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Challenges with staff recruitment hamper the consistent provision of safe care at Ysbyty Ystrad Fawr

Healthcare Inspectorate Wales (HIW) has issued a report (13th December 2022) highlighting the need for improvement within mental health wards at Ysbyty Ystrad Fawr in Ystrad Mynach.

Mental Health Wards - Ysbyty Ystrad Fawr

HIW completed an unannounced inspection of two mental health wards, Ty Cyfannol and Annwylfan, across three consecutive days in September this year.

The inspection evidenced areas of good practice where patients told HIW inspectors’ that they felt hospital staff were committed to providing safe and effective care and understood their individual needs and requirements. However, HIW also identified that not all staff had up-to-date mandatory safeguarding training, including violence and aggression, despite attending incidents requiring patients to be restrained.

A number of issues requiring immediate assurance were identified by the inspection team and are referenced in the report. During the onsite inspection, staff informed inspectors that there had been a number of incidents of restraint on both wards inspected, and that these involved staff who had not completed adequate training. Due to this, HIW inspectors were not assured that staff and patients were being fully protected and safeguarded against harm and injury in the event of restraint being required.

Inspectors noted the high use of agency staff on Annwylfan Ward, subsequently putting pressure on regular staff, as agency staff are less familiar with the patients, and tasks such as handovers can take longer.

Patients told inspectors that staff were caring, respectful, dedicated and demonstrated a good level of understanding. Inspectors witnessed a supportive leadership team and staff stated that they were happy with the level of management support. A review of medical records evidenced that patients had access to a specialist mental health advocate who provided further tailored information and support.

During the inspection, HIW requested immediate action was taken to ensure the safe storage of medication. On Ty Cyfannol Ward inspectors witnessed a damaged cupboard storing a variety of medication which could be easily accessed. The inspection also highlighted that not all staff had appropriate access cards, which meant that they could be locked in areas waiting for other members of staff to let them out. In the event of an emergency, staff without access cards had to use the emergency call bell for assistance to exit the area. Regular staff told inspectors they were continuously letting agency staff in and out of the ward areas with their own swipe cards, distracting them from their duties.

A plan has been produced by Aneurin Bevan University Health Board which contains a comprehensive set of actions to support improvement. 

Chief Executive of HIW, Alun Jones said:

It is positive to see staff working hard to tailor care to patients’ individual needs on both wards at Ysbyty Ystrad Fawr, however, the challenges, felt across Wales, of recruiting and retaining teams of regular staff, have seen a reliance on agency staff which may be hampering effective risk management and the consistent provision of safe care. Our inspection identified a number of improvements and immediate concerns which required the service to take immediate action.

Aneurin Bevan University Health Board has already taken positive steps to improve following our feedback and have shown a commitment to addressing the concerns highlighted. We will continue to engage with them as they seek to tackle the challenges they face.

Hospital Inspection Report

Inspection Summary Report