Unit where police take people detained under the Mental Health Act not up to national standards say inspectors

Northamptonshire Healthcare Foundation Trust has been criticised by inspectors for its 136 suite and its high use of prone restraint.
Northamptonshire Healthcare Foundation Trust has been criticised by inspectors for its 136 suite and its high use of prone restraint.

Northamptonshire’s mental health service provider has carried out an immediate review of a unit people sectioned by police are taken to, after criticism from inspectors.

The Care Quality Commission (CQC) found during a one day well-led inspection in October that Northamptonshire Healthcare Foundation Trust’s (NHFT) 136 suite at the Berrywood Hospital in Duston was not up to national guidelines.

A 136 suite is where people detained under Section 136 of the Mental Health Act by the police on concerns they are suffering from a mental disorder are taken. Once in the suite, the person is assessed to establish whether they need treatment.

The CQC also said in a letter from head of hospital inspections Julie Meikle to NHFT that it had concerns about the high numbers of restraint and prone restraints its staff were carrying out. This follows similar concerns made by inspectors last year. In 2014 the Government said restraint was an ‘outdated practice’ and issued new guidance to reduce its use.

A final report from the CQC is due to be published soon.

A spokesman for NHFT, which also runs a second 136 site at St Mary’s Hospital in Kettering, said: “Whilst we wait to receive the final report and its publication NHFT, as part of its learning culture and commitment to patient safety, have immediately commenced a review of our 136 suites to benchmark them against best practice and national guidance to highlight areas of learning.”

The organisation said it was committed to reducing restraint and regularly scrutinised its use. The numbers of restraints used are not publicly available but an inspection by the CQC in June last year stated that 56 percent of all recorded restraints between December 2017 and 2018 were face down (prone restraints) and that 96 percent of prone restraints by NHFT related to administration of rapid tranquillisation or safe seclusion exits.

From the latest visit CQC inspectors said: “We were concerned about high numbers of restraint and prone restraint. We saw evidence of how the board have scrutinised data in this area, and how the board have taken a reasoned response to address this. However, we would expect the trust to give further consideration to the actions required to decrease levels of restraint.”

NHFT says it has developed a reduction strategy which includes introducing seclusion pods into wards and equipping staff with body worn cameras.

It said: “In 2018 the CQC rated us as ‘Outstanding’ overall with a ‘Good’ in safety. Since that time we have continued on our journey of continuous improvement with a particular focus on safety. We are confident with the direction we are travelling in and will proactively review and adopt recommendations highlighted in the CQC inspection report once published.”

The CQC was complimentary about the clarity of culture and leadership in the organisation, said there were many examples of quality improvement and was impressed how NHFT celebrated success.