A mental health care hospital has been shut down by watchdogs after investigators uncovered shocking practices. The care unit was slammed for staff 'not respecting the privacy and dignity' of patients, as 'staff often talked over patients, ignored patients, and talked about their personal hygiene needs in the main lounge', while 'patients were told to sit down whenever they tried to get up'.
Monet Lodge in Withington provided care for up to 20 older people with complex mental health problems, specialising in dementia care. After the damming inspection in early March of this year, the location was barred from admitting any further patients and instructed to discharge current patients, or find them new placements, by the end of that month.
Concerns were first raised by the Care Quality Commission (CQC), a social care watchdog back in February 2021, when Monet Lodge was placed into special measures. It found that the building was 'not safe, unclean, not well equipped, not well furnished, not well maintained and unfit for purpose', and that 'staff had not received basic training to keep patients safe from avoidable harm'.
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By August, there had been little improvement at Monet Lodge, according to the CQC. Another inspection revealed that 'emergency medicines were out of date, prescription charts not completed correctly and [staff [were] giving patients medication without waiting the required time between doses as instructed on the prescription charts'.
The hospital facility, operated by national mental health charity Making Space, was inspected a final time on March 3 and 4 of 2022. The findings were, again, so shocking that the CQC forcibly closed Monet Lodge. In the report, published on May 30, investigators said: "The service was not safe. It did not have enough nurses to provide care for the patients.
"Staff did not manage risk well. There were a high level of restrictive practices including enhanced observations (when a specific number of staff stay with patients at all times) with no clear rationale, the use of containment (stopping patients moving freely around the hospital) and the use of mechanical restraint in the form of lap belts and groin straps which stopped patients moving out of their bed or chair.
"The need for these to be used had not been assessed by a specialist in this area and there was no clear rationale for their use. Staff were sometimes restraining patients and were not trained to do this. This meant that there was a high risk of injury to patients due to incorrect techniques potentially being used."
Along with restrictive practices, staff 'talked over and ignored patients' and told them to 'sit down whenever they tried to get up' and did not know the names of their own patients in yet more concerning findings. "Staff did not always treat patients with compassion and kindness and did not respect their privacy and dignity," said the CQC.
"We saw many examples of this during our two-day inspection. We saw that staff often talked over patients, ignored patients, and talked about their personal hygiene needs in the main lounge. Patients were told to sit down whenever they tried to get up.
"Staff did not understand the individual needs of patients. Some staff we spoke with did not know the names of the patients they were looking after. We found that care plans did not contain information about the patients’ lifestyle, hobbies, and family.
"Care plans were often generic containing information that did not refer to the patient in a meaningful way. Staff did not involve patients in any decisions about their care, although families were asked to review care plans and sign them."
Staff also did not understand the Mental Health Act or the Mental Capacity Act, which cover the assessment, treatment and rights of those with mental disorders. The Mental Health Act also sets out patients' rights when they are detained in hospital against their wish or when they do not have the capacity to make their own choices about their life, safety and treatment.
"We found that staff made the assumption that patients lacked capacity without undertaking any assessments of their capacity," continued the report. Families were often asked to sign for decisions without consulting the patient first and outside of a legal framework.
"It was difficult to identify which patients were detained under the Mental Health Act (MHA) or were subject to a Deprivation of Liberty Safeguard as recording in patients' notes was poor and staff had little knowledge and understanding of their responsibilities."
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The 'lack of skilled staff' was so severe that patients 'stayed in the hospital for much longer than they needed to', as assessments could not be carried out. Just four of the 18 patients at the time of the CQC inspection were discovered to need continued hospitalisation.
"We found that many patients at the hospital were ready for discharge but there had been no attempt to support patients to move on from the hospital. Following our enforcement action, all patients were reassessed and only four of the eighteen patients were found to require continued hospital care," reads the report.
A spokesperson for Making Space told the Manchester Evening News : "After 14 years of Making Space providing the service, Monet Lodge officially closed on 31st March 2022, in-line with requirements set by NHS Manchester Clinical Commissioning Group (CCG).
"Following the decision to close the service we worked closely with families, social workers and the CCG to find and relocate patients safely to suitable, alternative provision based on their unique assessed needs. The building has now transferred back to the NHS.
"We deeply regret that we were unable to turn the service around, and have apologised to patients and families for our unsuccessful efforts.
"Our senior leadership team have begun to implement the changes needed to ensure we provide the high standards of care we expect of ourselves, and that the CQC are accustomed to from our charity."
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