An under-fire NHS Trust has seen two hospitals hit with "inadequate" Care Quality Commission ratings amid safety concerns, including that at one - Lanchester Road in Durham - three patients were injured while being restrained.
After an inspection over May and June, the CQC has rated the Tees, Esk and Wear Valleys NHS Trust's wards for people with a learning disability or autism as "inadequate". The trust also currently has an overall rating of "requires improvement". Its wards for older people, psychiatric intensive care units and community mental health services also "requires improvement".
Inspectors, who visited learning disability and autism provision at Lanchester Road in Durham and Bankfields Court in Teesside, raised issues around patient independence, "high levels of restrictive practice including seclusion, restraint and rapid tranquilisation", and a lack of "appropriately skilled staff".
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In response, the NHS Trust's Jennifer Illingworth - care group director for children and young people and learning disabilities at the Trust - said an "urgent action plan" was in place. An independent review was also commissioned following the CQC inspection.
The report details worrying failings - and also reflects that families of patients at Lanchester Road had grave concerns about the safety of their loved ones. In the report, the CQC inspectors said: "The families of people at Lanchester Road were unhappy with the care and treatment.
"Two families told us their loved ones had been hurt during restraints and that they were worried about the safety on the wards. They did not feel listened to or reassured by managers especially after restraints and injures. They felt that people had stayed in hospital for too long."
Regarding the safety of use of restraint at Lanchester Road, the inspection team wrote: "People had unwarranted restrictions placed on them because the service did not always assess, monitor and manage safety well.
"People were being restricted due to a perceived risk rather than actual incidents. Staff at Lanchester Road did not always use effective de-escalation techniques and people and staff were not always safe."
Karen Knapton, the CQC's head of hospital inspection, said: "When we visited Tees, Esk and Wear Valleys NHS Foundation Trust, we found a significant deterioration in standards of care at Lanchester Road, as well as some concerns at Bankfields Court, since our last inspection in 2019.
"We found some people didn’t have the opportunity to lead inclusive and empowered lives due to overly restrictive practice on both sites, which must be addressed as a priority to keep people safe."
Ms Knapton said "high levels of vacancies and staff sickness" were also an issue, and added: "Additionally, at this site staff didn’t always understand how to protect people from poor care and abuse. Three people had been injured during restraints, and 32 incidents of injury had been reported for healthcare assistants, some requiring treatment. This is unacceptable and measures must be put in place to keep patients and staff safe."
The Trust has been told to improve and will be monitored closely by the regulator going forward.
In response, Ms Illingworth said: "Given the previous good ratings for this service, this is clearly disappointing. We are committed to improving the experience for patients in our care and we are delivering an urgent action plan that is already showing we are making improvements.
"We immediately commissioned an independent peer review into the service after the inspection in May and acted swiftly on its recommendations. Going forward, we will continue to work with our partners on the future provision of learning disability and autism services to ensure that together we offer the right packages of care that meets the needs of patients and their families."
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