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Wards at health facility at centre of patient abuse scandal criticised by CQC
Patients complained of feeling unsafe on wards, with staff doing 'things to deliberately provoke them'
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Wards at the mental health facility at the centre of an abuse scandal have been criticised by watchdog inspectors, with concerns raised over the safety of patients.
Care Quality Commission (CQC) staff visited the Edenfield Centre - an inpatient unit run by Greater Manchester Mental Health Service (GMMH) - between April and May last year. It came after allegations of abuse of vulnerable patients by staff were exposed in September 2022.
The facility was shut down to new patients as internal, independent and criminal investigations began. The facility reopened, but was hit with an 'inadequate' rating.
A report into forensic inpatient and secure wards has now been published. The trust said improvements have already been made since the inspection.
Its chief nurse said that although it accepted the findings at the time of inspection were 'accurate', the trust is 'disappointed that this report into the review of adult forensic services has taken such time to be shared in public'.
The CQC inspected the Edenfield Centre - along with forensic inpatient and secure wards run by the mental health service, which care for people who are mentally unwell and involved in the criminal justice system.
The unannounced inspection took place at the Edenfield Centre, at the trust's main site in Prestwich, and Wentworth House, in Eccles. The wards inspected include Rydal, Dovedale, Silverdale, Ferndale, Keswick, Delaney, Isherwood, Borrowdale, Derwent, Buttermere, Newland and Wentworth.
Among the concerns raised in the report, the CQC found: "Seven patients had some concerns including two patients who said that they did not feel safe on the ward, two patients said that staff did things to deliberately provoke them and two patients said staff did not respect their privacy. One patient said that staff used excessive force when restraining them and one patient said that they had been assaulted on the ward.
"This meant that the service did not always protect people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect."
The service came away from the inspection with an overall rating of 'inadequate', with further 'inadequate' ratings for how safe it is and how well-led it is, specifically. The wards were rated as 'requires improvement' for how effective, caring and responsive they are.
The rating for the trust itself, which is Greater Manchester’s largest mental health care provider, remains unchanged - 'inadequate' overall following a huge overhaul in the wake of the scandal.
Staff told inspectors incidents of people smoking on the wards had significantly reduced. However, on one ward staff described ongoing issues with people vaping in communal areas, according to the report, published today (January 17).
The trust had recruited more staff which had led to concerns from managers about the challenges of managing an influx of new staff alongside more experienced staff. Inspectors were told this had led to a cultural divide on some wards and led to isolated complaints of bullying and discrimination.
Cleaning records were incomplete or not available during the inspection, said the CQC. Some staff told inspectors they didn’t feel engaged with leaders and felt changes had been made without their participation.
People gave mixed feedback about their experiences on the wards. Some told inspectors staff didn’t listen to them when they raised concerns and didn’t speak positively to them. However, during the inspection staff were observed treating people with kindness and compassion, said the health watchdogs.
Fire safety checks were also not always carried out in line with the trust’s policy and not all staff had received a fire induction. There was no evidence fire drills had taken place on some wards.
Care plans reflected people’s individual needs and were personalised, holistic and recovery-based, the CQC added. While the trust held regular community meetings and made improvements based on feedback from people who used the service.
Salli Midgley, chief nurse at Greater Manchester Mental Health NHS Foundation Trust (GMMH), said: "This is the final report that is outstanding from the Care Quality Commission (CQC) following inspections nine months ago in April and May 2024. We are disappointed that this report into the review of adult forensic services has taken such time to be shared in public, however we fully accept this report as being correct at the time of assessment. At the time of the inspection, CQC shared their findings with us and we have worked at pace to address those concerns.
"We will always be sorry for the failings in the past but under the trust’s new leadership we are focussed on getting the fundamentals of care right, every time for our service users, their families and carers.
"We are sorry for the distress this late report may cause to our service users, families and the wider Greater Manchester community and we will ensure that we continue to talk to our service users and their carers to share with them the improvements that have taken place.
"NHS England Specialised Commissioning team have provided support and oversight of our progress and additional scrutiny and integrated support has continued to be provided by NHS Greater Manchester Integrated Care, regional and national NHS England (NHSE) teams.
"After working tirelessly and commissioning an independent clinical review of the re-engineered service, we have been able to advise that our adult forensic mental health services are now in a position where they can be re-opened to admissions.
"We know we still have a lot to do to improve our services and are absolutely committed to this work. We are very clear about what needs to be done and confident we can build on the positive changes already made to get the basics right every time, for every service user and create the conditions in which our staff can deliver care safely and our service users receive high quality care."
In September 2022, shocking findings were revealed in a BBC Panorama documentary, showing patients being abused by staff in the trust's Edenfield Centre, an inpatient mental health facility on the site of the former Prestwich Hospital.
Before that episode aired, the Manchester Evening News had already been reporting on the unsafe understaffing of those mental health services, and how trust failures had been cited in court as contributing to the tragic deaths of multiple people supposed to be under its care. GMMH has spent years being criticised by health watchdogs - the Care Quality Commission (CQC) - and has been the subject of numerous investigations by the Good Governance Institute, NHS England, and Greater Manchester Police.
Even before the Panorama programme, and increasingly after the episode aired, GMMH has promised improvements – and declared that some progress has been made. But the M.E.N. has often reported how many of the improvements the trust promised have ‘not been progressing to plan' – and have even got worse in the intervening years, despite the trust being plunged into the highest levels of scrutiny by the NHS.
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