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New report into 'inadequate' Teesside hospital West Lane reveals staff and support problems

West Lane Hospital in Middlesbrough, which closed earlier this year. Credit: ITV News Tyne Tees

A report into a mental health unit on Teesside has found it was under-staffed and young patients were not supported enough.

West Lane Hospital, in Middlesbrough, was closed in August, after Care Quality Commission (CQC) inspectors found it to be 'Inadequate' and two patients died in its care.

The Tees, Esk and Wear Valleys NHS Trust, responsible for running the unit, has said it 'fully accepts the findings' and is "deeply sorry".

The CQC published two inspection reports on the trust's child and adolescent mental health (CAMHS) wards at the hospital over the summer following three visits in August.

These led to the commission imposing conditions on the trust's registration, which stopped anyone else being admitted to West Lane, ultimately leading to its closure.

The trust's CAMHS inpatient service - made up of five units across three sites, West Lane Hospital, West Park Hospital and Roseberry Park - was inspected in June 2018, receiving a rating of 'Good'.

It was examined again in June this year though because of concerns raised about the treatment of young people receiving support, low staffing, a poor culture and a "significant number" of self-harming incidents. It was rated 'Inadequate' overall.

The August 2019 inspections only looked at the care being provided in West Lane Hospital. Both inspections were unrated, meaning the 'Inadequate' stayed in place.

The inspection on August 6 specifically focused on the question of whether the services there were safe, following the death of a patient there. the subsequent reported that staffing, although improved, was not in line with established agreements and agency staff were overly relied on.

The second inspection, on August 20-21, was prompted by whistleblowing information about the care of a person at the service. Inspectors reported being told by staff that they were "struggling" and that the service was "traumatised". Inspectors identified that staff did not complete incident reports consistently to clearly identify that physical restraint was being used, little learning had taken place from reported incidents and again found observation records were poor.

Jenny Wilkes, the CQC's head of mental health inspection, said:

Leading into these inspections we had deep concerns about the quality of the care being provided at West Lane Hospital - we had previously placed enforcement conditions on the service and were monitoring its performance very closely.

Despite being repeatedly assured that improvements were being made to the service, we were alerted to further concerns and found the care had not improved. People were not safe or being provided with care in line with their needs. Observations were not being recorded well, staff training and knowledge of care for young people with complex needs was poor and incidents were not consistently reported or reviewed well. There was limited experienced managerial oversight of the wards and a culture existed that was not working to the benefit of the people there.

Ultimately, considering the inspections' findings, we could not allow the service to continue and took urgent action to prevent further admissions being made to the service, which led to the closure of the hospital. We appreciate action of this nature can cause distress to the people using the service and their families, however our priority is always the safety of people that use services and we will use our enforcement powers to ensure this. We continue to work closely with the trust, NHS England and local commissioners to ensure that those affected are receiving the care they need.

– Jenny Wilkes, Care Quality Commission

Colin Martin, the trust's chief executive, said:

We fully accept the findings in the reports and we are deeply sorry that we didn't provide safe, high quality care to the young people at West Lane Hospital.

There were 11 young people in our care when the CQC made the decision to close the inpatient wards at West Lane Hospital. Working alongside partners, including NHS England, all 11 young people have transferred or have been discharged as appropriate. As a result the inpatient wards at West Lane Hospital closed in September.

We continue to work closely with partners, including NHS England and local commissioners, to ensure that those affected are receiving the care they need.

A number of internal and external reviews and investigations will now take place to look at the issues and events at West Lane Hospital. This includes an independent investigation, commissioned by NHS England, which is at a very early stage and will involve stakeholders, patients, families and staff.

We are working closely with NHS England and other stakeholders to look at the future model of care for children's inpatient services in the region.

– Colin Martin, Tees, Esk and Wear Valleys NHS Foundation Trust