CQC raises management concerns with care home owner following BBC Panorama programme

A review by the Care Quality Commission (CQC) of mental health and adult social care services run by Cygnet Health Care Limited has raised a number of concerns requiring action from the provider.

CQC carried out a provider well-led review of Cygnet Health Care between 2 July and 2 August 2019, after significant concerns were identified regarding the safety and culture of Whorlton Hall following the BBC Panorama programme aired on 22 May.

Prior to the review, CQC inspected 47 of Cygnet Health Care’s registered locations in England between May 2018 and April 2019 as part of its planned inspection programme. Whilst the inspections identified several positive factors they also identified some concerns linked to the provider’s leadership and governance arrangements.

At the time of the review a number of Cygnet Health Care’s services were being inspected or subject to the early stages of enforcement action. Prior to publication of this report nine services had been rated inadequate or placed in special measures.

The review highlighted several significant issues:

• CQC inspectors found the structure and in place did not support the executive board to effectively identify emerging issues.
• The provider used different information systems across the organisation, so the executive team did not have oversight of significant risks identified by regional teams.
• Care and treatment did not always include best practice.
• Training was not provided to all relevant staff across services where physical intervention or rapid tranquilisation was used.
• There was a high use of physical restraint and seclusion across services compared to similar services
• The number of patient assaults by other patients and self-harm recorded were also higher compared with similar services.
• The executive team did not ensure all locations had a registered manager in post.
• At June 2019, 8% of locations did not have a registered manager. Three of these had not had a registered manager for a period of six months.
• The required checks had not been carried out to ensure that directors and members of the executive board were “fit and proper”.

However, the review also identified there was a stable senior executive and leadership team in place with a range of skills, who worked together to support the delivery of care and senior leaders took steps to improve the quality of patient care once concerns were identified. Most services across health and social care had been inspected by the CQC and rated as good and some as outstanding.

Dr Kevin Cleary CQC’s deputy chief inspector for mental health and community services, said: “During the well-led review, we identified serious concerns about Cygnet Health Care’s governance and leadership and the impact of this on the quality of care being provided to vulnerable people in some services.

“Cygnet must now take immediate action to address our concerns. They must ensure that effective governance systems and processes are embedded across all services and that policies and procedures are consistent across all services to support staff to provide high quality care and treatment.”

“Since our review Cygnet have commissioned a corporate governance review from an independent person and are taking action to make improvements at a number of locations. We will be closely monitoring the provider to ensure the necessary improvements continue to be made to ensure patients are receiving safe care.”

Cygnet said it was taking steps to improve services, but added it was “not complacent” and would “take on board” the recommendations.

A spokeswoman, said: “We treat some of the most acute patients that other providers may not be able or willing to support.

“We always aim to de-escalate and advocate least restrictive practices in line with current good practice guidelines.”

Picture (c) BBC / PA Wire.