CQC report: Nottinghamshire Mental Trust medical staff falsified documents and assaulted patients

The Care Quality Commission (CQC) has reported incidents of staff falsifying records and assaulting patients at Nottinghamshire Healthcare NHS Foundation Trust following an inspection in 2023.

The trust’s adult and elderly acute wards were visited by inspectors last year.

The inspection report, published on Friday 1 March, identified deficiencies across the services, resulting in the overall rating of both services being reduced to ‘inadequate’.

As part of its inspection, CQC visited the acute adult mental health units at Highbury Hospital in Nottingham and Sherwood Oaks in Mansfield.

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Reports on these visits highlight a number of concerns, including inconsistent approaches to recording patient details on leave at both hospitals and incidents of assault on patients by staff at Sherwood Oaks. .

It also details instances in which staff at Highbury Hospital were found to have falsified records, two of which occurred after police became involved following the deaths of two patients and before CQC inspections. It was discovered.

CQC also observed instances of staff falsifying records during visits to Redwood 2 Ward at Highbury Hospital.

The patient, who was at risk of self-harm and required regular 10-minute observation, was found ligated in the bathroom.

Although the findings were recorded in the electronic patient record, the CQC found that on two occasions staff recorded that the patient had been tested, even though the patient had not.

Mr Greig Rielly, CQC’s Deputy Director of Midland Operations.

“A CCTV trust investigation found that these staff had falsified care records to show that supervision had taken place when it had not.”

“Our inspectors also examined CCTV footage from acute wards and psychiatric intensive care units, where working-age adults are admitted, and found that staff were assaulting people and causing physical harm. discovered.

“There have been four previous incidents of two people being physically assaulted on Elm Ward. The staff involved have been suspended and the trust is investigating the incidents.

“This is completely unacceptable behavior and must be addressed by the trust as a priority.”

Inspectors discovered the deficiencies when they visited the trust’s elderly units at Highbury Hospital and Millbrook Mental Health Unit in Mansfield.

Among the deficiencies were that patients were given sedatives against prescribed doses and doctors’ advice, and that some patient cards were missing signatures.

The report also said the ward lacked clear signage to support people with dementia and that the signage that was in place “did not comply with best practice”.

Inspections of both services were conducted in October, November and December last year.

The CQC noted that adult acute wards were clean, patient records were comprehensive and staff working in geriatric wards felt supported.

Lilly said:

“Since the inspection, we have told the trust where swift and extensive improvements are needed and issued notices of demand, so the trust knows where they need attention.

“We will continue to closely monitor the trust while these improvements are made to keep people safe.

“If we are not confident that improvements are being made and incorporated, we will not hesitate to use further enforcement powers to keep people safe.”

In response, Trust Chief Executive Ifti Majid said:

“Today, the Care Quality Commission (CQC) published a report examining services in acute adult wards, psychiatric intensive care units (PICUs) and wards for older people with mental health problems. The inspections were conducted in October, November and December 2023.

“CQC found a number of areas that needed improvement, so we were rated as inadequate overall in both our inpatient and aged care provision.” These are from previous inspections. The rating has decreased.

“Patient safety and health are always our top priority. We welcome testing as it is an important way to understand where we are and identify areas for improvement and opportunities to improve the situation. To do.

“We fully accept that these inspections found care that was not up to the standard and quality that it should have been, and that we have let down patients who did not receive the level of care that they deserved. I sincerely apologize.”

“We are committed to improving and delivering care to help those who need us and to reassure the people of Nottingham and Nottinghamshire that it is a good thing to turn to us for care and support. We recognize that we have to change the way we deliver.”

“We acted quickly to begin our improvement efforts. Examples of changes we have made since the inspections included:

There is increased support and oversight for clinical practice, including a group responsible for overseeing improvement, listening to patient feedback, and taking action.

Adding senior nurse capacity and support to adult and aged services, and merging the roles of service manager and house manager to reduce the number of wards each covers. This means that their supervision will be strengthened.

We have strengthened drug management training and improved drug management.

A review of all observations with a special focus on listening to patient experiences, and a revised and enhanced training package for substantive and bank staff to ensure they know how to conduct treatment observations to protect patient safety. Everyone is now fully aware.

We have strengthened our patient safety team with the addition of a senior nurse to further support the implementation of the national Patient Safety Incident Response Framework (PSIRF), ensuring we can learn from incidents and act as a result.

We have established a ward manager training program.

Aggressive recruitment campaign to reduce the need for agency staff.

Increased daily checks of patient absence records to ensure risk assessments and safety measures are in place.

“We continue to work closely with CQC, our colleagues and, importantly, the people who use our services and their families to ensure that the experience of everyone who uses our services is significantly improved. I’ll go.”