• Bullying and physical injury among patients noted by inspectors
  • Patients to be moved out with unit’s capacity downsized from 99 to 30
  • Service will remain in special measures after second inspection in a year

Inspectors have highlighted a series of failings at an independent provider, including treatment of a patient and children being dragged across the floor.

An adolescent mental health unit in Northampton run by St Andrew’s Healthcare has been rated “inadequate” for the second time in a year, following a litany of failings found by the Care Quality Commission.

St Andrew’s said it has “taken action against a handful of staff members” and made referrals to the Nursing and Midwifery Council and Disclosure and Barring Service. A spokeswoman said some staff had left.

The inspection has also prompted the relocation of some services, reducing patient numbers from 99 to 30.

Inspectors rated the service, based at Fitzroy House, “inadequate” overall, and within the safety, care and leadership domains. The CQC said the current service in Fitzroy House will close, with the services downsized and relocated elsewhere on the site.

The report stated: “Staff did not always use approved restraint techniques, which resulted in staff dragging patients along the floor or physically injuring patients during restraint. Senior staff told us they observed CCTV footage of these incidents and were concerned that other staff present had not acted to intervene.”

The CQC also noted staff did not always take bullying incidents seriously and that one such incident had been recorded as a “bit of fun”.

The report stated: “Staff referred to a patient who identified as male as her/she, this upset the patient and continued after the patient complained. We found staff recorded an incident of bullying behaviour between patients as ‘a bit of fun’. 

“We found examples of a punitive culture on some wards. Staff criticised and sanctioned patients, without justification, for talking to other patients and cooking different meals to those planned.”

In a draft report initially issued, the CQC described the incident involving the patient who identified as male as “cruel and taunting”, but this phrase did not appear in the final published report. The CQC acknowledged the staff member, who was from an agency, had been ignorant rather than cruel. 

CQC’s deputy chief inspector of hospitals Kevin Cleary said: “This is the fourth time that we have inspected St Andrew’s Healthcare Adolescents Service in the past three years and we are hugely disappointed that over that time, the service has failed to address some of the concerns we have raised. In some important respects, the safety of care has deteriorated.

“This is why we have taken urgent enforcement action, included restricting any new admissions to the service without our consent.”

Mr Cleary said the CQC was pleased that plans had been made to reduce the number of patients and that they would continue to monitor the situation.

The regulator said they had also observed some outstanding areas of practice including an impressive range of therapies and “well designed and spacious” environments to facilitate therapies.

St Andrew’s said it was “working closely with patients, carers, staff members and commissioners to identify clinically appropriate locations for our CAMHS patients and minimise any disruption to them during this move.”

Kate Fisher, chief executive of the charity, said: “The current model of care we are providing to some of the most vulnerable young people in our country is wrong. Our CAMHS facility is the largest in Europe, which means our permanent staff are overstretched, we have to rely on agency staff and, as a result, we are not always able to provide the high standards of care we expect.

“I’m personally committed to resolving this situation with urgency and purpose, which is why we are implementing a new strategy that will see the service move out of Fitzroy House and a reduction in the number of young people we support.”

Story updated to reflect that a description issued in a draft report was not included in the final report.