Charity raises concerns over restraint at children's mental health unit

By Joe Lepper

| 15 March 2019

A charity has raised concerns about the use of restraint by staff at a children's mental health unit after it emerged almost 30 complaints have been made by parents or children over the last six years.

West Lane Hospital's Westwood Centre ward cares for 12 children at a time. Image: Google Earth

Children's rights charity Article 39 submitted a Freedom of Information (FOI) Act request to Tees, Esk and Wear Valleys NHS Foundation Trust after 20 staff were suspended from its child and adolescent mental health inpatient unit at West Lane Hospital in Middlesbrough, amid concerns around the use of restraint techniques.

The FOI request relates to the use of restraint in the hospital's Westwood Centre ward, which cares for 12 children at a time. This found there had been a total of six formal complaints and a further 23 concerns raised through the hospital's patient advice and liaison service.

Article 39 is concerned about the number of complaints and says the trust has not provided detailed information about the use of restraint techniques in its response or to children and parents.

"The FOI response from Tees Esk and Wear Valleys NHS Foundation Trust reveals an alarming lack of accountability, reporting and sparse information sharing with child patients and their parents/carers," says a statement from Article 39.

Under the Mental Health Act (1983) children have the right to an independent mental health advocate when they make a complaint. But none of those who made complaints between 2013/14 and 2016/17 received such help, says Article 39.

Only two of the 10 complainants in 2017/18 received support from an advocate, and only two of the eight complainants since 2018 have been helped in this way.

"A child or young person's right to an independent advocate in settings such as the Westwood unit is an essential safeguard against poor and dangerous practice, including the use of excessive restraint," said Article 39 assistant director Helen Donohoe.

"We are alarmed that so many complaints could occur without children and young people receiving assistance from independent advocates, to make sure they are heard and their rights upheld."

Article 39 is to seek further information from the trust about action taken to address the rise in complaints. It also wants to know what restraint methods are approved and more detail about why there is such a low use of independent advocates by complainants.

A Care Quality Commission inspection last year found that there had been an increase in the use of restraint on West Lane Hospital's Westwood and Newberry wards.

However, it stated that "staff ensured they documented episodes of restraint, and rapid tranquilisation in accordance with trust policy".

The CQC added: "Staff treated patients with kindness and compassion and involved families and carers.

"Patients described staff in positive terms highlighting their caring, friendly and supportive approach.

"Staff encouraged patients to give feedback about their care and experience via electronic devices and in regular community meetings. Staff acted on feedback.

"There were good patient risk assessments on each ward. The service provided a safe environment and managed risks well. Patients told us they felt safe."

A statement released in January by Tees, Esk and Wear Valleys NHS Foundation Trust confirmed that 20 members of staff, including nurses and healthcare assistants, had been suspended over concerns around the use of "non-approved techniques" for moving patients. This statement also confirmed that an investigation into the concerns had been launched.

A trust spokeswoman said that the trust supplies detailed information to patients and parents about restraint procedures, how to raise concerns and how to access a mental health advocate. She added that this information was also sent to Article 39.

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