CQC downgrades NHS young people's mental health ward rating

In a report published on January 15, the Care Quality Commission (CQC) detailed how, following an inspection prompted by "concerns", it had dropped the rating across the trust's five CAMHS wards from good to requires improvement.

Four of the wards, Redburn, Riding, Fraser and Stephenson are based at Ferndene in Prudhoe, West Northumberland, a purpose-built inpatient mental health unit providing assessment and treatment for 12 to 18-year-olds with complex mental health, behavioural, and emotional needs, including those with a learning disability.

The other ward, Lotus, is based at Acklam Road Hospital, Middlesbrough, and is a specialist adolescent mental health service which provides a safe place to stay, with support from trained staff.

Alongside ongoing "monitoring" of the trust, CQC said they inspected all five wards to follow up on "concerns" received about the standard of care people were receiving.

CQC reports that they found "breaches of regulation" in relation to safe care and treatment, safeguarding people from abuse and improper treatment, person-centred care, staffing and good management.

Lotus ward, at Acklam Road Hospital, Middlesbrough, was visited by inspectors over the summer (Image: Google Maps)

The health watchdog has dropped the CAMHS rating for being "safe" and "caring" from good to requires improvement; "well-led" has been re-rated as requires improvement; "effective" has gone down from outstanding to good; and "responsive" has been re-rated as good.

In the inspection, the CQC found that the service did not always carry out “comprehensive ligature risk assessments” on the wards. Inspectors also reported a “high” use of face‑down restraint, and said mechanical restraint was not always used in line with national guidance - practices which “could put people at risk of harm”.

The trust had already begun reducing these incidents at the time of the inspection.

The trust has been told to submit a plan "showing what action it is taking" in response to these concerns, say CQC, who added that they will continue to monitor the trust to ensure these improvements are made and that people are safe while changes take place.

"Staff hadn’t received all the necessary training to be able to support people appropriately," the CQC said.

"Staff didn’t always raise safeguarding concerns to relevant partner organisations when required, to help protect people from harm.

"The trusts’ information systems weren’t always effective in identifying or addressing areas for improvement to keep people safe."

The CQC did say, however, that staff treated people with "compassion and kindness" and "gave them emotional support and advice when they needed it."

"The service provided a range of activities for people, which included boxing, as well as education, which was tailored to meet their individual needs and support their wellbeing," the CQC added.

"Staff managed people’s medicines well and in line with national guidance. They were also stored appropriately."

Sarah Glacken, executive director of nursing and therapies, said that the trust "welcomes" CQC’s inspections, "accepts" the findings of the report and is "working hard to make improvements."

"Providing safe, high-quality care is our top priority," she said.

"I am pleased that the report highlighted a number of positives. Young people told inspectors that staff treated them with warmth, empathy, and respect. Inspectors also highlighted how well staff knew the young people in their care, tailoring activities, education and support to individual needs. Our medicines management was rated as outstanding, with inspectors praising exemplary practice and a strong culture of safety across our teams.

"But we know there is more we must do to make sure our CAMHS wards always meet the standards our patients deserve. Since the inspection in August, we have acted quickly to make improvements. 

"All our CAMHS wards are now using a new, enhanced ligature assessment tool, helping us to identify and act on areas of higher risk. We are also adding managing ligature risk to our mandatory staff training programme. 

"Earlier in 2025, we also introduced mandatory training in how to support autistic people and people with a learning disability. We are now focused on ensuring all staff receive this vital training as soon as possible. 

"We are pleased that the report recognises that our use of restraint is reducing and we remain committed to improving this further.  Staff continue to receive regular training in both safe restraint as a last resort and in de-escalation techniques to prevent situations from escalating.

"Several projects are underway to create calmer, safer environments for both young people and staff. We are also reviewing and updating our restraint policy to ensure it is clearer about the exceptional circumstances in which restraint can be used."