Mental health patients at risk of sexual assault on mixed sex wards, watchdog warns

NHS trust admits it was unable to improve services due to staffing pressures

Trust’s mixed-sex wards put women at risk

Vulnerable female patients have been sexually “exposed” on a mixed gender ward deemed not “fit for purpose”, the NHS watchdog has warned.

The Care Quality Commission found that sexual incidents had occured at Hill Crest, a 25-bed mixed gender mental health unit in Redditch, as male and female were being put at risk.

It found male patients are able to walk into female bathrooms and bedrooms, leading to risks of sexual assault and relationships. It found that sexual incidents had taken on the unit because of the risks.

The rate of assaults on mixed sex wards is significantly higher than on single-sex wards, data has shown.

Following an inspection, the CQC has issued the Worcestershire Health and Care Foundation Trust, which runs the unit, with an urgent warning notice.

According to the CQC, the trust graded sexual incidents between patients as “low harm” but did not fully consider them or follow up actions to keep patients safe.

“We were told by some of the patients we interviewed that male patients regularly entered this room without being challenged by staff,” the report said.

The watchdog also warned in a report, published Wednesday, that the trust was not carrying out physical health assessments of patients after admission. In December last year, an investigation by The Independent revealed mental health patients on wards are dying due to inadequate physical healthcare.

The inspection, carried out into the trust’s psychiatric intensive care unit, which is a service for the most acutely unwell patients, revealed an incident had occurred in which a patient attempted to throw boiling water over a staff member.

Despite the incident, boilers with hot water were still accessible to patients when inspectors visited.

Inspectors also warned the trust over the state of its wards which it said were bare, had no furniture and were missing skirting and floor coverings. The fire extinguishers were out of date and had not been changed since 2009.

The wards were also not cleaned regularly, with “damaged” walls showing “flaking plaster”. Toilets were also “visibly dirty”, the report read.

Vicki Nash, head of Policy, Campaigns and Public Affairs for charity Mind said: “The fact that sexual incidents occurred on a mental health ward is abhorrent. Mental health hospitals are a place where people have the right to feel safe, and should never be put at risk of any harm, including traumatising sexual assault. We expect Worcestershire Health and Care Foundation Trust to take immediate action to address these risks and ensure people are kept safe.

“Mixed-sex NHS accommodation has been expected to be eliminated, except where it is in the best interests of the patient, for over a decade.”

She said Mind is calling for a public inquiry into mental health units adding “sadly problems in our mental health hospitals are not isolated to one trust, the system is riddled with deep-set issues.”

The news comes after The Independent revealed dilapidated mental health facilities across the country are in need of £677m worth of repairs to fix sewerage issues, collapsing roofs and wards that deprive patients of their dignity.

Craig Howarth, CQC’s deputy director of operations in the Midlands, said: “When we inspected Hill Crest, it was disappointing to see significant deterioration in safety and quality of the wards, as well as the care being provided.

“It was concerning that lessons were not being learned from serious incidents where people could have been seriously harmed.

“However, it was positive that the provider promoted equality and diversity in its day-to-day work and provided opportunities for career progression.”

Following the inspection, which also warned that the trust was overusing agency staff, the trust admitted staffing pressures meant it was struggling to improve services.

Mental health trusts are under increasing pressure as rising demand for beds means many wards are also operating at or above capacity.

It added that it had addressed urgent issues following a prior inspection last year but that it continued to have “very low” levels of permanent nurse staff and healthcare staff and so has overplied on agency staff, which had affected the quality of care.

Last week, the trust agreed to reduce the number of available beds on the ward to reduce staffing pressures.

Sarah Dugan, chief executive of Herefordshire and Worcestershire Health and Care NHS Trust, said: “We recognise that the standards of care and professionalism at Hill Crest at the time of the inspection last July were not good enough. I would like to apologise to the patients and families concerned.

“While the steps we took following the inspection last July addressed the immediate issues raised and helped stabilise the ward, we continue to have some significant staffing challenges which affect our ability to embed and sustain these improvements.”