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Mental health unit allegations to be investigated by regulator

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The Farndon Unit, Farndon Road, Newark.
The Farndon Unit, Farndon Road, Newark.

ALLEGATIONS that staff shortages are resulting in more violent assaults at a secure mental health unit in Newark are being investigated.

A whistleblower told the Advertiser that staffing levels, coupled with patients knowing they won’t face harsh punishments, is putting workers at risk at The Farndon Unit, Farndon Road.

"I worked at the Farndon Unit for years and feel it’s about time I told my horrifying story of constant staff attacks from the mental health patients who live there," said the whistleblower.

"It’s a hell hole — a terrible place.

"It’s classed as a low secure mental health unit but there are some very violent people there."

In one case, they claimed, a staff member had their hair ripped out at the roots and on another occasion one was strangled.

The Care Quality Commission (CQC) says it is investigating the claims.

It said it was working closely with Elysium Healthcare, which runs the unit, and said the company had been responsive in tackling the issues and bringing about change.

Elysium Healthcare said the health, wellbeing and safety of its staff and service users was of the utmost importance.

Two patients recently appeared before Nottingham magi-strates charged with assaults at the unit.

One was found guilty of six assaults — against three men and three women — between November last year and January.

She was ordered to pay a total of £500 in compensation to those she harmed.

Another admitted assaulting the same woman three times in one day and was told to pay £225 in compensation.

According to the latest CQC report in November, there were 40 serious incidents at the unit between October 12, 2016, and September 2, 2017.

The report said the most common serious incident was self-harm. The remainder varied from hostage-taking, a patient going absent without leave, and a serious medication error.

"Be under no illusion just how dangerous a place this is," the whistleblower said.

"There was one incident where a member of staff who was 4ft-nothing was being strangled by a patient who was 6ft tall and 25 stone. We heard her screaming and went in to rescue her.

"One member of staff had her head slammed against the wall."

The whistleblower said court appearances held no fear for patients because if they were considered mentally fit to plead, the punishment would not be severe because of their diagnoses.

"What do the courts do with them? They are already locked up and have been diagnosed as being mentally ill," the whistleblower said.

A police source confirmed officers were regularly called to the unit.

The whistleblower said a lack of permanent staff meant an over-reliance on agency workers who did not know the patients.

They said shortages meant staff often found themselves alone in a room with a violent patient and that sometimes there was no one available to respond to alarms at night.

The CQC report said there were 818 instances of physical and medicinal restraint used on patients between April 1 and September 1, 2017.

"There is no segregation room and if something does occur, five staff have got to be found to manually put someone in restraints — and they can then be left like that for hours, an inhumane amount of time," the whistleblower said.

The CQC said it was aware of whistleblowing concerns.

A spokesman said: "We are planning to re-inspect soon where we will look closely at the allegations received.

"The unit was taken over by Elysium Healthcare, which has been responsive in tackling the issues and bringing about change.

"Staffing is something we have been looking at and the provider has provided information to CQC in how they are addressing this."

The CQC rated the Farndon Unit as requiring improvement in March last year and issued two warning notices to the operators.

It re-inspected in November and found there had been improvements and the unit was compliant. An overall rating of good was awarded.

The CQC report said: "The provider had a restrictive intervention reduction programme and staff commented they felt that there had been less incidents of restraint since the new provider had increased staffing levels."

Patients told the CQC in the November inspection the unit had improved from the previous one and was less chaotic. Staff morale was also said to have improved.

Elysium Healthcare said: "The health, wellbeing and safety of our staff and our service users is of the utmost importance to us and we take any concern raised by staff or service users extremely seriously.

"We have robust policies and procedures in place, which guide our practice, and these are signed up to by every member of staff. We also ensure that our services are staffed safely. Safe staffing levels are constantly monitored to reflect patient need and with management support available where required with upward report at least twice per day.

"When incidents occur in our services our staff are fully supported. We share the details of what has happened and any lessons learned with the CQC and case managers.

"We also fully support staff in their roles, which includes assistance from occupational health, staff health and wellbeing managers; formal supervision for clinical staff; a range of ways to raise concerns, including talking to our Freedom To Speak Up Guardian and 24-hour access to a staff support line, which is operated by an independent company where staff can report concerns.

"There is also direct access to the board. As a hospital we take our role very seriously and we are open and transparent and share information with our regulator, the CQC, as well as our commissioners so they are fully informed regarding any issues."

According to the Care Quality Commission, the Farndon Unit accommodates 48 female patients aged over 18 detained under the Mental Health Act.

The unit offers assessment, care and treatment to meet the needs of individual patients with a diagnosis of mental illness, personality disorder and/or learning disabilities.

The CQC’s report of March last year identified a need for action to make sure the environment was safe and clean.

"There was also action needed to make sure the the systems and processes in place assessed, identified, monitored and reduced risks to health, safety and welfare of patients and staff," it said.

Two warning notices were served in respect of safe premises and good governance.

A follow-up inspection in July found the hospital had made improvements.

On staffing, the November report said: "The number of shifts covered by bank or agency between July 1 2017 and September 1 2017 was 1,746. There were 18 shifts that could not be filled."

In giving a good rating in the latest inspection, the CQC said there was an increase in registered nurses and that staff reported they were well supported after incidents and had a good debrief.

Morale had improved and staff said they felt more positive and motivated, particularly since Elysium had taken over, and they felt valued and well supported.

The CQC said it observed positive interactions between staff and patients; staff recorded their analysis of incidents to identify themes; inspectors saw examples of learning from incidents; and staff reported that were well supported after incidents.

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