Mental health trust inspected after concerns over care for patients during meal times

By Sian Bayley, Local Democracy Reporter

A South London hospital’s eating disorders service has been inspected by the care regulator after concerns that staff did not understand how to care for patients during meal times, and had occasionally shouted at them.

The Care Quality Commission (CQC) made an unannounced inspection of the Avalon Ward at South West London and St George’s Mental Health NHS Trust in August.

Head of Hospital Inspection, Jane Ray, said a number of the concerns raised at the hospital, in Tooting, “were already being addressed.”

Following the inspection, the service remains on a “requires improvement” rating, given by the CQC in September 2019.

“The team know what further improvements are needed and will return to check that those improvements have been made at a later date,” Ms Ray said.

Inspectors said they were prompted to inspect the ward after concerns that staff were not always supportive or encouraging of patients, and could be rude and abrupt.

They were also informed that some staff did not understand how to care for patients with eating disorders at meal times, that incorrect portion sizes were sometimes given, and that on occasion meals ordered were replaced due to error or unavailability.

Previous issues from the September inspection around physical health observations and ligature risks were also assessed.

The inspector found that occasionally meals were replaced without the patient being informed in advance.

Errors and problems with unavailability were only raised to the catering contractor on one occasion.

Patients told inspectors some staff were unhelpful and inexperienced at supporting them during meal times and while a training course on therapeutic eating had been set up, the service had not kept records of attendance.

There was only limited support from a qualified dietician to assist staff due to temporary maternity leave cover arrangements.

The majority of staff treated patients “with compassion and kindness”. However, patients reported that a small number of staff had been rude and had shouted at them on occasion, including at mealtimes.

Managers were aware of this and said they were working to improve staff engagement with patients and were taking steps to address poor and unprofessional behaviour by specific staff.

The CQC said patients and carers were encouraged to discuss their concerns and that these were treated seriously.

Inspectors also found staff managed ligature risks to patients and knew where those were within the wards and managed them effectively.

Staff undertook checks on patients’ physical health and raised concerns when required.

A spokesman from South West London and St George’s Mental Health NHS Trust, said it was “committed to providing safe and supportive care” for all service users and “welcomed” the CQC’s recent report.

He added: “We are aware of the concerns that have been raised and have been working with our staff and service users to make improvements and address the issues.

“We also have robust action plans in place to address any outstanding issues and ensure improvements continue.”

Pictured top: The Springfield Hospital, which houses the Avalon ward, in Tooting (Picture: Google Street View)