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‘Barbaric’ restraining of Camden mental health patients under fire

16:10 04 September 2014

Aaron Dover experienced first hand the 'brutality' of face-down restraints. Picture: Polly Hancock

Aaron Dover experienced first hand the 'brutality' of face-down restraints. Picture: Polly Hancock

Polly Hancock

The safety of mental health patients treated in Camden and Islington has been brought into question after the government’s health watchdog uncovered a high use of face-down restraints by staff, a prevalence of dangerous ligature points in wards, and centres struggling to keep out illegal drugs.

The Care Quality Commission (CQC) published its report into Camden and Islington NHS Foundation Trust following an inspection this year.

While saying the trust treated patients with “dignity and respect”, the CQC found it in breach of six regulations.

These include not having an effective system to learn from incidents; compromising patient care by regularly moving its patients from ward to ward; and having staff with a poor knowledge of what rights mental health patients have.

It also revealed that a cluster of unexpected deaths are under review.

This comes after other deaths in March and April last year were investigated – something the CQC said was not due to “systemic issues”.

The watchdog’s “greatest concern”, however, lay in wards where ligature points which could be used by patients to hang themselves were “putting people’s safety at risk”.

“There were multiple ligature points on the acute wards across the trust,” the report said. “On four of the five wards at the Highgate Centre these assessments had failed to record any specific action to be taken to mitigate the risks.

“We noted a number of serious incidents had occurred in the trust over recent months which had involved the use of ligature points and resulted in serious harm to people.

“At the Highgate Mental Health Centre we found evidence of four separate serious incidents in March and May 2014 which involved attempts to self-harm with a ligature.”

It added: “This sadly resulted in one death.”

In May, the Ham&High reported the death of a patient at Highgate Mental Health Centre in Dartmouth Park Hill, seen by a fellow patient two days before “with her dressing gown tie around her neck”.

The patient said warnings had gone unheard. An internal investigation is still ongoing.

Face-down restraints were also highlighted in the CQC’s findings, a practice the Department of Health has urged trusts to stem.

In the last year, two-thirds of restraints used by the trust had been face-down, with 77 per cent of those restrained then medicated.

Aaron Dover, who was sent to Highgate Mental Health Centre last September and a tribunal later found was wrongly sectioned, had face-down restraints used on him three times.

The IT consultant, of Keats Grove, Hampstead, said: “They use very painful wrist locks, drag you while you’re screaming in agony and throw you onto the bed.

“They then inject you without telling you what it is they’re putting into you and lock the door. It’s barbaric.”

He is currently pursuing a private case against the trust after his foot was allegedly broken while being restrained.

The Ham&High has been in contact with another person whose arm was broken while being restrained.

A third former patient at Highgate Mental Health Centre, who did not want to be named, accused the trust of using “tricks” before CQC inspectors arrived.

She said: “Suddenly pictures are put up on the walls, flowers are put in rooms and the walls are painted. Care plans are also completed in the run-up to inspectors arriving. But I’m glad the inspectors come. It improves conditions here.”

A spokesman from the trust said: “The trust has invested £4million in refurbishing its hospital sites, including tackling all high-risk ligatures, so that patients are cared for in safe environments, and this is one part of a plan to reduce the risks of self-harm by patients.

“The Trust’s policy on face-down restraint was developed in line with existing National Institute for Health and Care Excellence (NICE) guidance.

“However we are phasing this form of restraint out, along with all other trusts, in line with the national guidance from the Department of Health that was recently issued.”

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