This was posted on the DPAC Facebook page by Stephen Luke
After reading the Chronicle article on the 1st September 2016 in relation to mental health services in the North East being described as “outstanding” following an inspection by the Care Quality Commission, I am now left disturbed and extremely concerned. This is because these supposed ‘outstanding’ mental health services have not only left my brother for dead but have also put him, myself and the public in life threatening circumstances on several occasions. I hope the following will serve to explain my incredulity at the NTW NHS rating of ‘outstanding’.
After years of being involved in the mental health system, when my brothers medication becoming critically life threatening his medication was immediately and highly dangerously stopped. Whilst doing so the mental health services failed to admit my brother into hospital for monitoring, they also failed to monitor him adequately at home and also failed to administer the relevant provision for his inevitable withdrawal impacts and relapse of psychosis. Due to these failures I found my brother half dead with extreme dehydration with dry and chapped lips, malnourished with a loss of at least three stone, bloodshot eyes and his left pupil was like a pinhole. He was also deluded, psychotic, hysterical and had a complete loss of memory. I immediately rushed him to A&E where he was prescribed a drip and medication. However the Gateshead NHS Trust failed to administer any drip or medication and also failed to detain my brother in hospital for monitoring and immediately discharged him, despite my pleas.
It was then left to myself to help feed and monitor him. Within 2 days my brother was then admitted into a mental health ward, which was out of his locality due to lack of beds. During his physical examinations they failed to weigh my brother despite his extreme loss of weight which I had explained and was unmistakably evident. I immediately demanded they weigh him where he was found to be far below his BMI and had lost at least 3 stone. He was then prescribed vitamins and Fortisip weight gain protein supplement drinks, though this still took services several days to administer. They also failed to monitor his meals adequately and were negligent of throwing his meals away despite his extreme wight loss.
On several occasions clinicians failed to attend meetings, staff prescribed and gave the wrong medications, they failed to recognise relapses in psychosis, they dismissed violence and abuse as family squabbles, they mismanaged the withdrawal of medication which lead to unnecessary seclusion and stopped ground leave. In addition, blood test went missing, a multitude of errors were found in medical records, staff were eating patients meals, there was unnecessary confusion over capacity and confidentiality, including failure to adequately engage with myself as my brothers carer and nearest relative. Within this they failed to return phone calls, they failed to invite me to relevant meetings, they failed to provide a “getting to know you” form, they failed to provide written care plans. Clinicians and Community Psychiatric Nurses also ignored concerns and pleas that myself and my family had of my brothers relapse in psychosis and even hung up on the phone. They also failed to follow up on their own recommendations of assessments of care. They failed to provide Carer Assessments and even Ward Managers failed to follow up concerns and complaints raised.
The Crisis Team refused to come out until I threatened legal action. Clinicians and Community Psychiatric Nurses ignored threats I received from my brother and failed to recognise his deterioration of psychosis, to the point he went out onto the streets with a rifle, a knife and a bat and threatened neighbours. He was then surrounded by armed police and detained in police custody. My mentally disabled brother could have been shot and killed as well as the neighbours. The forensic psychiatrist who assessed my brother then FAILED TO SECTION my brother and put him on a none secure acute ward on his own free will, despite having threatened the neighbours with a rifle, a knife and a bat.
On the non secure acute ward my brother then attempted to escape several times every day for 5 days, the staff failed to adequately monitor him and also failed to engage with myself and ignored my continuing pleas to have my brother sectioned and detained in a secure mental health unit. On the 5th day my brother managed to escape from the ward. This lead to the police not only having to search the north east but they also had to surround the home and protect the family of which my brother had previously threatened. This caused further unnecessary stress and anxiety for this family and also for my family. It also put my brother in yet another extremely vulnerable and life threatening position and also threatened the lives and well-being of the general public. Ironically the police only found my brother after he subsequently assaulted members of the public. He was only then detained on a secure Psychiatric Intensive Care Unit.
During my brothers stay on this unit he was assessed by forensic mental health services, who deemed him eligible to be transferred to a forensic mental health ward. However we were told there was a 3 months waiting list for bed availabilities. During this time the Psychiatric Intensive Care Unit was closed down and my brother was transferred again to a Psychiatric Intensive Care Unit in Sunderland. He was there for 5 weeks and this unit was also to be closed down and my brother was then transferred to out of area forensic services in Middlesborough. Eventually after 5 months of waiting my brother was eventually transferred to the forensic mental health ward in Newcastle.
During the past three and half years my brother has been admitted to 4 different hospitals, 7 wards, had 9 psychiatrists, 6 Community Psychiatric Nurses, and been prescribed 14 different combinations of antipsychotics. There has been no continuity of care at all and that I his brother and carer have been the only constant thought all of this time, yet they still have failed to fully engage with myself and have gone against not only their own policies but also that of the Carers Charter, the Triangle of Care and Human Rights Act.
