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Inadequate Hospital in UK May Close After Patients at Prolonged Risk of Harm

Background on Inadequate Hospital in West of UK

A Hospital rated Inadequate by the Care Quality Commission may close after patients were deemed to have been put at prolonged risk of harm A struggling hospital in the West of the UK, where staff were caught sleeping on CCTV three times in a row may have to close its doors for good.

St John’s House is run by Priory Group subsidiary Partnerships in Care. They provide hospital care for vulnerable adults with Learning Disabilities and Mental Ill Health. The facility has 49 patients, 29 of whom had been detained there under the Mental Health Act 1983. The Care Quality Commission inspectors placed the facility in special measures and stopped admissions in December 2020 after finding some interactions between patients and staff “demonstrated elements of abuse.” This included confining patients who were “difficult” to
their rooms for extended periods, neglect, and lack of regular review of care plans.

At the December inspection and twice since, CCTV footage captured staff sleeping when they should have been observing vulnerable patients. Hospital chiefs said the decision to consider closing the hospital was not taken lightly and said it had continued to suffer from recruitment difficulties. There are just 7 full time care staff, and they report that Management do not listen to them when they need to discuss issues. Training has been limited due to the lack of staffing and working with Agency staff is difficult as they do not know the patients.

The use of Agency staff and Senior Nursing staff has contributed to the problems and the Manager and Team Leader say that because they get the most difficultvpatients it is challenging to ensure that staff receive supervision on a regular basis.

CQC experts returned to the facility in July 2021 and uncovered furtherbinstances of “unacceptable care... (and) staff were not responding appropriately to patients who were self-harming, with one patient not being sent to hospital quickly enough after swallowing a foreign object, despite complaining of abdominal pain.” (CQC 2021).

Despite CQC visits and warnings there remained a lack of improvement in keeping patients safe. Further concerns included male staff being placed on intimate female patient observations.

1) Discuss the factors in the case study that reflect an invisible asylum for the service users.

2) Explain the actions that need to be taken in order to mitigate the factors that create the invisible asylum

3) Outline the actions that you see as priorities and discuss the risks to:
A. The Organisation if not addressed.
B. The Service Users if not addressed.

4) Present and explain how a Model (or Models) of intervention can be used to effect positive change in planning, management and improved delivery of the service.

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