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A mental health hospital in Wrexham has been de-escalated as a Service of Concern

Healthcare Inspectorate Wales (HIW) has issued a report (26 January) following an inspection of New Hall Independent Hospital, managed by Mental Health Care UK 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.

New Hall Independent Hospital Mental Health Service

HIW completed an unannounced inspection at the hospital on three consecutive days in October 2023. The inspection focused on two wards, the Glaslyn Ward and the Adferiad Ward.

Following a previous inspection in March 2023 the hospital was placed within HIW’s Service of Concern process, which is used when there are significant service failures, or when there is an accumulation of concerns about a service or setting. This resulted in HIW imposing the condition on the setting not to admit any new patients due to the level of risks identified. These risks included a number of medication administration errors, the availability of life-saving equipment and fire safety breaches.

During the recent inspection we found the service had made significant improvements and it has since been de-escalated from the Service of Concern process. Inspectors found that the setting had strengthened areas which previously required immediate improvement, including incident and risk reporting procedures, and the process for checking the availability of emergency life-saving equipment. Inspectors found evidence of fire risk assessments being regularly updated and noted fire exits were now easily accessible.

Throughout the follow-up inspection, we saw staff communicating with patients in a kind and respectful manner. Inspectors identified good processes in place to help and protect the physical needs of patients, including access to person-centred activities and regular family contact. All patients also had access to additional space, which we confirmed would be retained once admissions to the service increase. Inspectors viewed some bedrooms and found these to be personalised to provide a homely feel.

Management and staff at the service demonstrated a well-rounded understanding of the patients. We observed staff responding calmly and appropriately to challenging behaviours, and there was an overall good approach to risk management. Inspectors confirmed that patients had regular access to attend meetings and information relating to their care and treatment. We observed staff communicating with patients in an individualised and engaging manner according to each patient’s needs and preferred communication style. This included the use of verbal, written and pictorial tools as required. Patients had access to advocacy and representation in helping to understand and express their opinions on their care and treatment. 

The setting was generally clean and well maintained but some maintenance safety risks were identified including broken fire door closers. During our assurance work we found evidence all medicines were being stored appropriately, in secure cupboards through a locked door. However, inspectors found an expired inhaler, and adrenaline being stored out of its usual kit, which could delay timely administration in an emergency. Inspectors escalated this to staff during the course of the inspection and action was taken to immediately rectify this. Inspectors identified aspects of stock checking which could be strengthened. The setting was aware of these issues and was in the process of improving them. 

We found strengthened arrangements since the last inspection in relation to the storage, access and checking of emergency equipment, including defibrillator and ligature cutters. Equipment was now stored in an appropriate location, with access for all staff. When asked, staff were aware of the location and how to access items in the event of an emergency. Inspectors did note that aspects of the hospital’s record keeping could be strengthened, for example by ensuring plans are correctly dated, and expired plans are clearly indicated as such.

The feedback provided by staff was generally positive with most agreeing that they would be happy with the standard of care provided by this organisation for their friends or family. We initially found good levels of compliance with mandatory and specialist training. However, due to discrepancies in the way data was recorded, we noted percentage completion rates in several training areas required improvement. The setting had recently been successful in the recruitment of several nursing positions to support continuity of care and patient familiarity. 

Chief Executive of HIW, Alun Jones said:

‘It is reassuring to see improvements have been made since our previous inspection of New Hall Hospital to ensure patients are receiving safe and effective care. The setting must ensure that these measures remain in place and the processes implemented are sustainable now and in the future. We will continue to engage with the service to ensure progress against our findings are actioned and improved.’

October 2023 - Inspection Summary report - New Hall, Ruabon

October 2023 - Independent Mental Health Service Inspection - New Hall, Ruabon