• Watcombe Hall, run by the Huntercombe Group, closed indefinitely
  • Third privately run mental health unit for children to have safety concerns in recent months
  • Local NHS trust was concerned about the number of admissions from the unit

A third privately run mental health unit for children and adolescents was forced to close to new patients following safety concerns earlier this year, HSJ can reveal.

Watcombe Hall in Torquay, run by the Huntercombe Group, was closed to new admissions on the second day of an inspection by the Care Quality Commission in May, which led to it being rated inadequate and placed in special measures. The unit was rated inadequate in all domains except caring where it was rated requires improvement.

It has now closed indefinitely after several safeguarding inquiries were launched.

Torbay Hospital, run by Torbay and South Devon Foundation Trust, raised concerns about the number of young people with malnutrition and dehydration being admitted from the unit – including one who was admitted three times in three days.

It is the third privately run children’s mental health unit where the CQC has raised safety concerns in recent reports: two other units, both run by Cygnet Health Care, were closed to new admissions but have subsequently reopened. All three units took adolescents who needed intensive psychiatric care and in some cases were detained under the Mental Health Act.

The report on Watcombe Hall highlighted:

  • Patients’ physical health was not always checked – one patient had not eaten or drunk for four days but there was a delay in taking observations despite these being requested by a doctor. Weighing of patients with eating disorders did not always follow doctors’ requests.
  • Torbay Hospital raised concerns about the number of admissions from the unit. The CQC said Watcombe Hall staff had not received specific training in caring for young people with eating disorders.
  • A group of three young people overpowered staff before absconding from the unit. The same group forced open a door to the unit the weekend before the inspection.
  • There was a high level of serious incidents, including 18 in the first three months of 2017, as well as 38 staff injuries in six months. However, inspectors felt not all incidents were being recorded.
  • Four patients were restrained 29 times or more during their stay on the unit.
  • Staff turnover affected care quality and new staff were not adequately trained, inducted and supervised. Only half of staff had up to date safeguarding level three training despite this being mandatory. Inspectors asked for a safeguarding referral to be made after a patient showed them upper arm bruising – staff had not checked for bruising after the patient had been restrained. The report said the company was working with NHS England, the local authority and the local NHS hospital to improve safeguarding.
  • Some young people had not engaged in any activities for three months and use of outside areas and the gym was very limited.
  • Inspectors saw a young person climb a fence and abscond. The fence was not of the required height.
  • Patients coming to the service were not always adequately assessed; however, sometimes full information on them was not available, including that one young person had organised a riot in another service. Some patients were waiting to be transferred to units that could better meet their needs.

In a statement, the Huntercombe Group said the decision to close the unit had not been arrived at easily.

It said: “Our quality assurance procedures identified that Watcombe Hall was not meeting the standards we expect to provide, so we established an improvement team to work in close liaison with the CQC and NHS England.

“We voluntarily suspended admissions following discussions with the CQC. We also identified that there were some patients who were inappropriately placed in the service and recommended to NHS England that they be transferred to provision better suited to their needs.”

The final three patients were moved in July and the unit closed in September after consultation with staff.