what the cqc and i said in early 2011-what the echo says dec 2012


We saw that the new J unit had been operational since June 2011. This was the

first medium secure unit that had been provided by this hospital. The ward manager

explained that none of the unit staff or managers had previous experience of medium

secure units.

On the J unit the activity staff post was vacant. People said, “The staff try and do

as many activities as possible, like board games. We make things, like Christmas trees

and Halloween hats. An art man comes in and we go on the Wii. But what interests

me is outdoors. You don’t get the chance to go out much at stage one”.

We saw from restraint records that of 141 highest level restraints carried out in the

J unit since it opened in June 2011, 92 had occurred between 5pm and

midnight. This may indicate a lack of diversionary activities for the young people staying


In addition to this, most people did not have access to their rooms. The manager told us

that people liked to watch different TV programmes, but because of the locked

bedrooms and lack of individual TVs some people could not watch what they wanted.

Our judgement

Overall P Hwas not meeting this essential standard

because it did not always provide appropriate care, treatment and support that met the

needs and protected the rights of people using the service.

What people who use the service experienced and told us

On two of the three wards we visited people said that they generally felt “safe”.

One person said he felt nervous being alone in areas where staff were not around. He

said that he had never been verbally or physically abused by other patients, but he felt

vulnerable at times.

On one ward people commented: “Staff take you to seclusion to calm you down.

Sometimes you are asked to walk in and staff shut the door but they don’t lock it.”

“I feel safe sometimes. Staff sometimes help. Sometimes I’m led into seclusion,

sometimes I’m asked to go in.”

One person said, “I don’t feel safe because of the young ones.”

Another person said, “I would feel able to talk to (the manager of the ward) if I had to

make complaints about the staff attitude.”

All four of the staff we spoke with on J unit felt that the staff levels meant that

they “struggled” to get safely through a shift. All staff on this unit told us they felt


One staff said, “Motivation is very poor. The hospital doesn’t understand why we keep

saying we need more staff. I don’t feel safe. We have potentially dangerous people on

this ward. There have been assaults on staff.”

(Shortly the inspection the J unit told us it was planning to change the type of

treatment on the J unit to a recovery programme. The ward manager felt this

would also have a positive impact on the number of staff required to support people on

this unit.)

Our judgement

Overall did not meet this essential standard. This

was because staffing levels on one unit had not been kept under review to meet the

changing needs of people.



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