• CQC revisited Rampton secure hospital after highly critical inspection late last year
  • Again raised concerns about staffing and culture
  • CQC also found “dilute skill mix” to be concerning

Problems with culture, racism and staff shortages compromising safety have persisted at one of England’s three secure hospitals, the care regulator has warned.

Following a focused inspection at Rampton Hospital — part of Nottinghamshire Healthcare Trust — the Care Quality Commission found it did not have enough nursing and medical staff and relied on moving them between wards to maintain safety, requiring them to skip breaks and work additional hours.

The regulator was also critical of the hospital’s governance systems and said there was a lack of consistent recording of staff shortages.

It also warned the ratio of registered nurses to healthcare workers resulted in a “dilute skill mix”.

“Consultants reported concerns about the skill mix on wards and the impact on managing relational security,” the report said.

It also found some patients still reported “racist attitudes by staff” and their “dignity not respected”.

Rampton Hospital was given an “inadequate” rating last October by the CQC following an inspection in July.

The regulator raised numerous safety concerns in its initial report, including severe staff shortages, an unhealthy staff culture and issues in the senior leadership team.

The CQC also reported patients and staff raising concerns about some staff “using or condoning the use of racist and other inappropriate language towards and around patients”.

Following the October report, executive director for forensic services Peter Wright left the hospital and the trust set up a “Rampton improvement board”, which included people from outside the trust.

According to the most recent CQC report, which does not change the rating, the improvement board has developed an action plan, and management changes have been made.

Other improvements were also found including changes to ward environments, and commissioning a patient survey to focus on racism and bullying.

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