Girl restrained at hospital in Wales left traumatised

A teenage girl was "traumatised" by regular use of physical restraints at a private hospital for girls with mental ill health, her father has claimed.

The pair described conditions at Hillview Hospital in Blaenau Gwent as "inhumane" and are taking legal action.

This follows "immediate concerns" about patient safety raised by a recent inspection at the Ebbw Vale hospital.

Operator Regis Healthcare denies all allegations and said Hillview is one of the UK's most "successful services".

Hillview is an independent hospital which is registered to provide mental health services to women and girls aged between 13 and 18.

The teenager, who we cannot identify, is currently detained at the hospital under Section 3 of the Mental Health Act.

She and her father said instead of trying to calm her down, three to five members of staff restrained her on the floor, sometimes for more than two hours.

The teenager spent time at other hospitals before Hillview following an attempt to take her own life.

Her father said previously there were few incidents and very little use of restraints.

He said things "quickly started to deteriorate" when she moved to Hillview.

Hillview "took away her dignity" he claimed, by using restrictive practices such as taking her personal items, her toothbrush, her underwear and clothes.

The teenager told her father that she hadn't showered for 10 days, hadn't brushed her teeth and her hair was "disgusting".

"They're treating me like an animal," she told him. "Get me out of this hellhole, I feel like I've been kidnapped. They're making my mental health worse."

A lack of female staff also meant that at first, she was not able to change her sanitary protection or use the toilet regularly, her father claimed.

At previous placements, the daughter had been observed by one person, but at Hillview that increased to at least three support workers who were at arm's length from her even as she slept.

In one week she was restrained 17 times and seven of those were for two hours or more.

"I don't recognise my daughter. It's really affected her greatly. She's been restrained countless times and that's trauma I just can't imagine," her father said.

In the latest inspection report, the tenth since 2018, Healthcare Inspectorate Wales (HIW) said the number of restraints "continued to remain high".

Physical restraints should be a last resort and should not last longer than 10 minutes, according to National Institute for Health and Care Excellence (NICE) guidance.

The father also said his visits and phone calls had been restricted and nearly all calls were conducted on a speakerphone in a corridor so everyone could hear.

"It was, and is, horrible for her. It's been a nightmare," the father said.

"She went from a place where she had freedom, the use of her telephone and ability to contact friends and family but when she came here they took everything from her."

Legal representatives and independent mental health advocates also claimed that they were challenged by the hospital when they asked for private meetings with their client.

The father and daughter complained to the hospital and other authorities.

Now the patient and her family are taking legal action, saying that the Human Rights Act 1998 has been breached and that care provision at Hillview is "inhumane".

"If she continues to stay there, she will never recover," the father said.

"For me, it's the hardest thing I've ever had to deal with. It takes its toll, but you have to stay strong. You have no choice," he said.

The Health Inspectorate Wales (HIW) inspection, carried out in November 2021, found the hospital needed 'significant improvement', particularly around governance and leadership, medication management and infection prevention and control.

Inspectors said the hospital "failed to provide a safe and clean environment" and that there were issues around medication that were a "direct risk to patient safety".

It also said the recording and monitoring of restraints was not effective and care plan records were not comprehensive and were difficult to find.

HIW said there were a number of areas that required 'significant urgent improvement' and that there were inadequate arrangements in place to support the delivery of safe care.

Due to concerns about patient safety, HIW served Regis Healthcare with a non-compliance notice and is closely monitoring the service.

Prof Edwin Jones, from the Restraint Reduction Network, said a culture change was needed in learning disability and mental health services.

"The use of restraint has been accepted and I don't think we can do that any longer because of the very serious, detrimental side effects," he said.

"People die in restraint, people are injured - apart from the actual trauma of it. It also doesn't address the actual root cause of the problem. It doesn't address how we help people not to be so distressed."

Rocio Cifuentes, the children's commissioner for Wales, said the impact of restraint was "unimaginable".

"These are some of the most vulnerable children and young people who need the highest level of care that we can offer," she said.

"For anybody to experience a restraint would be traumatic but for these young people, the impact is indescribable," she said.

In a statement, Regis Healthcare said it welcomes visits from HIW and the NHS and it recognises the importance of receiving guidance on areas where "we are doing really well" and also areas for improvement.

It said HIW noted that Hillview worked "really well" in several areas including the good rapport between staff and patients, good feedback from patients as well as training.

"Negative points within inspection reports can sometimes appear subjective and not display a true reflection of the very high level of care that is provided within the service," it said.

It said it was open, transparent and willing to take action when given constructive feedback.

It said there was an improvement plan which provided HIW with "sufficient assurance" that improvements and progress were being made to ensure patient safety.

The hospital had been commended and awarded the highest level of the quality standards rating system following a NHS Wales quality assurance audit, it said.

It said it "refuted" all allegations against the company but was unable to comment on specific cases due to client confidentiality and being involved in a current legal dispute.

It said that Hillview Hospital remains one of the most successful services in the UK for delivering positive outcomes for patients.