There have also been incidents on wards where my brother has been left, against health and safety and ward practice, with scissors. As a result of this, he has cut the cable from the back of a TV, stripped the wires bare at one end, plugged them into a wall socket and threatened to electrocute anyone who came near and could have killed himself in the process. Despite this he was left alone yet again a few months ago on another ward with a pair of scissors where he shredded a mattress to pieces in the belief his mattress was possessed by a demonic entity. When I complained about this and explained he could have harmed himself or stabbed another patient or staff member, the response I was met with “well he didn’t though did he?”. To add to this appalling response the services were also going to charge my brother for the damage he caused to the mattress and when I challenged this they explained they had charged other patients up to thousands of pounds for damages.
During the course of this time I now have 246 complaints against health services which are presently been investigated by the Health Ombudsman Specialist Team. I also have many additional complaints currently being looked into by PALS and the Health Trust Service Manager. For three and a half years I have been requesting the full history of my brothers medication and the side effect in the hope to help with his care pathway, which I have only now recently received and I have even found errors within this.
Till this day the services still fail to engage adequately, and fail to invite me appropriately to CPA and CCR meetings to discuss care pathways. Also despite repeatedly requesting a “Getting To Know You” form they failed to provide this for 15 months on his present ward. Also, in July 2016 during a visit on the ward I was assault by my brother and sustained broken ribs, where the staff ran away and failed to restrain my brother. After this assault I was informed that they could not accommodate my visits and they repeatedly asked if I wished to press charges against my mentally disabled brother.
My mentally disabled brother has also been assaulted several times on several wards and sustained multiple injuries such as bite marks on his chest and fingers and bruises on his arms and elsewhere. He has been forced medication without the presence of a clinician. He has recently had an accident and broken his wrist and the staff have failed to help with washing his armpit or cutting his fingernails.
These appalling services have not only jeopardised, threatened and almost cost my brothers life, as well as exacerbated and been detrimental to his mental health condition; they have also lead to him becoming homeless due to these events leading to the loss of his home. He is also now detained indefinitely due to the extreme deterioration in his psychosis and well-being. This situation has developed due to the catalogue of bad practise, negligence, unprofessionalism and failure of communication by NTW NHS Trust.
It is also very concerning that during 2010 to 2015 NTW NHS Trust have already closed 459 mental health beds and it’s no surprise there has already been a 62% increase in suicide and violence towards staff during this time and that the North East also have the highest suicide and violence rates on mental health wards in the country. The present remaining wards are also full and over capacity and there has also been a 63% increase of inpatient referrals under the Mental Health Act which means they must be admitted by law.
Yet despite all of this the NTW Trust plan to close a further 40% of the remaining acute mental health beds in Newcastle and Gateshead, and this August 2016 have already closed 20% of those remaining beds. The staff did not even know of this until on the day and some only found out by watching the local news. Many have been forced to work elsewhere with no consultation. These cuts are not only putting more and more vulnerable patients at risk on hospital wards and in their homes, but also their carers, family members and children at risk and potentially that of the community.
During the recent CQC Care Quality Commission inspections of these services there were focus groups and interviews held for patients, carers and relatives to attend. However myself and many others carers who I engage with at carer forums, were not informed or invited to any of these focus groups or interviews, despite them been held on the very wards our loved ones are presently detained.
I personally have 42 years experience of psychosis due to being brought up by schizophrenic mother. I have also cared for my schizophrenic identical twin brother for 20 years and have both have been subject of study in the London Institute of Psychiatry for 10 years. I have also suffered my own mental health conditions. I have also engaged with carer and service user forums, the Primary Care Trusts, the Clinical Commissioning Groups and voluntary organisations for 14 years helping in the improving of mental health services. So due to this I feel I have an in-depth and invaluable knowledge of psychosis and services, just as I am sure many other Service Users, Carers and family members also have.
I myself am struggling to cope and keep up with the endless errors and complaints, which are causing myself to become stressed and ill. Unfortunately till this present day I am still having to make complaints almost on a weekly basis to the point where I have had to have the Service Manager step in to try and help resolve the endless and relentless errors by the “Outstanding” NTW NHS Trust.
Also despite my brother having been passed from hospital to hospital like cattle several times already, they are now planning to transfer my brother again and due to lack of local bed capacity yet again he could potentially be placed anywhere in the UK.
Several months ago I also found on the NTW Trusts own website, a page for service user feedback, which was 90% negative. Unfortunately this page was deleted and taken down before the CQC Inspection. Given that myself and so many other carers, services users and family members were excluded from the CQC Focus Groups and interviews, then it’s no wonder that the CQC came to such a skewed, bias and inaccurate conclusion in their assessment. Whatever practice the CQC use to make it’s assessments needs to be seriously re-evaluated to prevent Trusts potentially cherry picking those giving feedback, and give the opportunity for everyone involved in services an opportunity to contribute. The NTW NHS Trust are anything other than “outstanding”. The only thing NTW NHS Trust seem to be “outstanding” at is making their services look “outstanding” on paper.
It’s important to remember that whilst the engagement and involvement of carers and family members are overlooked, mental health services are exacerbating bad practice and compromising the health of their patients. Two vital new reports this year from both the Royal College of Psychiatrists and NHS England stress the importance of Service User and Carer involvement as key to the effective development of mental health services.