Under-fire specialist unit given deadline to fix problems after whistleblower contacts inspectors

An anonymous letter to health regulators just over six months ago prompted a series of surprise inspections of the Lakeview Hospital facility on the outskirts of Londonderry.

Inspectors then uncovered a host of problems — including worries about patients’ money being “exposed to potential financial abuse”, the incorrect dosage of medication being given, and patients being kept in “stark” rooms without “privacy and dignity” — at Lakeview Hospital on the outskirts of Londonderry.

The letter was recieved by the Regulation and Quality Improvement Authority (RQIA) — the body responsible for regulating heathcare in Northern Ireland and carrying out inspections to ensure standards are up to scratch — on August 2 last year.

The inspection report that followed was published in September and found “a number of significant concerns relating to adult safeguarding and incident management; financial governance, staffing, physical health care and hospital governance”.

Amongst the findings, the inspection report noted that “some patients were regularly prescribed multiple anti-psychotics with dosages exceeding BNF recommendations”.

It also found that “staff had access to one patient’s bank card with a significant amount of funds”, and that “evidence indicated that patients’ monies were exposed to potential financial abuse”.

Part of the RQIA team included specialist “finance inspectors”.

Following the initial surprise inspection, a follow-up was carried out in February to “assess progress on the areas for improvement”.

The RQIA has now decided that while there has been improvement in some areas “concerns about adult safeguarding and incident management at the hospital remained.” It also found “concerns about the need to improve care and treatment to support recovery and resettlement of patients” had been “heightened”.

The latest inspection report is due to be published in May.

The regulators have decided to issue the Western Trust, which has responsibility for the specialist facility, with enforcement action.

Two ‘improvement notices’ have now been issued, meaning the Trust must bring the running of the learning difficulty unit up to the bare minumum standards expected before September 10, or face further action from the regulators.

The Western Trust has insisted it has made “considerable progress” since the unannounced inspections by the RQIA.

In a statement, Karen O’Brien, Director of Adult Mental Health and Disability Services at the Western Trust, said: “Through an improvement plan, the Trust has made considerable progress in a number of areas, with evidence of improved outcomes for patients.”

She added: “However, a number of areas of improvement remain and the Trust has received two Improvement Notices in relation to Adult Safeguarding and Care and Treatment.”

The Trust director continued: “An Improvement Plan was provided RQIA by the Trust which establishes the key focus and related work that will continue to be taken forward in relation to the identified concerns. This is managed through a Project Team and Project Board as well as being overseen by the Trust Corporate Management Team. As part of the normal RQIA inspection processes, families of patients in Lakeview Hospital continue to be communicated with.

“The Trust is committed to providing the highest quality services for all the patients and service users in its care. The Trust take very seriously the areas identified as requiring improvement in Lakeview Hospital and has demonstrated its willingness to take whatever actions are necessary to ensure the service is compliant with the relevant standards and practices.”