Muckamore Abbey: RQIA takes action after abuse claims

Northern Ireland's health regulator has taken action against the Belfast Trust over standards of care at Muckamore Abbey Hospital in County Antrim.

Police are currently investigating allegations around the physical and mental abuse of patients. Twenty nurses have been suspended.

It has been alleged that a number of vulnerable men and women were abused.

The formal action has been taken by the Regulation and Quality Improvement Authority (RQIA).

Three enforcement notices have been issued about staffing and nurse provision; adult safeguarding and patient finances.

In a statement to the BBC, the trust acknowledged the improvement notices and said, alongside sister organisations across health and social care, it was trying to develop a model of care "which is receptive to the changing needs of patients".

Muckamore Abbey Hospital provides in-patient assessment and treatment facilities for people with severe learning disabilities and mental health needs.

While inspections have been ongoing, issuing enforcement notices means the local health watchdog is not satisfied with the trust's attempts to improve services.

Specialist nurses are in short supply in Northern Ireland and the problem has been heightened as some have been suspended until the police finish their investigation.

The RQIA has finally acted and not before time.

It has been over a year since the spotlight fell on Muckamore, when parents of vulnerable adults broke their silence and their worst fears were realised when CCTV footage confirmed patients had been abused.

Read more here.

On nursing, the RQIA said the trust had failed to demonstrate it is ensuring that nurse staffing at ward level and across the Muckamore Abbey site is "planned and managed on the basis of assessed patient need".

Following inspections it found evidence of insufficient nurse staffing to meet patients' needs and to appropriately manage patients health care and to implement and "execute appropriate therapeutic care plans for patients".

According to the RQIA, while it has been working with the trust since February, and plans have been escalated it felt it had no other choice at this stage but to formally issue enforcement notices.

According to the RQIA, the trust has failed to ensure effective safeguarding arrangements for its patients.

Safeguarding ensures the safety and well-being of all patients and provides additional measures for those least able to protect themselves from harm or abuse. It notes that on 19 July and 9 August it was notified of two incidents of an adult safeguarding nature.

"We were concerned about the quality and timeliness of the information provided with respect to both of these matters," it said.

Following an unannounced inspection, the RQIA's inspection identified concerns in relation to a potential failure to refer patients appropriately to the Office of Care and Protection; non-completion of patient property records.

The BBC understands that considerable amounts of money have gone missing from patients' bedrooms.

The Belfast Health and Social Care Trust has been given until 16 November to comply with the regulator.

The statement also said that the trust is "pleased that RQIA has noted the very real progress we have made across all areas of care in Muckamore and we would like to thank our patients, their families and our staff for working with us at this very challenging time".

It added: "In particular over the last 12 months, patient care in Muckamore has changed significantly. The use of seclusion is much reduced; patient health checks - similar to health checks the NI population can avail of - are now delivered in Muckamore; our patients have many more social and therapeutic activities to attend; and daily governance and leadership is clearer.

"The trust has enlisted support from East London NHS Foundation Trust to assist in benchmarking hospital practice and to aide changes to practices in Muckamore.

"Additionally, there is a full-time carer advocate in place, and most recently, when Margaret Flynn, author of the Independent Review into Muckamore, revisited the hospital, we were pleased that she found a much improved picture."

Muckamore Abbey Hospital hit the headlines last June when nurses were suspended following allegations of abuse of patients.

In December, and revealed by the BBC, the review surrounding the protection of vulnerable adult patients at Muckamore Abbey Hospital found that many lives were "compromised".

The report charts a series of "catastrophic failings" and found there was a culture of tolerating harm.

Parents of young adults told the BBC they were distraught that their loved ones were subjected to physical and mental abuse.

The authors said it is "shattering that no-one intervened to halt the harm and take charge".