Failing mental health services that do not improve, whether run by private firms or the NHS, could be shut, a Care Quality Commission chief has said. It follows the watchdog judging as "inadequate" three child wards at the Priory Group's biggest hospital.
The wards at Cheadle Royal, near Manchester, "did not always provide safe care", the CQC found. Priory Group has disputed the CQC's finding, saying it does not accurately reflect the quality of the service.
The company says it has invested almost £2m since last year to improve the service. The Priory Group describes itself as the leading independent provider of mental healthcare and adult social care in the UK.
The unannounced inspection of Cheadle Royal took place earlier this year "in response to concerns about safety". The CQC's new director of mental health services, Chris Dzikiti (pic), said he was determined to drive up standards in all units and warned he will close services who fail to improve.
"If we don't see a service improving from 'inadequate' or 'requires improvement', we might get to a point whereby we might have to use our enforcement powers," he said. "It might mean for any provider, whether NHS or independent sector, we might get to a point where a service is closed. Is that possible? Yes, it is possible."
The CQC is responsible for inspecting more than 900 mental health units across England. Despite a 4,000 bed decrease in mental health beds in a decade according to the Nuffield Trust, the number of beds operated by private companies has increased with those providers reported to receive approximately £2bn of taxpayers money each year.
Addressing Priory Hospital Cheadle Royal's CQC report, Mr Dzikiti described the findings as "serious" and that he expected an improvement action plan to be put in place with clear timelines. In the report, the whole hospital was downgraded from "good" to "requires improvement".
It looked at three Child and Adolescent Mental Health (CAMHS) wards and found a series of problems including wards that were not well maintained, large numbers of staff vacancies and high levels of restraint.
Inspectors concluded the CAMHS service was "inadequate" and found:
- Standards of care "well below those people have a right to expect"
- It found that "the service did not always provide safe care"
- And concluded "people shouldn't have to live in an environment with these poor conditions"
Mr Dzikiti said the watchdog was continuously in contact with the Priory Group and it will review their progress.
Priory Group CEO Rebekah Creswell said she was committed to addressing issues raised by the report but was "disappointed" by the findings.
She disputed "the factual accuracy of many aspects of the report" and said: "Our responsibilities are first and foremost to our patients and their families, and while we take the report very seriously and remain committed to addressing any issues raised, the misrepresentation of our service is unhelpful both to them, and to our dedicated and hard-working staff."
Ms Creswell said the company had already invested £360,000 this year in refurbishing its Orchard CAMHS ward. The Priory runs more than 60 hospitals and wellbeing centres in the UK, including the Priory Hospital Roehampton where a number of celebrities have sought treatment.
One former patient on Orchard welcomed the CQC's findings. Meredith Movel, 22, was 15 when she was admitted to the Priory Hospital Cheadle Royal. She spent 18 months on CAMHS wards at the hospital, which she describes as "cold", "uncaring" and "lonely".
"It's been years now. But at least the CQC is finally saying something," she said. "I agree with everything they're saying, like, it was absolutely appalling when I was there and I'm not surprised that it hasn't changed".
A former CQC inspector, who wants to remain anonymous, said that in his opinion after years of inspections, private providers did pose particular concerns. "The companies were focused on reputation management, the larger ones, certainly,” he said.
“And they were focused on having hospitals that were full. You'll see the same issues coming up again and again." He said that could have serious consequences: "They are not risk assessing well enough to prevent people harming themselves seriously or dying".
In response the Department of Health and Social Care said: "Private companies have always played a role in the NHS, and patients should expect a safe and good quality service regardless of whether their care is delivered by independent or public sector providers."