Care watchdog steps in at Greater Manchester neuro care and assessment centre with inadequate rating

The care watchdog has stepped in and taken action at a Greater Manchester facility which has an inadequate rating.

The Care Quality Commission (CQC) visited LANCuk Heywood in Rochdale to follow up on concerns raised on a previous trip there last year which resulted in it being placed in special measures.

Inspectors found the centre, which provides treatment and assessment for people with ADHD and autism, had not sufficiently improved and now the CQC’s written permission will be required for it to add new patients to its medicine-prescribing service.

It expressed concerns about issues with oversight of medicine being prescribed, multiple record-keeping systems being used and a backlog of correspondence which could prevent people getting timely treatment.

LANCuk said a new interim manager has been appointed and it is working hard to put in place the improvements required of it.

What has the CQC done at LANCuk Heywood?

The CQC has stepped in following its latest visit to LANCuk (Learning Assessment and Neurocare Centre) Heywood in March and April this year.

This was to follow up on concerns raised in October, when the service had been rated inadequate.

The watchdog decided that insufficient improvements had been made regarding safe care and treatment as well as the governance and leadership of LANCuk Heywood.

The CQC has now therefore used enforcement powers to impose conditions on the provider.

The organisation cannot admit any patients to the medicine prescribing service without prior written agreement from the CQC.

The overall rating for LANCuk Heywood remains inadequate. The ratings for the service being safe and well-led are both still inadequate, while it is judged to be good on being effective and caring and being responsive has improved from requires improvement to good.

What did the CQC find at LANCuk Heywood?

On its March and April visit to Independence House, where the service which provides assessment and care for adults and children with attention deficit hyperactivity disorder (ADHD) and autism, the CQC found the following:

• The service was not well led, and the governance processes did not ensure that procedures relating to the work of the service ran smoothly.
• Staff did not engage in clinical audits to evaluate the quality of care they provided.
• There was no information provided to patients regarding the service, including what to expect and timescales of how long their treatment or care would last.
• Staff records did not include all the required documentation and checks.
• The service did not have oversight of the prescription management process to mitigate the possible misuse of prescription medicine and ensure it was safe or appropriate to increase the dose of the medicine before prescribing or continuing to prescribe for patients.

Were there more positive aspects to the latest inspection?

The CQC did find several things at LANCuk Heywood which were much more positive and did not lead to criticism. These included:

• The clinical premises where patients were seen were safe and clean. Staff assessed and managed risk well and followed good practice when it came to safeguarding service users.
• Staff provided a range of assessments and treatments that were informed by best-practice guidance and suitable to the needs of the patients.
• The service included or had access to the full range of specialists required to meet the needs of the patients. Managers ensured that these staff received training and supervision.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients, families and carers in care decisions.

What has the CQC said?

Brian Cranna, the CQC’s head of hospital inspection, said: “When inspectors returned to LANCuk Heywood, it was disappointing to see that its leadership team hadn’t taken the necessary action to remedy the concerns raised during the last inspection.

“We remained concerned that there was no oversight of the prescription management process to prevent the possible misuse of medications. Thorough checks should be carried out before increasing the dose of medicines which wasn’t happening.

“The service had three different systems where care records were stored which made it difficult for staff to keep track. In addition, there was a two-month backlog of letters for GPs and patients which could delay people’s care and treatment and put them at risk.

“Patients told us getting through to the service was challenging and sometimes messages weren’t being passed on or calls returned. They also said that seeing different clinicians on each visit wasn’t ideal as they felt like they were explaining their story repeatedly. Patients would benefit from knowing the time scales and what to expect in between appointments.

“Multi-disciplinary meetings hadn’t taken place and key information wasn’t always shared with clinicians. This meant staff weren’t given the opportunity as a team to discuss any updates or learn from incidents.

“We were pleased to see, however, that the service had introduced an incidents and complaints database which has clear records to support any decision making and learning.

“Leaders now understand where improvements must be made, and we’ll continue to monitor the service closely to ensure people are safe. If we’re not assured people are receiving safe care, we will not hesitate to take further action.”

What has LANCuk Heywood said?

A spokesperson for LANCuk said: “An interim manager has recently been appointed and we are working very closely with the CQC and CCG to implement the recommendations and actions they have given us.”