Inspection finds immediate improvements are required at an independent mental health hospital in Wrexham

The hospital provides specialist care to a maximum of 10 patients aged between 18 and 64 years, who have been diagnosed with both learning disabilities and mental disorders.

Inspectors found staff were treating patients with dignity and respect. However, a number of risks were identified which required immediate action including a number of medication administration errors, the availability of life-saving equipment and fire safety breaches.

HIW completed an unannounced inspection at the hospital on three consecutive days in March 2023. During this period, multiple assessment areas were inspected within the facility which provides a combination of high-dependency and complex care.

Our work found the hospital had good processes in place to help protect and promote the physical health of patients, with a range of facilities to support the provision of therapies and activities. However, staff could do more to undertake therapeutic observations to better engage and support patients at the hospital, including up-to-date bespoke care treatment plans, regular health checks and ensuring complaints are recorded effectively.

Inspectors uncovered further improvements were required including ensuring life-saving emergency equipment is stored in a clear and accessible place for staff in an emergency.  On the first night of inspection, it took hospital staff approximately ten minutes to locate a defibrillator. Inspectors also witnessed fire doors had been sealed shut and fire risk assessments were out of date. Personal alarms were not issued to all staff and when asked, some staff were not aware of how to report a safeguarding concern. However, there were up-to-date ligature point risk assessments for each ward that detailed the actions taken to mitigate and reduce the risk of ligature. Each patient had support and crisis intervention plans in place, which were completed to a good standard.

Staff appeared committed to providing safe and effective care and understood their individual responsibilities in relation to implementing effective infection control measures at the hospital. The clinic rooms on each ward were clean and tidy and medication was being stored securely at all times. Inspectors, however, were not assured that medication errors were being recorded and managed effectively. There was no evidence that a Root Cause Analysis had been undertaken for any of the six medication errors that had occurred at the hospital in 2022. Therefore, opportunities to identify what went wrong and prevent future errors through lessons learnt were missed.

Staffing levels were appropriate to maintain patient safety within the wards at the time of our inspection. Compliance with mandatory staff training was high and a safety huddle was being held every morning for staff to update senior management on any concerns. However, it was clear from the number of improvements identified during the inspection that the governance processes and systems in place at the hospital were not effectively identifying risks and necessary improvements to the service, particularly those in relation to immediate patient safety.

The setting has produced a comprehensive plan which sets out improvement actions. HIW will continue to closely monitor progress against this plan.

Chief Executive of HIW, Alun Jones said:

‘It is concerning to see the issues identified within this report, and immediate assurance has been sought to address the risks to patient and staff safety. We will continue to engage with the service to ensure progress against our findings.’

March 2023 - Inspection Summary Report - New Hall Independent Hospital

March 2023 - Independent Mental Health Service Inspection Report - New Hall Independent Hospital