Private mental health unit scrutiny recommended by Norfolk committee

A report into the care of three women at a former mental health unit has recommended greater monitoring and scrutiny of private provision.

The Norfolk Safeguarding Adults Board (NSAB) review focused on care given to women known as L, M and N, who lived at Milestones Hospital near Norwich.

The women, in their 20s, were found to have visited accident and emergency 53 times, mostly due to self-harm.

The unit shut down last year and the company that run it has been dissolved.

The review focused on the patients' time between October 2019 and February 2021 when they were at the hospital designed for women in Salhouse, near Norwich.

It found that although agencies were quick to respond when a safeguarding referral was made in December 2020, there should have been earlier identification of repeat admissions to A&E departments and flagging of multiple police incidents.

These should have resulted in earlier escalation to local authority safeguarding teams and the Care Quality Commission (CQC), the report said.

Patients M and N were placed at Milestones by Sussex NHS Trust on October 2019 and July 2020 respectively. Patient L was placed by Lincolnshire NHS Trust in October 2020.

The review said there were also multiple probes into allegations of abuse and assault from these patients, with no further action taken after investigation.

Heather Roach, chair of NSAB, said: "When vulnerable patients are placed in hospitals like Milestones, it's vital that our whole system works together to keep them safe.

"This review has shown that there are gaps in the monitoring of private provision, particularly when patients are placed in Norfolk from out of our county.

"The arrangements need to be addressed urgently to ensure there are the checks and balances in place to make sure those with mental ill health are safe."

Ms Roach acknowledged that at the time staff were "working in very difficult conditions at the height of the Covid pandemic and that placed vulnerable people at greater risk".

Milestones closed in February 2021 following an "inadequate" CQC inspection. Its owner, the Atarrah Project Ltd, dissolved earlier this month.

Several recommendations were made by the board, including more monitoring of "all in county placements" by their placing authorities.

More training was also suggested to better understand difficulties with communication regarding autistic people and those with learning disabilities, and how self-harming behaviour could occur.