make improvements at this service.

“It is a matter of some concern that the trust has failed to address these issues.

“We found that patients were still not being treated with consideration and respect.

“There was a blanket ban on caffeinated drinks, or the use of aerosols or proper cutlery.

“While only little things in themselves, they are an indication of a culture which is not interested in people's dignity or personal choices.”

He added: “It was apparent the ward was failing on many levels. Patients were not receiving appropriate and safe care because the trust didn't have effective systems in place to deliver what was needed. “This can't continue.

“Where we have continuing concerns, we have a range of powers we can use to protect the safety and welfare of people who use this service.

“We will consider further action and publish information about this in due course.”

The report found the Minterne Ward failed in the following areas: Respecting and involving people who use services - patients were not treated with consideration or respect, and their dignity was not maintained.

Consent to care and treatment - regular reviews of patients' mental capacity to consent to treatment did not take place.

Care and welfare of people who use services - risk assessments were incomplete, and activities were limited and restrictive.

Safeguarding people - patients were not protected against the risk of abuse, were not protected against unlawful or excessive use of control and restraint, and the use of restraint was not always properly documented.

Safety and suitability of the premises - hot taps in some rooms supplied orange-coloured water and the seclusion facility designated as not fit for purpose was still in use.

Staffing - ward staff said there were not enough nursing staff to cover at times, especially when new patients were brought in during the night.

Cleanliness and infection control - effective systems were not in place to maintain appropriate standards of cleanliness and hygiene.

Management of medicine - medicines were not handled safely, securely and appropriately and no clear procedures were in place for medicine handling.

Supporting workers - staff were not properly trained, supervised or appraised.

Assessing and monitoring the quality of service provision - patients did not receive safe quality care, treatment and support because effective systems were not in place for the management of risks to their health, welfare and safety.

James Barton, director of mental health services at Dorset HealthCare, which is responsible for the Minterne Ward, said 'substantial improvements' have been made since the CQC first undertook its report, including taking on extra staff, more staff training, providing more activities and putting more feedback procedures in place.

“We want to provide inpatient care that we can be proud of, which is why we've invested a huge amount of time, energy and resource to make sure the ward, when it reopens in April, will be a service we can take pride in.

“More than £1million has been invested since the inspection in refurbishing the ward and building a new seclusion facility to comply with all the latest requirements.

“We are confident that, as a trust, we have responded in a very positive manner to the feedback from the CQC.

“We are sorry that the standards of care sometimes weren't as high as patients always deserve, which is why we've worked hard to address all the issues raised.

“We are determined to ensure the best possible inpatient care for our patients at what is a very worrying and vulnerable time for them.

“This is clearly a damning report, but I really think that with clinical leaders making sure that every day, we are providing a service they would want to receive themselves, that we can make sure this never happens again.”