Mental health service warned it could face closure as it’s placed in special measures for a second time

A community mental health service has been warned it could face closure after it was again placed in special measures.

Heywood-based LANCuk provides assessment and treatment for adults and children with autism and attention deficit hyperactivity disorder (ADHD).

But the service has a history of shortcomings and has been rated as ‘inadequate’ by the Care Quality Commission (CQC) following a recent inspection.

Officials noted it had made some progress in April 2019, when the Adelaide Street centre was upgraded to ‘requires improvement’. However, it is once more under the lowest possible rating due to issues identified during a CQC visit in October.

It is the second time it has been placed in special measures and the third time it has been classed as ‘inadequate’.

The service has now been hit with a ‘warning notice’ and told ‘urgent enforcement action’ could follow if it fails to up its game.

The watchdog’s latest report states: “If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service.”

It adds that the service will be kept under review and, if needed, could be escalated to urgent enforcement action. 

“Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.”

Patients had raised concerns over receiving the wrong medicines or late prescriptions – causing withdrawal symptoms for one and a mental health crisis for another. 

They described the manager’s response to their complaints as ‘disappointing’ – and CQC officials shared their concerns.

The report notes that ‘the service did not use systems and processes to safely prescribe, administer, record and store medicines.’

It adds: “Staff did not follow current national practice to check patients had the correct medicines. The service did not complete regular medicines audits to ensure prescribing was in line with best practice guidelines.”

Inspectors also found that information was not shared with patients’ GPs ‘in a timely way’ and staff flagged that there was a month’s backlog of letters waiting to be sent.

LANCuk is commissioned by the NHS to provide assessments and diagnostics for people living in Oldham, Rochdale and Bury.

But staff did not continually monitor patients on waiting lists for changes in their level of risk and there was not an accurate record of patients waiting to access the service.

Records showed that at the end of March 2021 there were 277 NHS patients waiting for their first appointment.

“The service did not manage patient safety incidents well,” the report found.

“Staff did not recognise incidents and report them appropriately. Managers did not fully investigate incidents and share lessons learned with the whole team and the wider service.”

However, when things went wrong, staff had apologised and given patients ‘honest information and suitable support’.

Inspectors were also damning of how LANCuk was run noting that ‘leaders did not have the skills, knowledge and experience to perform their roles’.

The report adds: “They did not have a good understanding of the services they managed and were not visible in the service.

“The registered manager was based in South Wales and managed the service remotely by use of email, phone and virtual meetings.”

LANCuk has since been visited by senior NHS staff from Heywood, Middleton and Rochdale Clinical Commissioning Group (CCG).

A statement from HMR CCG reads: “The visit made several observations including no delays in assessments, improvements to admin processes and record-keeping, good infection prevention and control, good duty of candour and a good clinical supervision model being in place.

“A further improvement delivery plan has also been put in place which includes new record-keeping processes and training opportunities for staff. These are being monitored during regular provider site visits to ensure improvements are implemented. “

The CQC inspection was unannounced and took place on 8 and 13 October.

Nick Statham, Local Democracy Reporter