HIW calls for immediate improvement in the Angelton Clinic at Glanrhyd Psychiatric Hospital
Healthcare Inspectorate Wales (HIW) has issued a report (15 March 2023) following an inspection of Angelton Clinic, Glanrhyd Psychiatric Hospital in Bridgend.
Inspectors highlighted serious issues which required immediate action by Cwm Taf Morgannwg University Health Board, to prevent significant harm to patients and staff. The inspection identified a number of areas that required significant improvement including security issues, ligature risk assessments, adequate care planning and conducting regular audits.
HIW completed an unannounced inspection of the hospital on three consecutive days in November last year. During this period, a number of assessment areas were inspected within Wards 1 and 2 at Angelton Clinic. The service provides care for older people with serious and enduring mental health diagnoses and dementia.
Staff within the unit were found to be committed to providing a high standard of care to patients. Inspectors witnessed staff interacting and engaging respectfully with patients and their visitors, with effective feedback processes in place.
Governance and audit processes were found to be inadequate and when reviewing patient care plans, inspectors found they were not regularly assessed and monitored. Ligature risks assessments were not being effectively managed and neither ward had access to ligature cutters. There were rooms within the hospital which were deemed ‘ligature free rooms’, however there did not appear to be a robust plan for preventing ‘high risk’ patients entering other rooms and potentially obtaining items with which they could ligature. The health board should consider having an agreed list of restricted and prohibited items that are permitted on the ward, which is clearly displayed within the hospital.
There was low compliance with mandatory training, and we recommended that the health board conduct a skillset analysis to provide staff with bespoke training relevant to their role.
Significant improvements were also required in the completion of clinical documentation to accurately and clearly record the care provided at the hospital. It was also noted that security of the internal ward doors needed improving, as patients could abscond, or unauthorised persons could enter the wards. This presents a risk to both patients and staff.
The staffing levels during the inspection were adequate and inspectors observed good relationships between staff who were working well together as a team.
Due to our concerns, we issued an Immediate Assurance letter, in which we wrote to the service immediately after our inspection with our findings requiring urgent remedial action.
Chief Executive of HIW, Alun Jones said:
Our inspection identified a number of areas for improvement that pose a serious risk to patients and staff within Angelton Clinic. When we identify concerns that pose an immediate risk to patient safety, we ask the health board to undertake urgent action. Cwm Taf University Health Board has produced a comprehensive plan which sets out improvement actions, which we will continue to monitor the progress against.