Already at the centre of one of the biggest maternity care scandals in the UK, Shrewsbury and Telford Hospital NHS Trust (SaTH) is once again making headlines for all the wrong reasons with the Care Quality Commission (CQC) rating its children's mental health services in particular as inadequate.
The Care Quality Commission (CQC) carried out a targeted inspection on 24 February 2021 after receiving what it described as "concerning information" about treatment for under 18-year olds with acute mental health needs at SaTH. In common with many other health providers during lockdown, SaTH said it had seen an increase in the number of young people with "significant mental health issues" and learning disabilities over the past year.
Specifically, CQC inspectors reported that children were not receiving adequate risk assessments on admission. In one example, the risks a ward posed to someone admitted after attempting self-harm were not mitigated. Inspectors also said staff did not follow best practice in anticipating and de-escalating challenging behaviour and were not always appropriately trained in restraint. Indeed, some security staff involved in interventions were described as not having any restraint training at all.
CQC inspectors also commented that staff "generally relied" on rapid tranquilisation, noting that a child was twice given double the "safe" dose of a rapid tranquiliser at Telford's Princess Royal Hospital and put at "significant risk of harm."
The Trust has been in special measures since November 2018, the same year an investigation was launched into its maternity services led by senior midwife Donna Ockenden. It’s children’s mental health services, which were rated as "requiring improvement" in November 2019, were deemed "inadequate" as a result of the latest inspection. Ted Baker, chief inspector of hospitals, has insisted that the Trust must stop seeing under 18s for acute mental health needs, review records of all young patients admitted with mental health issues, monitor staff compliance with safeguarding procedures and give the CQC weekly reports on actions to improve patient safety.
Pam Westwood, a clinical negligence solicitor in Shoosmiths medical negligence team, commented:
“We have represented adult clients in relation to poor mental health care and are disappointed to see the same clearly inadequate standards in mental health service provision for children and young adults. The pandemic has put a huge strain on many young people who were already struggling with their mental health because of social isolation, a loss of routine and a breakdown in formal and informal support. It is saddening to read this report at a time when it is even more important than ever that adequate mental health services are available to our children and young people.”