Scandal-hit NHS mental health trust caring for Wigan patients is ordered to improve

The Care Quality Commission (CQC) carried out inspections at Greater Manchester Mental Health NHS Foundation Trust, some prompted by whistleblowers raising serious concerns about the quality of care.

The trust provides mental health care across Wigan and other parts of Greater Manchester, with its services including Atherleigh Park in Leigh, a range of mental health care, children and adolescent mental health services (CAMHS), autistic spectrum disorder diagnostic services and support for young people with eating disorders.

The trust hit the headlines earlier this year when undercover footage broadcast on the BBC Panorama programme showed staff bullying, humiliating and mocking patients at the Edenfield Centre in Prestwich, Bury.

The trust has also been under scrutiny after three young people died within nine months, with families saying staff needed to be held to account.

An inquest in October ruled that communication failures “probably caused or contributed to” the death of 18-year-old Rowan Thompson at the trust’s Prestwich site.

Mr Thompson, who identified as non-binary, was being held while on remand awaiting trial accused of murdering his mother Joanna Thompson in July 2019.

The inquest into Mr Thompson’s death heard five members of staff working that day had either wrongly signed records saying he had been observed or failed to carry out the duty.

The CQC report said inspections over the summer found problems with the assessment of suicide risk, the way medicines were managed, cleanliness, consent to treatment and the safety of patients.

There were too few staff, a lack of proper oversight and scrutiny by the trust’s board, inadequate fire safety and poor maintenance, with dated wards.

The CQC took enforcement action against the trust after the inspections, saying the quality of care in some areas requires “significant improvement”.

The warning notices set out a legally set timescale for the trust to improve.

NHS England has also put the trust into its Recovery Support Programme and will commission an independent review into the failings identified.

The CQC report said: “The trust did not provide safe care. The ward environments were not all safe, clean, maintained or well presented.

“We had significant concerns about fire safety in the acute wards. Ligature audits were poor because they did not identify all risks or effectively mitigate these.

“The service did not have enough registered nurses and healthcare assistants to ensure that patients got the care and treatment they needed.

“Staff frequently worked under the minimum staffing establishment levels, wards had unfilled shifts and there was not always a registered nurse present.”

The CQC also raised concerns about mixed-sex wards and the “sexual safety” of patients.

It added: “Services were not always caring, some patients told us that wards were noisy and chaotic, and that they did not always feel safe.

“The trust did not provide responsive care in all services. Bed occupancy often exceeded 100 per cent and patients did not always have a bed when they returned from leave.

“The acute wards regularly used rooms designed for other purposes as patient bedrooms.”

Patients also told inspectors there were not a lot of activities on the wards “other than television”, while “food portions were small” and patients thought “the food was unpleasant”.

After the inspections, the CQC said the overall rating for acute wards for adults and intensive care had deteriorated from good to inadequate.

The safe and well-led areas also dropped to inadequate, while ratings for effective, caring and responsive moved from good to requires improvement.

The overall rating for forensic inpatient and secure wards also dropped from good to inadequate, as did the safe and well-led ratings.

How effective, caring and responsive the service was declined from good to requires improvement.

Ann Ford, the CQC’s director of operations network north, said: “Our inspections of Greater Manchester Mental Health NHS Foundation Trust in June and July were prompted by information of concern and we took enforcement action as a result.

“Since our inspections in June and July, we’ve been contacted by whistleblowers and additional serious concerns have emerged.

“We have carried out further inspections in other services run by the trust in response to those concerns and found further breaches of regulation which the trust must address as a matter of urgency.

“We expect to see leaders make rapid and widespread improvements and will continue to closely monitor this progress.

“We will return to carry out further inspections to ensure action has been taken and the quality and safety of services has improved.”

In its letter to the trust, NHS England said the independent review “follows concerns raised by patients, their families, and staff, some of which have been presented through the media.

“The intention is that the review’s work will bring some clarity and reassurance to patients, their families, and staff, as well as the broader public, in respect of the ongoing safety of services that the trust delivers.”

The mental health trust’s chairman Rupert Nichols announced his resignation on Friday, saying his term in office was due to end in July 2023, but he felt it was vital to leave earlier.

In a letter to governors, board members and staff, he wrote: “Our trust is facing significant challenges following the inexcusable behaviour and examples

of unacceptable care that have been exposed at the Edenfield Centre. Both I and the board have apologised to those affected directly and indirectly.

“It is clear that it will take some time for the trust to navigate the challenges of successfully implementing our improvement plan and rebuilding faith and confidence in our services.

"My term of office as chair ends next July, but I believe that the trust would benefit from a new chair, bringing new ideas and energy to lead the board through this recovery period and beyond.”