Whistleblower raises the alarm at Co Armagh psychiatric unit
WHISTLEBLOWER allegations about mistreatment of mentally ill patients in a specialist unit at a Northern Ireland hospital have led to a high-level independent investigation being carried out.
Correspondence leaked to The Irish News reveals concerns relating to over-use of restraint and seclusion of vulnerable adult patients at the 'Bluestone' unit at Craigavon Area Hospital last year.
Bullying of some staff is also alleged alongside a culture of 'cronyism', "lack of compassionate leadership" and poor management.
One of the most alarming reports relates to an elderly dementia patient being locked in their room with a chair up against the door, "on which staff sat while undertaking observations".
Grievances were reported by 'peer support workers' - employees who previously had a mental health problem and use their experience to help others - who felt they had been "discriminated against", resulting in several quitting.
The modern £12 million mental health inpatient unit was opened in 2008.
A trust spokesman said in a statement it had "thoroughly investigated" care issues under the organisation's whistle-blowing policy and had also ordered an independent probe by the Royal College of Psychiatrists.
He added that while "no safeguarding issues" had been identified in the RCP review recommendations had been made in order to improve services. These "are being implemented", he added.
The report was ordered in April but was not "signed off" until September. It was not received by the Department of Health until last month.
Such is the serious nature of the claims that a top official at the department wrote a letter to the Southern health trust on November 4 in which he expressed concerns about the "culture and practices" within Bluestone.
The allegations centre on a 10-bedded secure Psychiatric Intensive Care Unit (PICU) in Bluestone, known as 'Rosebrook'.
Whistleblower allegations highlighted by the department chief include:
- The 'no force first' mantra - in which physical restraint is used as a last resort by staff - was largely ignored
- Inexperienced nursing staff being placed in PICU
- Seclusion used too often
- "Victimisation" of peer support workers with their illnesses "made light of"
- Over-use of restraint and failure to undertake 'de-briefs' when it was used, meaning "key learning" was lost
- "Threats" issued to vulnerable patients about being "sent" to other units in the north
The November letter, seen by The Irish News, was written by Mark Lee, Director of Mental Health, Disability and Older People, at the department and issued to Barney McNeany, Southern health trust's Director of Mental Health and Disability Services.
Mr Lee notes that previous correspondence had been sent to the trust's chief executive earlier year by Permanent Secretary Richard Pengelly regarding separate whistleblowing concerns within Bluestone.
He writes: "I have recently been contacted by a new whistleblower...who raised a number of issues with me. Some of these related to the treatment of him as as individual employee and to poor management. Some related to poor practices in wards within which he worked.
"This does, of course, raise concerns about the culture and practice within the Bluestone unit, particularly when considered alongside previous whistleblowing allegations."
Mr Lee, who took up the senior post this year, adds: "I would appreciate your comments on these allegations, and confirmation of appropriate actions so as to ensure (the whistleblower) has been treated fairly; that steps are being taken to ensure that peer support workers as a group are appropriately managed and supported;
"...and that the culture, management and practices at Bluestone are in line with best practice and supporting patients to recover."
He concludes that he would "also very much appreciate a full copy of the written report as soon as possible."
The Irish News asked the Southern health trust if the Royal College review or its own internal report had examined CCTV footage linked to the allegations.
A Southern trust spokesman said: "The Royal College of Psychiatrists were requested to undertake an invited review of the service, not specific incidents. They were not requested, nor would it be appropriate, for them to view CCTV.
"Where safeguarding incidents occur in areas which are covered by CCTV, then footage is routinely reviewed if it is available."
The trust said the RCP report had "looked at all information" including "interviews with staff, clients and carers".
"This information has been shared with the whistleblowers, and accepted by them, and formally shared back to the Department of Health."
Meanwhile, a department spokeswoman said they had received a response from the Southern Trust last month regarding "the steps taken to address the whistleblower’s concerns".
"The department is currently considering the trust's response," she said.