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NORTHERN IRELAND’S only inpatient mental health hospital for children and young people failed in its duty to deliver safe and effective care, a secret inspection report shows.
Concerns about Beechcroft Child and Adolescent Mental Health Unit, located in south Belfast off the Saintfield Road, were reported to the Regulation and Quality Improvement Authority (RQIA) in February 2021.
This resulted in Beechcroft being inspected by the RQIA the following month. Inspectors found “serious concerns” about the under-18s inpatient mental health hospital, which falls under the responsibility of the Belfast Health and Social Care Trust (BHSCT).
Northern Ireland’s Children and Young People’s Commissioner (NICCY), Koulla Yiasouma, told The Detail: “This is a very worrying report. These are some of our most vulnerable children whose mental health has deteriorated so significantly that they require hospitalisation.
“They deserve the highest standard of service and therefore the findings of this report are unacceptable.”
As a result of this March 2021 inspection, the RQIA determined insufficient improvements were made in Beechcroft – in regard to numerous issues found during a previous inspection which occurred a year-and-a-half earlier.
These repeated failings related to:
- staffing numbers and skill-levels,
- the training and knowledge of staff,
- detention practises used on the children and teenagers,
- water safety remedial works and a lift safety assessment,
- medicines policy,
- access to pharmaceutical professionals,
- procedures regarding ‘medication-related incidents’ and
- multiple important policies.
The RQIA also found problems in Beechcroft relating to the BHSCT’s approach to communications, the need for a newly updated ‘operational policy’, risks of Covid-19 spreading, the cleanliness of wards and the retention of expired medicines.
Due to its findings, the RQIA determined that Beechcroft was failing to meet the standards required for the hospital to be delivering safe and effective care.
NICCY’s Koulla Yiasouma said it’s incumbent upon authorities to demonstrate improvements have been made in Beechcroft since the March 2021 inspection.
A spokesperson for the BHSCT told The Detail that after reviewing the RQIA’s recommendations, the trust “provided inspectors with a comprehensive action plan and took the necessary steps to address the issues identified” at Beechcroft.
The BHSCT also said that the RQIA revisited Beechcroft, in November 2021, to assess the effectiveness of the trust’s action plan – but neither the RQIA or the BHSCT told The Detail the outcome.
However, the BHSCT said it “continues to engage with the RQIA to show evidence that improvements continue at Beechcroft” and that its aim is for the hospital to “provide the best care and support possible for our young people”.
Secret report
Beechcroft has two wards; ward 1 – the treatment ward and ward 2 – the admission and assessment ward.
Ward 1 has the capacity to care for 10 young people, but it also has a psychiatric intensive care unit in which additional young people can be accommodated. Ward 2 has the capacity to care for 15 young people and there is an extra bed for when emergency care is required.
The Detail uncovered a partially-redacted version of the March 2021 Beechcroft inspection report by submitting a Freedom of Information (FoI) request to the RQIA.
Previously, The Detail uncovered an RQIA inspection report into Lakewood – Northern Ireland’s only secure care facility for under-18s – which similarly revealed “serious concerns”.
Both reports had previously been kept secret from the public as the RQIA does not routinely publish its findings from inspections of children’s services.
The RQIA said this approach is taken to protect the privacy of vulnerable children, but the organisation said it understands how it could be interpreted as lacking in transparency.
A spokesperson told The Detail: “This may be seen as preventing service users and prospective service users from taking informed decisions, keeping relevant information from other stakeholders and the wider public, and limiting accountability.”
Furthermore, the RQIA confirmed it was undertaking a review of its approach in relation to the findings from inspection reports on under-18s services.
Children’s commissioner, Koulla Yiasouma, said NICCY supported the publication of these reports. Upon being alerted to the Beechcroft report by The Detail, the commissioner added it was “disappointing” that the RQIA had not raised the report findings directly with her office.
She also referenced how her legal team has previously raised issues with the head of Beechcroft “as a result of complaints made” to NICCY.
The RQIA responded by saying it had recently met with Commissioner Yiasouma to “discuss how liaison between the two organisations may be further enhanced, building on the existing memorandum of understanding”.
In addition, while the RQIA inspects Beechcroft it does not have regulatory responsibility over the hospital – meaning it does not have the power to take enforcement action which legally must be obliged with, it can only make recommendations.
This is because the RQIA does not regulate mental health services in Northern Ireland, a situation which has been described as a “dereliction of duty” and which all parties in the Stormont Executive have said should change.
Meanwhile, the BHSCT said: “We regret that anyone at Beechcroft feels that they have not received the right level of support and we are keen to listen to suggestions from young people, their families and our staff, on how we can provide a caring and supportive environment for everyone at the facility.”