Safety fears at Welsh hospital May 31 2004
Robin Turner, The Western Mail
INSPECTORS have highlighted safety concerns at a Welsh psychiatric hospital.
Members of an inspection team from the Mental Health Act Commission claimed the safety of patients and staff appeared to be at risk when they visited the 70-year-old Swansea's Cefn Coed Hospital building in March.
The inspectors noted "with anxiety" shortages of staff meaning that a safe environment was difficult to maintain.
And during the visit, on March 3 and 4 this year, obsolete forms were found with patients' prescription sheets.
In a worrying episode, members of the commission spotted one instance in which a patient was being administered more medication than had actually been authorised.
The inspectors added that the doors of the acute admission wards at the hospital were locked "for considerable periods of time".
Swansea NHS Trust which runs the hospital says this is partly down to staff shortages.
The critical report comes just weeks after the Audit Commission issued a scathing critique of the NHS throughout Wales.
The Audit Commission report on May 7 said the Welsh NHS was badly managed and structured.
Entitled Transforming Health and Social Care in Wales: Aligning the Levers of Change, the report found, "The main problem is not that Welsh people are 'sicker' than elsewhere, but that the whole system of health and social care is not organised to best effect."
The latest poor report centres on Cefn Coed Psychiatric Hospital sited on a hill at Cockett to the north-west of Swansea's city centre, a 72-bed facility which takes in patients from Gower, Swansea, the Swansea Valley and Neath Port Talbot.
The hospital has been giving rise to concerns for some time.
In January 2002, a joint independent report by the Sainsbury Centre for Mental Health and the University of Wales, Swansea recommended it should be closed down.
The report said instead, Cefn Coed should be replaced by a building "more suited to the 21st century".
Of the patients interviewed in the 2002 study, 83% said they felt vulnerable on the wards and 67% said they witnessed either staff being attacked, a suicide or attempted suicide or restraints being used by staff or forced medication.
More than half said there were no quiet areas on the wards.
Nine months after the report was made public, patient Kurt Howard, 32, of Langland, Swansea, died at the hospital during what the Mental Health Act Commission has called "an episode of physical restraint".
A police inquiry was launched after the tragedy but no action was taken against anyone involved.
An inquest is due to be conducted into the patient's death later this year by Swansea and Gower Coroner Philip Rogers.
Swansea NHS Trust conducted an internal investigation which included a review of policy, procedures and training.
Following its March 2004 visit to Cefn Coed the Mental Health Act Commission has said, "We would welcome an update on the implementations of all the recommendations made by the internal investigation."
Members of Swansea's NHS Trust board which will discuss the commission's inspection report at their monthly meeting later this week have been told many of the recommendations have been carried out while others are being implemented in line with "proposed time scales".
Regarding staff shortages, the inspection report said, "Nurse staffing levels remain a source of concern.
"During their visit to the acute admissions ward, commissioners noted with some anxiety that nursing staff appeared under great pressure to maintain a safe environment.
"The high level of disturbed behaviour, coupled with seemingly low nursing establishments meant not only the safety of patients and staff appeared sometimes to be at risk, but also that nurse led therapeutic activities plus escort duties were sometimes compromised."
In a report to the board, one of the trust's senior mental health service officials says, "A recruitment campaign is ongoing reflecting the longer term approach needed to address nursing establishment deficits.
"The issue is a high priority."