Date Published: 13 February 2009

Watchdog warns East Yorkshire mental health hospital to improve the safety of patients

The Healthcare Commission has warned a Yorkshire-based independent mental health hospital that it expects significant improvements in the safety and quality of services.

It today published two inspection reports on Linden House, a 97-bed medium- and low-secure hospital, owned by Care Principles Ltd and situated in Market Weighton, East Yorkshire.

The Commission inspected Linden House in September and December last year, issuing enforcement notices requiring action to comply with the Private and Voluntary Health Care Regulations (2001).

The notices make clear requirements for action and the Commission says it will carry out further spot checks to assess progress, stressing that it will take stronger enforcement action if necessary. The Commission's powers include prosecution and/or cancelling registration of a provider who fails to comply with enforcement notices.

The September inspection triggered two enforcement notices after the Commission found Linden House had not met requirements relating to the risk assessment of patients, seclusion of patients, handling of medicines, safe keeping of confidential information, staffing levels, staff training and meeting the needs of patients with learning disabilities.

The watchdog inspected again in December to check on progress. It found the hospital had responded appropriately in some areas but not others, triggering a third enforcement notice.

There were improvements to: the use of seclusion; the previous lack of activities within the local community; staffing levels; staff training; meeting the needs of people with a learning disability; compliance with fire regulations; refurbishment and some elements of risk assessments had been reviewed. The provider has reassured the Commission that it has worked with the local police on its policies on absconding patients.

But the Commission found that Linden House had not met some of the requirements of the two enforcement notices issued in September:

* Failure to investigate or review the hospital's policies on the administration of drugs after giving inappropriate medication to a patient with a documented allergy. Medication stock checks were not being completed and expired medication was not disposed of.
* Not all risk assessments had been reviewed and updated following significant untoward incidents, in some instances they did not take account of the views of patients and not all patients had risk assessments on file.
* The provider had failed to report all incidents of violent and aggressive behaviour.
* Decisions to grant, or not grant, leave to patients were not appropriately documented and it was not possible to audit decision-making for activities that may pose a risk.
* Patients had not been provided with a lockable storage facility in their rooms to help maintain their privacy.
* It was unclear whether all staff had been appointed in line with the appropriate employment procedures.

Nigel Ellis, the Commission's Head of Investigations, said; "The situation that we found in September at Linden House was unacceptable and potentially put the safety of patients at risk, which is why we have had to take tough action.

"It is positive that Linden House has taken action in a number of areas - for example by increasing staffing levels and working more closely with the police in the event that a patient goes missing. This is good for people using the service and the wider community.

But there remains more to do. It is so important for Linden House to ensure that risks are identified, managed properly and lessons are learned. This is the best way to prevent further incidents occurring and protect the safety of patients.

We are continuing to monitor the situation at Linden House and will make further checks to ensure all necessary action is taken. No-one should be in any doubt that if we do not see rapid improvements in the areas we have highlighted, further enforcement action will be taken."

Linden House is registered with the Healthcare Commission to provide services for patients with a learning disability or for people who have been detained under the Mental Health Act.

The hospital is registered for 97 beds, 45 in a medium-secure and 52 in a low-secure environment and is a major provider of beds in these categories in the region.

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