A WATCHDOG has raised concerns about the leadership of a health care provider following a review made after allegations of abuse were made at a private mental health hospital in County Durham.

The Care Quality Commission (CQC) said Cygnet Health Care, which ran Whorlton Hall, near Barnard Castle, which closed last year after the abuse allegations came to light as part of an investigation by the BBC's Panorama, must make changes.

The company, which runs mental health and learning disabilities services in 113 locations, also runs Newbus Grange, in Darlington, which is currently closed for refurbishment after being put into special measures by the CQC because of concerns about patient safety.

The CQC carried out a well-led review following a rise in enforcement action being carried out against Cygnet by the watchdog, finding the company had a high number of cases where patients were restrained and said it had more instances of self-harm than other providers.

Dr Kevin Cleary, CQC’s deputy chief inspector for mental health and community services, said: “During the well-led review, we identified serious concerns about Cygnet Health Care’s governance and leadership and the impact of this on the quality of care being provided to vulnerable people in some services.

“Cygnet must now take immediate action to address our concerns.”

During the review CQC inspectors found that a clear line of accountability could not be established across all of Cygnet Health Care’s locations.

The structure and processes in place did not support the executive board to effectively identify emerging issues, while care and treatment did not always include best practice and training for intermediate life support was not provided to all relevant staff across services where physical intervention or rapid tranquilisation was used.

Darlington and Stockton Times:

Whorlton Hall, near Barnard Castle

There was a high use of physical restraint and seclusion across services compared to similar services in other mental health providers.

The number of patient assaults by other patients and self-harm recorded were also higher in Cygnet Health Care compared with NHS providers of similar services.

The CQC has said Cygnet must make improvements in five areas, including ensuring risks are identified at every level, that governance systems are effective and embedded across all services, that policies and procedures are consistent and that a "freedom to speak up" guardian be appointed for all NHS-commissioned services.

It made an eight further recommendations that should be made to improve, including taking action to reduce the use of restrictive practices and making sure staff who safeguard children and adults have supervision.

However, the CQC did say the company's senior leadership team was responding to concerns, and pointed out that most services run by the provider were rated as good, with some as outstanding.

Since the CQC’s review, Cygnet commissioned a separate, independent corporate governance review.

A spokesperson for Cygnet said it has a “zero tolerance” approach to abusive behaviour and was taking steps to improve services.

It added it was “not complacent” and would “take on board” the recommendations.

The company added: “At Cygnet, we treat some of the most acute patients that other providers may not be able or willing to support.

“We always aim to de-escalate and advocate least restrictive practices in line with current good practice guidelines.

“The report recognises it does not take into account the level of need or acuity of individual patients admitted to these wards.”

In response to concerns about short staffing, Cygnet said it was a “well-recognised challenge” in the mental health sector and had several initiatives to support the recruitment and retention of staff.

A spokesperson said: "Cygnet runs more than 140 services across the UK and we are pleased the report highlights that most of our services inspected by the CQC have been rated as good and some outstanding. Many have maintained these ratings over multiple inspections, over many years, showing sustainability in our provision."