Warning notices were served after the Care Quality Commission (CQC) inspected the Greater Manchester Mental Health NHS Foundation Trust (GMMH). On Wednesday the trust was told it would face the highest level of intervention from NHS England.
The trust said improvement work was already under way.
A BBC Panorama investigation, broadcast in September, found patients at the Edenfield Centre in Prestwich, near Bury, were being put at risk.
Since that programme, some staff have been sacked or suspended as a result of the trust’s formal disciplinary procedures.
GMMH’s outgoing chairman Rupert Nichols previously said the trust was facing “significant challenges” after “inexcusable behaviour” at the unit.
The trust has also been under scrutiny after the deaths of three young people within nine months.
An inquest in October ruled communication failures “probably caused or contributed to” the death of 18-year-old Rowan Thompson at the trust’s Prestwich site.
The CQC served the trust with two Section 29A warning notices – one relating to ligature and fire risks, the other to staffing and governance, requiring significant improvements within a set timescale.
The report said inspections over the summer found problems with:
suicide risk assessment
the management of medicines
levels of cleanliness
consent to treatment
Inspectors found there were not enough staff and there was a lack of proper oversight and scrutiny by the trust’s board.
Inadequate fire safety standards and poor levels of maintenance were uncovered, while wards were “dated”.
‘Not enough nurses’
The CQC report concluded: “The trust did not provide safe care. The ward environments were not all safe, clean, maintained or well-presented.
“We had significant concerns about fire safety in the acute wards. Ligature audits were poor because they did not identify all risks or effectively mitigate these.”
The service also did not have enough registered nurses or healthcare assistants to help patients, with staff “frequently” working under the “minimum staffing establishment levels”.
The CQC also raised concerns about mixed-sex wards and the “sexual safety” of patients.
It added: “Services were not always caring, some patients told us that wards were noisy and chaotic, and that they did not always feel safe.”
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Source: BBC News, 24th November 2022