The Care Quality Commission (CQC) has rated acute wards for adults of working age and psychiatric intensive care units (PICU) and mental health wards for older people at Alderney Hospital as good following inspections in August last year.
The services, which are run by Dorset Healthcare University NHS Foundation Trust, were inspected in response to concerns regarding people’s care and treatment following an incident where a person died on one of their older person’s wards, St Brelades, in February last year. The trust closed the ward to admissions as a result from February 2024 until September 2024.
Following this inspection of both the St Brelades and Herm wards, mental health wards for older people has been re-rated as good overall and for how safe and well-led it is. Effective and responsive were not looked at during this inspection and they retain the previous ratings of good. Caring also retains its previous rating of outstanding.
CQC also inspected the acute wards for adults of working age and PICU at Waterston ward, which has been re-rated as good for being safe and well-led. The overall rating is unchanged and retains its previous rating of good. The areas of effective, responsive and caring were not part of the inspection and retain their previous rating of good.
The overall rating for the trust is unchanged and remains rated as outstanding.
Neil Cox, CQC deputy director of operations in the south said:
We inspected Dorset Healthcare University NHS Foundation Trust’s mental health wards for older people and its acute and PICU service, following an incident where someone sadly died on St Brelades ward.
While we rated both services as good overall, safety improvements were still needed in the mental health wards for older people. A new management team was in place and they were honest and open about the current challenges the service faced. They had introduced new governance systems on St Brelades ward but this needed further development to ensure staff were working safely.
Medicine records lacked detail on how some people should be given their medicines covertly and whether this was always in their best interests. This meant staff didn’t always have the guidance they needed to give people their medicines appropriately.
We also found people’s risk assessments weren’t always carried out in a timely manner and consent hadn’t always been sought when people had to share rooms during their stay. The trust used covert cameras in some rooms to support people at risk of falls, but there were no signs up to inform people they were being filmed.
However, the new leadership team were highly capable, and staff told us they felt better supported. Staff were receiving additional training and there were new procedures in place to reduce the risk of incidents reoccurring.
On the acute and PICU wards, we found it was welcoming with highly skilled staff who could provide a range of therapeutic treatments to meet people’s individual needs. People we spoke to said they felt safe and well cared for on the wards, and this had helped their recovery.
We have shared our findings with the trust and will continue to monitor it while improvements are embedded, including through future inspections.
In acute and PICU wards, inspectors found:
- The service had few incidents of violence and aggression as staff used effective de-escalation techniques to support people as needed.
- The service worked closely with community services to support people. When people were admitted staff recorded clear goals and discharge plans, which were regularly reviewed as they continued in their recovery.
- Staff worked well together as a team and said they felt valued by managers. Some spoke about issues with temporary staff refusing shifts because of the service’s rural location, but this had been mitigated by other staff and manager covering as needed.
- Medicines were managed and administered safely.
In mental health wards for older people, inspectors found:
- The executive team had reviewed admissions plans to improve the flow on the wards, so that they were not always operating at full capacity.
- Staff told inspectors working conditions had improved with the new management, they felt supported, and their training needs were being addressed.
- Staff on Herm ward could not always easily access information about people’s risks and information in care plans was inconsistent.
The report will be published on CQC’s website in the coming days.