The mental health trust where a “toxic culture” saw patients abused in 2022 has been rated as inadequate again despite some improvements.
The secure unit the Edenfield Centre in Prestwich, Greater Manchester, was the subject of a Panorama investigation which revealed how patients were humiliated and bullied.
Forensic inpatient and secure wards at the Greater Manchester Mental Health NHS Foundation Trust (GMMH), which runs Edenfield, were subjected to an unannounced inspection in April and May this year by watchdog The Care Quality Commission (CQC).
The CQC said it had identified issues with patient safety and pressures on staff, while some still felt unable to speak up about their concerns.
The trust overall remains inadequate.
Alison Chilton, CQC deputy director of operations in the north, said: “The trust’s processes didn’t always ensure the environment was safe for people.
“We found some wards which carried out 15-minute security checks to keep people safe had gaps and missing signatures in their records.”
Other issues included staff being asked to carry out observations for hours without a break, ligature risks not being identified, and unsafe management of medicines.
Ms Chilton said there was also evidence of restrictive practices across the wards within the trust, which also includes centres other than Prestwich.
“The service had imposed blanket restrictions without evidence to demonstrate the decision-making behind this, or that these were being kept under close review,” she said.
Management had expressed concerns about managing an influx of new staff, and inspectors were told of a “cultural divide” on some wards with complaints of bullying.
However there was signs of “cultural improvements” to learning, safety and leadership and inspectors saw staff treating patients with compassion.
GMMH said it was “disappointed” that the CCQ report had taken so long to be published but accepted it was an accurate depiction of the situation at the time.
It said it had “worked at pace” to address the problems identified since May last year.
Salli Midgley, chief nurse at the trust, said: “We will always be sorry for the failings in the past but under the Trust’s new leadership we are focussed on getting the fundamentals of care right, every time for our service users, their families and carers.”
Some staff at the Edenfield Centre were sacked after the Panorama investigation was broadcast.
The programmed sparked an independent report, led by Prof Oliver Shanley OBE, who found the trust repeatedly missed opportunities to act on concerns, and had a culture of “suppressing bad news”.
It said Panorama had exposed the “most shocking abuse and poor care” of vulnerable patients, and that concerns raised by families were “not always taken seriously”.