NHS Trust responds to safety concerns following inspections of inpatient units in Hertfordshire

An NHS Trust in Hertfordshire says it is taking action to mitigate safety concerns following inspections of two inpatient units.

Findings from an urgent inspection, by the Care Quality Commission, of Warren Court - a secure assessment and treatment service for men with learning disabilities and additional mental health needs – were published last week. Results from an earlier inspection of Oak Unit, a psychiatric intensive care unit for men in Radlett, were also published.

Both wards were given an overall rating of ‘good’ although some inconsistencies were noted.

Warren Court, part of the Eric Shephard unit in Abbots Langley, was inspected in November after concerns were raised surrounding patients’ safety. Inspectors looked into the categories including ‘well-led’ and ‘caring’, both graded ‘good’ while the area of ‘safe’ ‘requires improvement’.

Positive points included a reinstated carers’ forum to allow families to provide feedback, staff’s understanding of roles and responsibilities, good supervision of staff, visible and supportive leaders, regularly updated care plans and risk assessments, and safe and appropriate furniture.

Points noted for improvements included a lack of activities, a lack of behavioural support plans - resulting in poor understanding of individual needs, inadequate information of support services for patients, and inconsistent temperature monitoring leading to concerns over medication storage.

Meanwhile four out of five categories inspected at Oak Unit received a ‘good’ rating while the ‘safe’ category, similarly to Warren Court, required improvement.

Good points noted included staff coverage, understanding of abuse protection, positive interaction and good communication between staff and patients, and a safe layout.

However, improvements were recommended for patient observations which continued beyond the recommended time, staff turnover and sickness rates, and accessibility for staff to clinical information.

When speaking to patients, inspectors said they received mixed reviews. Three individuals told inspectors they felt safe while another three said the didn’t always feel safe due to physically aggressive patients. Others raised issues around noise in the ward, although quiet spaces were noted, while others reported an inconsistency in responses to conversations, including over sexuality. However, ‘numerous’ positive ‘thank you’ messages were noted in the meeting minutes.

The Hertfordshire Partnership University NHS Foundation Trust (HPFT) says both units have improvement plans in place including a recruitment drive, a ‘comprehensive’ programme of clinical audits to support learning and an expansion of activities at Warren Court and plans for an updated environment and a sensory integration room.

HPFT’s chief executive Karen Taylor said: “I am pleased that the CQC has rated both Warren Court and Oak ward as Good overall. Over the six months since the inspections took place, we have made a number of changes and I am confident that they are making a difference and we have addressed the concerns raised.

“I am particularly pleased that the inspectors observed positive areas of practice, including regular safety audits, risks being well managed, staff displaying our values, with positive interactions with service users regularly noted. We will continue to work closely with service users, their families, carers and the CQC to ensure we keep providing high quality care to our service users.”