Watchdog warns health trust over Muckamore Abbey hospital crisis
CONCERNS about staffing and financial mismanagement at a hospital at the centre of an abuse scandal have prompted the health watchdog to issue warnings to make urgent improvements.
On Friday the Regulation and Quality Improvement Authority (RQIA) imposed three “improvement notices” on the Belfast health trust, which is responsible for Muckamore Abbey Hospital in Co Antrim, due to failings in nurse staffing levels, handling of patient monies and adult safeguarding.
The hospital is at the centre of the biggest criminal safeguarding investigation of its kind in Northern Ireland, with police probing more than 300 allegations of ill treatment and cruelty of learning-disabled patients between April and September 2017. To date, 20 health-care professionals – mainly nurses – have been suspended from the regional facility.
Two unannounced inspections were carried out by the regulator in February and April this year during which a litany of failings, including financial mismanagement in relation to some patients with assets exceeding £20,000, were discovered. Confidential minutes seen by The Irish News after the critical inspections revealed that employees were experiencing “psychological trauma”, with some allowing themselves to be hit by patients – such is the level of concern about the abuse scandal and use of CCTV cameras in the hospital. The controversial use of ‘seclusion’ or isolation of patients to manage difficult behaviours was continuing in rooms which “did not meet the requirements for this purpose”. One vulnerable patient was secluded almost 70 times. Inspectors warned of the “low and unsafe” nurse staffing levels at Muckamore and the “psychological disconnect” between ward staff and management.
On Friday the watchdog’s medical director, Dr Lourda Geoghegan, confirmed that a further “announced” inspection was carried out last month and that a follow-up meeting with trust chiefs was held this week.
“During our inspections we identified concerns relating to: staffing arrangements; restrictive practices; safeguarding arrangements; and the management of patients’ finances. Following our inspections the Belfast Trust provided RQIA with action plans, setting out how it would address the concerns identified,” she said.
“We welcome progress in addressing concerns relating to patients’ physical health care needs, hospital governance and restrictive practices. However, we remain concerned about staffing arrangements, safeguarding arrangements, and the management of patients’ finances. Today we have issued three improvement notices to the Belfast Trust in relation to these areas.”
The father of a Muckamore patient who first alerted the Department of Health to the scale of abuse allegations at the hospital said on Friday that he believes the trust should be placed on “special measures”.
Glynn Brown (58) said that although there are some “very compassionate” staff at the hospital, there had been “catastrophic failings” around the trust’s handling of the safeguarding crisis.
“Two years on, no-one has been held to account for what has gone on with police telling me the number of incidents on CCTV involving alleged abuse of my son is now close to 100,” he said.
“While he is better looked after now, much more needs to be done for patients.”
Sinn Féin’s Pat Sheehan also called for the introduction of special measures and said it was “clear the trust hadn’t got to grips with the Muckamore crisis”.
The SDLP’s Mark H Durkan said that urgent intervention is needed to “assure the families of vulnerable patients that they are receiving appropriate care”, while DUP MP Gavin Robinson said he hopes the trust will take “immediate steps” to engage with family members to give assurances.
In a statement, the Belfast trust said that patient care in Muckamore has “changed significantly” over the past year and thanked “patients, families and staff for working with us at this very challenging time”.
“However, we are very clear that more remains to be done and we welcome RQIA’s improvement notices. In terms of staffing, RQIA is seeking assurance that we will maintain focus...to develop a model of care which is receptive to the changing needs of patients,” it read.
“Additionally, with regards to safeguarding and finance policies and practice... Belfast Trust is fully committed to working with RQIA to provide ongoing and detailed assurance. The board of Belfast Trust remains assured that the care in Muckamore Abbey Hospital is safe, effective, and compassionate and will continue to do it can to ensure that patients receive the best possible care.”